Care Home: Matthews Nursing and Rehabilitation Unit

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What the care home does well What has improved since the last inspection? There were no requirements made at the last inspection. The home now demonstrates that it involves the resident and/or their family or representative in decisions about their care by involving them in their review meetings. The home makes sure that the residents and their families are fully informed about any major changes in the home by holding meetings for them CARE HOME MIXED CATEGORY MAJORITY ADULTS 18-65 Matthews Nursing and Rehabilitation Unit Epinal Way Care Centre Hospital Way Loughborough Leicestershire LE11 3GD Lead Inspector Thea Richards Unannounced Inspection 09:30 19 August 2008 th Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 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 Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.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 and Care Homes for Adults 18 – 65*. 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. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Matthews Nursing and Rehabilitation Unit Address Epinal Way Care Centre Hospital Way Loughborough Leicestershire LE11 3GD 01509 217666 01509 262710 karen@rushcliffecare.co.uk 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) Rushcliffe Care Limited Manager post vacant Care Home 43 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (43), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (43), Physical disability (43), Physical disability over 65 years of age (43), Sensory impairment (43), Sensory Impairment over 65 years of age (43) Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Matthews Nursing and Rehabilitation Unit is registered to provide nursing care to male and female service users who fall within the following categories: Physicial Disability PD 43, Physical Disability over 65 years of age (PD(E)) 43, Mental disorder, excluding learning disability or dementia (MD) 43, Mental disorder, excluding learning disability or dementia over 65 years of age (MD(E) 43, Sensory Impairment (SI) 43, Sensory Impairment over the age of 65 years (SI(E) 43. The maximum number of persons to be accommodated at Matthews Nursing and Rehabilitation Unit is 43. 19th August 2008 2. Date of last inspection Brief Description of the Service: Matthews Nursing and Rehabilitation Unit is one of three units in the purpose built Epinal Way Care Centre, in Loughborough, Leicestershire. It is registered to provide care and accommodation for 43 residents for people with mental disorder, physical disability, and sensory impairment. The Care Centre is next to the Loughborough Hospital, and approximately one mile from the centre of Loughborough. The unit is easily reached by public or private transport and there is parking available to the front of the building. Rushcliffe Care, who are experienced care home owners, owns the unit that is part of a large group of homes. Mrs Christine Maling, an experienced nurse, is the acting manager who has made an application to the Commission for Social Care Inspection to be the Registered Manager. The unit has accommodation on two floors. On the ground floor there are twelve beds for those people with neurological conditions including acquired brain injuries and a transitionary living flat. There are a further 28 beds on the first floor for high dependency needs and for rehabilitation. The neurological unit provides specialist professional support and equipment individual residents. The unit is staffed twenty-four hours a day by trained nurses and care staff. The remainder of the beds on the first floor provide accommodation for older Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 5 persons. The bedrooms, that all have en-suite facilities, are spacious and can accommodate wheelchairs and any equipment that is needed to care for the resident. They have all been personalised to reflect the residents’ wishes. The first floor can be reached by the stairs or by a passenger lift. There are lounges and dining rooms on both floors. The kitchen next to the dining room is used to make drinks and snacks. There is a large physiotherapy room/gym that is used by all of the residents. There is a garden and patio area for the residents to use. The whole home is bright, well decorated and clean with furniture that is suitable for the residents needs. The home can be contacted by telephone or fax. The fees for the home are assessed individually according to the residents needs. There are additional costs for hairdressing, dry cleaning, chiropody and toiletries. The registration certificate from the Commission for Social Care Inspection, an up to date certificate of insurance were displayed and the latest inspection report was available. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 3 Star. This means that the people who use this service experience excellent quality outcomes. This was a key inspection of a care home for people with mental disorder, physical disability, and sensory impairment, which ended with an unannounced visit to the service. Before the visit we (throughout the report the use of ‘we’ indicates the Commission for Social Care Inspection), spent four hours reviewing information received by the Commission for Social Care Inspection (CSCI) since the annual service review that took place on the 22nd February 2008. The visit took place on the 19th August 2008 and lasted five hours. During the visit we checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called ‘case tracking’. Case tracking means that we looked at the care provided to three of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents although some of the communication was difficult; we managed to get feedback from them. With their permission the residents’ bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. We looked at the AQQA (Annual Quality Assurance Audit) that the home had sent to us when we asked for it. This provided us with information about the home and some numerical information about the staff and the residents. During the visit we spoke with the nurse in charge, a senior manager, the staff, the residents and to visitors in the home. We were told about the results of the homes’ quality audit that showed that the families were pleased with the service given. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 7 What the service does well: What has improved since the last inspection? There were no requirements made at the last inspection. The home now demonstrates that it involves the resident and/or their family or representative in decisions about their care by involving them in their review meetings. The home makes sure that the residents and their families are fully informed about any major changes in the home by holding meetings for them. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 8 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. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 (Adults 18-65), 1,3 (Older people) 6 is not applicable in this home. Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service People who may want to use this service have excellent support and information to make sure that they and their family can make the right decision as to whether the home can meet their needs. EVIDENCE: The manager or a senior manager completed the pre-assessment process with other staff from the physiotherapist, occupational therapy or speech and language teams. They visited the prospective resident wherever they were living and, where possible arranged visits to the home. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 11 This makes sure that a very thorough assessment is made and that the home can meet the persons’ needs and help them to improve. The person in charge on the day of the visit confirmed this, as did the records seen in the care plans looked at. They clearly described the residents’ needs giving the staff the information that they needed to care for them. The visitors spoken with and the residents, who were able to, told us that they had been given good information before they came into the home and had a good assessment. Some of the residents in the home have difficulty in remembering a lot of detail because of their brain injury but most were able to tell us about how they came to the home. Members of staff spoken with told us that they always knew and understood what a new residents needs were before they moved in. The Statement of Purpose and the residents’ handbook contained excellent information and were printed in a size of print that was easy for the residents to read and understand. The Statement of Purpose should be updated to include the current contact details for the Social services and the Commission for Social Care Inspection. Consideration could be made to include the results of the annual quality assurance questionnaires, which would give people deciding about the service some additional information. The current registration certificate from the Commission for Social Care Inspection (CSCI), an up to date certificate of insurance were displayed in the entrance hall and the latest report from the CSCI was available. The unit does not provide intermediate care for older persons. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 (Adults 18-65). 7,14,33 (Older Persons) Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The residents are supported in maintaining their independence and in making decisions in their daily life with dignity, giving them an excellent quality of life. EVIDENCE: The care plans and records looked at contained thorough information telling us how the residents’ needs were identified and their choices are made. Some of the areas covered, included information about what they wanted to be called, when they wanted to get up or go to bed, menu choices and how their bedrooms are furnished. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 13 The staff have developed different individual methods of communicating with words, noises and gestures for those residents with difficulties with communication. The staff were seen to be communicating with the residents patiently, in a suitable way for them. The care plans have all the information that is needed and describe each individual residents’ needs and wishes and have been developed with their keyworkers and other members of the team. There is evidence in the care plans that makes it clear that the residents have been involved in developing their care plans and have agreed with them. They told us that they had been involved and agreed with them and that they were happy with what was in them. Key workers are members of staff who have particular responsibility and interest in an individual resident. They make sure that they have all that they need and that they have the activities and work or education needs met. There is information made available for the residents to obtain an advocacy service if they wish it. There are risk assessments in place where there may be a risk to the resident either in an activity or in the environment. This allows the staff and the resident to be aware of the possible risk and protects them whilst allowing the resident to continue with the activity. Reviews of the care plans took place as often as there were changes but at least monthly. The whole team of nursing staff, physiotherapists, occupational therapists and speech and language therapists take part in the reviews. The residents took part of these reviews and where they could they signed to say that they agreed with the decisions. The residents have regular meetings to discuss choices in the home such as activities and menus and they and the staff make choices on a daily basis. This was seen on the day of the visit when a variety of lunches and activities were being chosen. The residents are supported to become as independent as possible given their disability. They are helped to make their own breakfast, do their own laundry, go out into the community and to go home for visits to their families. The residents and the visitors spoken with were happy with the care and support that they receive and confirmed that they were involved in their care planning and the reviews. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 15 12,13,15,16,17 (Adults 18-65) 10,12,13,15,(Older Persons) Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The staff support the residents in their interests in their different activities and therapies, in addition making sure that their nutritional and spiritual needs are met as they wish them to be. EVIDENCE: There was good evidence in the care plans, from our observation and from the residents and their families, that daily occupation, leisure activity and therapy are being provided for the residents. The occupational therapy team provide activity for the residents and on the day of the visit were helping some of the residents with designing logos for tshirts and printing them. There are regular group activities for specialist areas, such as for people with sensory needs. The residents regularly attend the gym in the home to help with their rehabilitation. There is a spa pool available to assist them in their movement. Different methods and equipment were developed to help the residents to sit and sleep in the best way for them. The staff help the residents to maintain their interest in the hobbies that they had before their injury and to develop new ones. Peoples sexual needs and differences are recognised. The home has a mobile sensory centre that provides stimulation of sight and sound and can be taken to the resident. During the day of the visit some of the residents were enjoying watching the Olympics on the television There was an individual programme of activities for each of the residents that is planned with them and their relatives, by the Core Brain Injury Team, in partnership with the multi-disciplinary team in the home. This is designed to develop the resident to his/her full potential. The residents are part of the local community, visiting local pubs and shops. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 16 The staff were seen to be treating all of the residents as individuals and recognised their different personalities and behavioural needs. They look after us well’ one of the residents told us. The residents and the families spoken with were happy that their needs were being well catered for and that they were treated with dignity and respect. The activities are recorded in well documented care plans which are regularly reviewed as the residents’ needs change. Relatives and friends are encouraged to take part in activities and therapies and are able to visit at any time. The residents have a choice of meals that are prepared in the main kitchen at Epinal Way and transported in a heated trolley. The residents and families spoken with were mainly happy with the food, but one told us that it was sometimes cold and needed to be reheated in the microwave. Special, soft and liquid diets are provided, as they are needed. A soft diet seen on the day of the visit was presented in an appetising way. Meal times were flexible to suit the needs and the activities of the residents. The staff were seen to be sitting with those who needed help with their meal. Birthdays and special occasions are celebrated. A summer fête is being arranged. Cultural and religious needs are recognised and special diets can be provided to support religious requirements. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) Service users retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 (Adults 18-65). 8,9,10 (Older Persons) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The well informed and trained staff meet the health and care needs of the residents safely, with a complete knowledge of their needs and how they wish to receive them. EVIDENCE: Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 18 The ‘case tracked care plans were found to have good descriptions of the care needs of the residents. This included a regular assessment of the residents’ weight and their nutritional needs. There are records of the involvement of G.P.s, chiropodist, optician and dentist present, giving evidence of thorough health care being provided for the residents. There are good descriptions in the care plans about the residents’ illnesses and brain injury that help the staff to understand them and how to care for them. There are excellent descriptions of how the resident should be sat or the position that they should be in bed to make sure that they are in the best position for them. These have been developed by the physiotherapy team in the home. The care plans show that they had been put in place by the resident and their key worker so that it was clear how each individual wanted to be treated. The staff and the records confirmed that the residents received good medical care when they needed it. Two of the residents spoken with said that they were happy with the doctors who gave them care. The local General Practitioners are supportive of the work being done in the home and visit regularly and whenever needed. The daily record of care is thorough and up to date which makes sure that the residents receive the right care and the staff know what has happened to them during the day or night. The care plans should have photographs of the residents on the front to help with their identification, particularly for staff who may not know them. The staff were seen to be giving care with dignity and privacy. There was an incident seen where a member of staff was moving a wheelchair out of a bedroom whilst another was giving care to the resident and had left him exposed to people in the corridor. The person in charge was told about this and spoke to the staff concerned. The trained nurses in the home give the medicines and they told us that they have regular updating and were audited, to make sure that they give them safely. This was confirmed by the person in charge and by the records seen. Medication records for the case tracked residents were in order. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were aware of the requirements for the receipt, storage and disposal of medicines. Medicines are stored in locked storage in the home. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 19 The home was not using any controlled medicines at the time of the visit, although the staff were able to describe how they would be monitored if they had them. There is a regular audit of the medicines and record sheets completed by the manager. The above process makes sure that the residents are protected with the correct medicine administration. There is a policy for residents who can look after their own medicines, but there were no residents responsible for their own medicines on the day of the visit. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 20 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 (Adults 18-65) 16, 18, 35 (Older persons) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to support and protect residents and staff are aware of how to manage the processes. EVIDENCE: There is a complaints policy in place which gives the details of how to complain and who to complain to if the residents or their families needed to. This needs to be updated to give the Social Services contact details in case there was a complaint. The person in charge told us that they would be able to print it in other formats or languages if it was needed. There have been no complaints received by the home or by the Commission for Social Care Inspection since the Annual Service Review on 25/02/08. The forms that were seen to be completed if a complaint was received were clear and provided all the information that was needed. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 21 The staff spoken with were aware of how to handle a complaint if they received one. The residents and the visitors spoken with were able to tell us who they would complain to if they ever needed to and were happy that it would be dealt with properly. The staff receive training in safeguarding adults from abuse during their induction period and this is updated regularly. The staff spoken with were able to describe how they would deal with an allegation of abuse and were able to tell us in which areas abuse may happen. The person in charge, the records seen and the staff spoken with confirmed that they had had training. The person in charge and the staff spoken with said that they had attended training in the mental capacity act that told them about peoples rights and how to find out their wishes. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 22 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 30 (Adults 18-65) 19, 26 (Older people) Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The residents are well protected by the policies and procedures in the home, which provides a safe, clean, homely and suitably adapted environment for them to live in. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 23 EVIDENCE: Matthews Nursing and Rehabilitation Unit is a purpose built home on a site with two of the other Rushcliffe Care homes on Epinal Way, Loughborough. The home was warm and welcoming and found to be very clean in all areas. The lounges and dining rooms were bright, well decorated and with suitable furnishings. The small kitchen that adjoins the dining room and is used to prepare drinks and snacks, was clean and well-equipped. The bedrooms that we looked at, with the residents permission, were spacious, designed for each individuals needs and had been personalised with the residents belongings. ‘ I like my room’ a resident told us. All of the bedrooms have en-suite facilties and there are adapted bathrooms for those with a mobility difficulty. One resident told us that he would like a key for his bedroom as another resident sometimes wandered in there. The person in charge said that she would look into the matter for him. There were many aids in the home for the residents to help them to be comfortable and safe. These included wheelchairs, hoists and special mattresses. There was a large well- equipped physiotherapy room/gym where the residents have treatment to help their mobility to improve. The staff spoken with had received health and safety training and were aware of how to handle chemicals. These were all stored in a locked cupboard. The hot water temperature testing was found to be up to date. There were no outstanding safety or maintenance issues noted on the tour of the premises. There was a pleasant, well -maintained garden with a patio area that the residents could enjoy. The registration certificate from the Commission for Social Care Inspection (CSCI) and a current insurance certificate were displayed in the entrance hall. The inspection reports from the CSCI are available. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35, 36 (Adults 18-65) 27,28,29,30 (Older Persons) Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The recruitment, numbers and training of staff make sure that the residents are protected from harm and that their needs are met very well. EVIDENCE: We were unable to look at the staff files on the day of the visit and will make a visit to the main office to look at the files for the whole Rushcliffe group. However, Rushcliffe have always managed their recruitment of staff Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 25 professionally and obtained all the correct information before employing staff. The senior manager told us that they were going to put a confirmation of the documents in all of their homes so that it was readily available. Staff spoken with confirmed that they had not started work until all the paperwork was complete. The home has a thorough induction programme in place for new members of staff that includes the specialist needs of this client group. This gives new staff good knowledge for caring for the residents. The person in charge and the records seen told us that most of the care staff either have completed National Vocational Qualification( NVQ) level 2 or above, or are currently working towards it. The National Vocational Qualification is a qualification for care staff to ensure that they receive appropriate training in the needs of the resident group whom they are caring for. Records show that the staff have had training on many subjects relevant to their work. Staff members spoken with were happy with the amount of training that they were given by the home and told us that they had training in safeguarding adults, challenging behaviour, sexual orientation, mental capacity, as well as moving and handling, first aid, health and safety and medicine updating. The home employs a range of staff with different experience that includes Registered Nurses, care team leaders, senior care staff and care assistants, supported by domestic and catering staff. There are occupational therapists, physiotherapists, language therapists and a clinical psychologist to make sure needs of the residents are met. The staff told us that they do not have regular, formal supervision and there were no records available. A phone call to the acting manager following the visit confirmed that they were not currently taking place. This process would give the staff and their ‘line manager’ the opportunity to have individual discussions about work and training needs. The staff rotas and the staff on duty on the day of the visit showed us that there were enough staff members to meet the needs of the residents. Staff members spoken with said they had enough time to complete their work and the residents and the families told us that there were always enough staff. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 (Adults 18-65) 31,33,35,38 (Older People) Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The residents live in a home where their individual needs and wishes are supported, in an environment that is run in their best interests. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 27 EVIDENCE: The nurse in charge accompanied us as the acting manager was on annual leave on the day of the visit. The acting manager, who is a Registered Nurse, has many years experience in the specialist field of brain injuries and has applied to the Commission for Social Care Inspection to be the registered manager. The staff and the residents told us that they are very happy with the new manager and thought that the staffing levels and the care had improved since she had been there. The residents and relatives have regular meetings with the manager when their views are discussed and areas such as meals and activities are decided. There is an annual questionnaire sent to the residents and their families that were very positive about the care given in the home. The home has clear and thorough policies and procedures, which are up to date and have recently been reviewed. The residents’ personal accounts were found to be correct, there were two signatures for each transaction and the receipts for each one were kept. The records for fire alarm testing and fire training were not available on the day of the visit and the home has not responded to a phone call following the visit. We could not confirm that they are up to date. Regular staff meetings were held, which was confirmed by the staff and by the minutes of the meetings. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.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 Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 3 2 4 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 2 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 2 43 X 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? None 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. 2. 3. 4. 5. 6. 7. 8. Refer to Standard YA1 YA1 YA19 YA22 YA26 YA36 YA42 YA42 Good Practice Recommendations That the registered person makes sure that the Statement of Purpose contains updated information. That consideration is given to include the results of the annual quality questionnaire in the Statement of Purpose. That photographs of the residents are placed on to the care plans and medicine sheets. That the registered person makes sure that the complaints policy includes the contact details for Social Services. That a key to peoples’ bedroom door is provided to make sure that their privacy can be respected. That the manager puts a programme of formal supervision of the staff in place at the required intervals. That the fire alarms are tested at the required frequency and that the recorded information is available. That the staff receive fire training and drills at the required DS0000001902.V371035.R01.S.doc Version 5.2 Page 30 Matthews Nursing and Rehabilitation Unit frequency and that the recorded information is available. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. Matthews Nursing and Rehabilitation Unit DS0000001902.V371035.R01.S.doc Version 5.2 Page 32 - 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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