Care Home: Inglewood Nursing Home

What the care home does well Inglewood provides a good standard of care for the people who use the service, based on their individual needs. Staffs working in the home are trained and competent. The home has a warm, welcoming and friendly atmosphere.Comments from surveys included; `The care is good, my family member is well cared for`. My family members care is much better here than at the last home and staff care and are pleasant with everyone even when they are busy`. `In sometimes very difficult circumstances I have found that all staff do their very best`. The care files of four people who use the service were examined. The documentation was based on individual needs, comprehensive and reviewed regularly. There was evidence in the plans to show involvement from people/relatives, and in two of them relatives had chosen to be kept up to date with any changes and attend reviews. Comments from surveys included `I would recommend this home to other families`. `Anything we are worried about regarding medical support is dealt with straight away`. `The home has met the needs of my family member since` What has improved since the last inspection? The requirements identified in the last inspection have been addressed. Training for staff at all levels is encouraged and more than 90% of care staff have achieved NVQ level 2 or above. Refurbishment and re decoration is ongoing throughout the home. Ten bedrooms had been upgraded, having new carpets, curtains and being re decorated. A number of profiling beds had been purchased. New furniture, carpets and curtains were in lounges both on the ground and first floors. The hairdressing salon had been refurbished and now has an adjustable back basin, more hairdryers and easy chairs for people to relax in. What the care home could do better: The home has a formal supervision system in place, however at the time of the inspection a number of records were not up to date. CARE HOMES FOR OLDER PEOPLE Inglewood Nursing Home Deal Road Redcar TS10 2RG Lead Inspector Val Daly Key Unannounced Inspection 4th September 2008 09:00 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 Inglewood Nursing Home DS0000000179.V371601.R02.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. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Inglewood Nursing Home Address Deal Road Redcar TS10 2RG 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) 01642 474244 01642 492735 ashtons@bupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd Mrs Susan Betty Ashton Care Home 48 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0) of places Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age category is for individuals with dementia aged 55 . Date of last inspection 25th September 2006 Brief Description of the Service: Inglewood provides care for up to 50 older people with dementia. The home was purpose built approximately 10 years ago and has two floors. The home is situated on the outskirts of Redcar and there are shops close by. Inglewood has pleasant well kept gardens for the residents to enjoy. BUPA is the registered provider and the Responsible Individual is Lesley Tart. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use the service experience excellent quality outcomes. This inspection was a key unannounced inspection and was completed by an inspector in two inspection days. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. A number of records were looked at including assessments of people who use the service and plans of care, staff recruitment records, complaints and maintenance records along with the annual quality assurance assessment. One person who uses the service, two members of care staff, the cook, the maintenance person and the manager, were engaged in discussion about living at Inglewood. The manager had completed an Annual Quality Assurance Assessment prior to the inspection. The AQAA is the services self-assessment of how they think they are meeting the National Minimum Standards. This information is received prior to the inspection and it is then used as part of the inspection process. On the days of the visits the manager provided the information and documentation required. The Commission for Social Care Inspection sent a number of surveys to the home for people who use the service to complete. Eight were completed and returned. Comments received can be read within the report. This was a positive inspection; people were open and friendly and welcomed discussion about the home. What the service does well: Inglewood provides a good standard of care for the people who use the service, based on their individual needs. Staffs working in the home are trained and competent. The home has a warm, welcoming and friendly atmosphere. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 6 Comments from surveys included; ‘The care is good, my family member is well cared for’. My family members care is much better here than at the last home and staff care and are pleasant with everyone even when they are busy’. ‘In sometimes very difficult circumstances I have found that all staff do their very best’. The care files of four people who use the service were examined. The documentation was based on individual needs, comprehensive and reviewed regularly. There was evidence in the plans to show involvement from people/relatives, and in two of them relatives had chosen to be kept up to date with any changes and attend reviews. Comments from surveys included ‘I would recommend this home to other families’. ‘Anything we are worried about regarding medical support is dealt with straight away’. ‘The home has met the needs of my family member since’ What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 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 Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs assessed. EVIDENCE: Each person has his or her needs assessed by a care manager prior to moving into the home. An assessment is also carried out by the home manager, meeting the person in either their own home or in hospital. The care files of four people were examined. The documentation is detailed, comprehensive and person centred. The areas covered in the assessment are; communication, lifestyle, maintaining a safe environment, mental state and cognition, breathing, eating and drinking, eliminating, personal cleansing and dressing, controlling body temperature, sleeping, pain, medication, end of life arrangements, any personal needs and expectations or medical conditions, activities including comments from the resident and showed evidence of resident/relative involvement. A map of the resident’s life is included, showing Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 9 their younger life, where they lived, employment, children, hobbies and interests. The home does not provide intermediate care. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. 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 using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The care files of four people who use the service were examined. They each contained an individual care plan following on from the assessment. The plans were detailed, with individual likes and dislikes such as; one person prefers to have their breakfast and dinner in the dining room and tea and snacks in the lounge, also enjoying a sandwich even after just finishing tea. Another person enjoyed particular activities, their mood predicting what they preferred to participate in. Personal and social care needs were included in the plans along with a ’map of the person’s life’. The plans were reviewed and evaluated regularly. There was evidence in the plans to show involvement from people/relatives, and in two of them relatives Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 11 had chosen to be kept up to date with any changes and attend reviews. Risk assessments were in place where required for example, using a wheelchair for one person and smoking cigarettes for another. The documentation was comprehensive and reviewed regularly. There was evidence to show that general practitioners, consultants and other health care professionals are meeting the health care needs of the people who used the service. Comments from surveys included; ‘The care is good, my family member is well cared for’. My family members care is much better here than at the last home and staff care and are pleasant with everyone even when they are busy’. ‘In sometimes very difficult circumstances I have found that all staff do their very best’. Policies and procedures are in place for the ordering, receipt, storage, disposal, administration of medication and self-medication. At the time of the inspection there were no residents, who managed their own medication. Comments from surveys included ‘I would recommend this home to other families’. ‘Anything we are worried about regarding medical support is dealt with straight away’. ‘The home has met the needs of my family member since day one’. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their lifestyle. A variety of food is offered. EVIDENCE: The home employs an activities co-ordinator who works thirty hours over four days a week. Activities are decided upon on a day-to-day basis depending on what people would like or are able to do, and their mood at the time. The activities co-ordinator said that following the admission of a new person to the home she finds out their likes and dislikes and also involves relatives. Mostly activities are in small groups or on an individual basis, such as; hand massages, one person likes to play draughts, a couple of people like to play dominoes, one person plays the organ, some enjoy art foil, looking at books, having sing a longs. The home arranges for a singer to entertain once a month and also has fetes during the year. At the time of the inspection staff from the ‘Zoo lab’ had brought some small animals and reptiles for the people in the home to see. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 13 The activities co-ordinator said she has bi monthly meeting with activities people form other BUPA homes in the area, which she finds useful to share ideas. Comments from surveys included ‘We are always told about anything going on and posters are put up around the home’. ‘Some of the people can’t choose what they want to do but staff try to find out’. Friends and family are welcome to visit at any time and there is a kitchenette on each floor where drinks can be made during their visits. The menus showed a variety of food being offered. The daily menu is placed on the notice board in the dining room. On the day of the inspection table top menus had been delivered and the manager said that they would be put in place. The cook ensures meals are nutritionally balanced, using a scoring system for the menus, which is then checked by the catering manager within the organisation. People in the home have a light lunch and a main meal at teatime. People are given choices at every meal and any special diets are also catered for. The home also has a ‘night bite’ menu, offering snacks and drinks for anyone, late in the day or during the night. During the inspection it was noted that people in the home were enjoying soup and sandwiches and staff were assisting those who needed help. Comments from surveys included; ‘The meals are really nice’. The meals available out of hours is useful as my family member is awake at night sometimes’. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and the home has an appropriate procedure in place. Training for staff in adult protection has taken place, keeping people who use the service safeguarded. EVIDENCE: The home has a complaints policy and procedure in place, which informs people and their relatives of their right to complain to any commissioning authorities such as Social Services. There had been four complaints made to the home since the previous inspection. There were records available, which showed that the complaints had been investigated and written reports of action taken were in place. Two of the complaints were unsubstantiated, one was substantiated, which was regarding missing items from a person’s bedroom and these had mostly been found and returned. One complaint was still in the process of being investigated. Following the outcome of investigations the complainant is asked if they are satisfied or not. The manager also offers to meet with the person to discuss the outcome. Comments from surveys included ‘I have never needed to complain, staff answer questions well’. ‘There are details of how to complain in the Welcome Pack, but I have never needed to the care is very good. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 15 The home has a whistle blowing policy and an adult protection policy in place that details action that staff should take if abuse is suspected. The manager said that staffs receive adult protection training during induction and then on a regular basis thereafter. This was confirmed during interviews with staff and also information within the staff training files. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 16 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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Inglewood is comfortable, homely and well maintained. EVIDENCE: A tour of the home was carried out. The atmosphere was warm, friendly and welcoming. Refurbishment and re decoration is ongoing throughout the home. Ten bedrooms had been upgraded, having new carpets, curtains and being re decorated. A number of profiling beds had been purchased. New furniture, carpets and curtains were in lounges both on the ground and first floors. Another standaid hoist with weighing scales had been purchased and the manager said that a spa bath for one of the bathrooms had been ordered. The hairdressing salon had been refurbished and now has an adjustable back basin, more hairdryers and easy chairs for people to relax in. On the day of the inspection the home was found to be clean and odour free. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 17 The garden area had been further developed and provided seating areas for people, and also pathways for them to walk along and enjoy the scents and colours of the bushes and flowers. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. The home has vetting and recruitment practices in place. Staffs is trained and qualified and relevant information that safeguards people who use the service is in place. EVIDENCE: The home has a rota in place, which shows a skill mix of staff being on duty on each shift. The manager said that the number of staff on duty could change for the needs and dependency of the people who use the service. She has recruited more part time staff for increased flexibility. The home’s recruitment procedure is robust. Evidence was available in four staff files to confirm that appropriate Criminal Bureau Checks are carried out before staffs start working at the home. The files examined contained all of the required information including, proof of identity and two references. Staffs receive Skills for Care induction training with different handbooks for each job. Each new member of staff has a mentor who guides them through the induction process. This was confirmed during an interview with the handyman who had recently commenced employment. The home has a training plan in place and each member of staff has a personal development plan. Since the previous inspection staff had undertaken training in Health and Safety, Fire Safety, Moving and Handling, COSSH, First Aid at Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 19 Work, Infection Control Personal Best, Protection of Vulnerable Adults, NVQ 2 and 3, completed a distance learning workbook for Understanding Dementia NVQ level 2 or above in care with a further six staff working towards the qualification. It was also noted that staff that have been employed in the home for a number of years are undertaking refresher induction training. The manager carries this out in a group of up to ten people over one day. A member of staff interviewed said she had enjoyed this training. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 20 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 excellent. This judgement has been made using available evidence including a visit to this service. The home regularly reviews aspects of its performance through a good programme of self-review, which include seeking the views of residents, staff and relatives. Finance systems are robust. EVIDENCE: The manager is registered with CSCI and had substantial experience and has the required qualifications and skill to manage Inglewood. There were a number of quality assurance systems in place for care documentation, activities, kitchen and maintenance, cleaning schedules, and recently a new medication audit had been introduced. There are also monthly audits looking at accidents, pressure sores, fire safety and maintenance both internal and external. The manager said she also carries out visual audits at meal times. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 21 The Area Manager carries out monthly visits and reports on many aspects of the home, the building, care records, health and safety, finance, recruitment, training, safeguard from abuse, infection control, medication, and wound management and promoting health. During these visits discussion also takes place with people who use the service and staff. Questionnaires are sent out annually to people and their relatives to seek their views about life in the home. Following the completion of the survey an action plan would then be formulated for any areas required. There are regular meetings held; a daily meting with a representative from each department in the home, Health and Safety and full staff meetings three monthly, kitchen staff monthly, hotel services bi monthly. Ad hoc meetings are also held if there are any particular issues. Samples of health and safety records were examined at the inspection and were found to be up to date. These included the information regarding the checking of wheelchairs, bed rails, window restrictors, fire checks, the gas safety certificate, hot water temperatures and various other records. Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 22 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 4 X X 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 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 2 X 3 Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP36 Good Practice Recommendations Supervision records for staff need to be up to date Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Inglewood Nursing Home DS0000000179.V371601.R02.S.doc Version 5.2 Page 25 - 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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