Care Home: Netherfields Rest Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well What has improved since the last inspection? Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 7All the requirements have been met from the last inspection. The people who use the service are provided with questionnaires twice a year to obtain their views on the service provided. This has resulted in the introduction of more activities and plans have been drawn up to extend the disabled access to be flush with the front entrance. The ongoing maintenance programme has resulted in new carpets fitted throughout in all communal areas and some resident`s rooms. New dining room furniture purchased. Refurbishment takes place in private rooms when they become vacant. There is now a cook employed at weekends. What the care home could do better: CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Netherfields Rest Home 17/19 Roe Lane Southport Merseyside PR9 9EB Lead Inspector Elaine Stoddart Unannounced Inspection 21st February 2008 08:30 X10029.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 Netherfields Rest Home DS0000067616.V348839.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. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Netherfields Rest Home Address 17/19 Roe Lane Southport Merseyside PR9 9EB 01704 54 1034 F/P 01704 54 1034 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) Ramos Healthcare Limited ** Post Vacant *** Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Date of last inspection 3rd August 2006 Brief Description of the Service: Netherfields Residential Care home is registered to provide personal care and accommodation for up to twenty-seven older persons. Twenty-one were resident at the time of the visit. The service does not provide nursing care. This is provided in conjunction with the district nursing services when required. The home is owned by Ramos Health Care and managed by Annette Worrell, who is yet to apply to the Commission for Social Care Inspection (CSCI) for registration. The home is situated on Roe Lane in Southport and is reasonably close to the town centre and all the amenities it provides. These include theatre, pubs, restaurants and parks. There are shops and access to public transport close by. The home is located in two buildings, which have been converted and joined centrally. Accommodation is located on three floors with a stair lift and passenger lift giving access to the upper floors. Bathrooms have suitably adapted equipment to assist residents with their personal needs. There are two lounges and a dining area giving ample communal space for the residents. There is car parking space to the front of the premises. There is a large rear garden and also a sitting area at the front of the building. Ramped access (with the exception of the front porch steps) is available to the exterior via the front entrance. The current rate of charges is £365.00 - £370.00 per week. Netherfields Rest Home DS0000067616.V348839.R01.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 2 stars. This means the people who use this service experience good quality outcomes. The inspection took place over one day for a period of nine hours. An Expert by Experience took part in the inspection process for approximately four hours. An Expert by Experience is a person who, because of their shared experience of using services and/or ways of communicating visits a service with an inspector to help get a picture of what it is like to live in or use the service. A tour of the building was conducted. A selection of care staff and service records were also viewed. All the core standards were assessed. During the inspection three residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. The manager, Annette Worrell, Audrey Tan, a Ramos Health Care representative, six staff members, ten of the twenty-one residents, three relatives, a visitor and a district nurse were spoken with and their views obtained of the service. Survey forms ‘Have your say about….’ were also given to residents to complete. Comments received from the surveys and discussions, which took place, are incorporated within this inspection report. An AQAA (annual quality assurance assessment) was completed by Annette Worrell, prior to the site visit. The AQAA comprises of two self-questionnaires that focus on the outcomes for people. The self-assessment provides information as to how the manager and staff are meeting the needs of the current residents and a data set that gives basic facts and figures about the service, including staff numbers and training. Details from the AQAA are threaded through the report. What the service does well: The service presents a pleasant, homely atmosphere and was found to be clean, hygienic and free from odours. Many staff have worked at Netherfields for many years and have continued to do this since the change in ownership and new management. Thus resulting in continuity of care for the residents. The staffing levels at the time of the visit were sufficient to meet the residents’ needs. Staff are recruited following the correct procedures to ensure the safety of the residents. 50 of the care staff have a qualification in at least NVQ (National Vocational Qualifications) Level 2 to ensure they have the skills to perform their duties. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 6 The manager/or deputy manager provided alternative weekend support to the staff and residents to ensure that management support is available over the weekend periods. The staff spoken with demonstrated their commitment to providing a good service and confirmed they strive to provide the care and support to the residents. Staff are supported by the manager and commented – “Annette is always there if I need her. She is very supportive” “We have a good team. We all work together and communicate well”. Residents spoken with confirmed the staff respect their dignity and privacy. Visitors and relatives spoken with confirmed the service is providing good quality care and support and comments included – “The staff are always very pleasant. I visit every day to visit certain residents and the atmosphere is always very pleasant and there are plenty of staff on duty who are always there to help. They have cared for many difficult residents very well. I would recommend this home for my relative. The staff recently cared for a resident who was terminally ill and the care and support was excellent”. District nurse. “I call in daily and there is always a lovely atmosphere and the staff are very nice”. Visitor. “I can’t speak more highly of the place. The staff have been great and have given my Mother lots of support and the family too”. Relative. “I looked at all the home’s in Southport, read all the CSCI reports and picked this one. It is lovely and not an institution. Very homely. The staff are very pleasant and easy to talk to if there is a problem”. Relative. The staff are very helpful. I came twice to have a look around before I decided to move in”. Resident. Residents commented that there are sufficient activities for them to take part in if they wish. These include – book club, flower arranging, quizzes and art classes. Information on the home is available for prospective residents and visitors to view. Visitors are encouraged to call anytime and join them for lunch if they wish. The residents and visitors spoken with at the visit confirmed this. All staff are instructed to read the Equal Opportunities policy and put this into practice in their work. What has improved since the last inspection? Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 7 All the requirements have been met from the last inspection. The people who use the service are provided with questionnaires twice a year to obtain their views on the service provided. This has resulted in the introduction of more activities and plans have been drawn up to extend the disabled access to be flush with the front entrance. The ongoing maintenance programme has resulted in new carpets fitted throughout in all communal areas and some resident’s rooms. New dining room furniture purchased. Refurbishment takes place in private rooms when they become vacant. There is now a cook employed at weekends. What they could do better: A number of good practice recommendations have been made which are included within this report and were discussed with the manager and representative of Ramos Health care during the visit. These include – A full time maintenance person should be employed to respond to day-to-day repairs and ongoing maintenance programmes. Repairs should take place to the external security lighting and potholes in the car park. The basement door should be made secure. A copy of the fire report and fire risk assessment should be forwarded to CSCI on completion of the visit by the Fire Department. Improve disabled access for the benefit of the residents. The service needs to extend their activity programme to provide trips out and staff support to enable residents to access the community i.e. walks, personal shopping. A number of comments from residents spoken with confirmed that this was an area that needed to be improved, as they often feel confined if they don’t have relatives to take them out. Comments include – “ I would like to get out more”. “My daughter visits and takes me out. Great therapy”. The manager should to apply to be registered with CSCI and obtain Level 4 in NVQ. The owners should visit the service more often as comments were received from both staff and residents regarding their lack of presence. Residents spoken with made both positive and negative comments regarding the food the lack of alternatives offered. The service should review this in consultation with the residents. Comments include- Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 8 “We need more choice” “The food is good but not a lot of choice” “Food very plain but good”. “We have to wait twenty to thirty minutes before is pudding served. This often causes arguments amongst residents”. “They do offer alternatives”. “I always like the meals”. Care plans and risk assessments should be more detailed to outline residents needs, action to be taken by staff and preferred outcomes for the residents. These should be dated and signed on completion and reviewed regularly to assess changing needs. Medication risk assessments were in place for some residents and these should be completed for all residents to show that they have been assessed to self medicate. The manager should complete competency assessments for all staff who administer medication to residents. The procedure for administering controlled drugs should be accessible to staff who administer medication and kept in the medication file for access. The induction process should be in line with ‘Skills for Care’ model to ensure staff competency is assessed. The manager should provide a training matrix to show training obtained and required for all staff. The training programme should include training in ‘Safeguarding Adults’. The policy and procedure for abuse should be updated in line with the ‘Safeguarding Adults’ procedures. Emergency lighting checks and fire checks should be recorded regularly in line with the Fire Service guidelines. 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. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with the information they require to make an informed choice about living in the home. Full assessments of need are conducted prior to admission to ensure that the service can meet their needs. EVIDENCE: Standard 6 Intermediate Care is not provided at the home. The manager and/or deputy manager undertake a full assessment for all potential residents to ensure the service can meet their needs. Assessments for three residents were viewed and contained sufficient detail with regard to personal/social information, general past medical history, medication and Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 11 current health care needs. Assessments provided by other professionals were also available. Residents and realives spoken with confirmed they had been provided with information prior to admission and had been invited to visit the home to meet the staff and residents. Comments include – “I came to view Netherfields on two occasions to visit before I moved in”. “I looked at all the home’s in Southport, read all the CSCI reports and picked this one. It is lovely and not an institution. Very homely. The staff are very pleasant and easy to talk to if there is a problem”. Relative. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Resident care plans are in place to enable the staff to meet residents’ needs. Medications policies and procedures are in place and staff are trained to administer safely. EVIDENCE: Residents have an individual care file and the plan of care is based on the initial assessment. Three residents’ care files were viewed and evidenced the daily activities of living with reference to diet, mobility, personal hygiene, Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 13 continence and social background. Care plans are reviewed monthly to reflect any change in the condition of the resident and any change in treatment or medication. The manager should make reference to changes in the care plans and update all care plans in the same format i.e. needs/action/outcomes. Records should show the date of the review and signed by the reviewer. General risk assessments including manual handling instruction are in place for those are at risk of falling or who require assistance with their mobility and are reviewed regularly. These to should be dated and signed on completion. Care files viewed evidenced visits by GPs and district nurses. Personal care records were viewed for the three residents case tracked and recorded personal care – baths, hair and weight. All visits by health care professionals are recorded in their daily records. Residents spoken with confirmed they have access to their GP and district nurses are in attendance where needed. “I always receive the medical support I need”. A visiting district nurse provided positive comments on the service provided. “The staff are always very pleasant. I visit every day to visit certain residents and the atmosphere is always very pleasant and there are plenty of staff on duty who are always there to help. They have cared for many difficult residents very well. I would recommend this home for my relative. The staff recently cared for a resident who was terminally ill and the care and support was excellent”. The dignity and respect of residents is maintained at all times and residents spoken with confirmed this.” Dignity and respect is good”. Staff were observed to interact positively with the residents and always knocked on doors prior to entering rooms. A pleasant atmosphere was evident and the residents were observed to be very comfortable and relaxed with the staff and chatted freely at all times. Available double rooms are occupied by male/female couples. All other rooms are of single occupancy. The laundry system was organised to ensure the residents wear their own clothes and residents were seen to be clean and tidy in their appearance and well cared for. Residents spoken with confirmed that laundry is washed, ironed and returned appropriately. There are sufficient communal areas for the residents to sit with relatives to talk or use their own private rooms. Medication records were viewed. Medication administration records (Mar) records were found to be up to date and records made of all administrations. Only staff with medication training are allowed to administer. Residents receive medical treatment in the privacy of their own rooms and a visiting district nurse spoken with confirmed this. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 14 The manager has conducted assessments of competency for some staff administering medication during supervision sessions. Staff spoken with confirmed this. This is recommended for all staff who administer. Medication is securely stored. It was recommended that the controlled drugs policy and procedures be updated and placed in the medication file for staff access. Medication risk assessments were in place for some residents and these should be completed for all residents to show that they have been assessed to self medicate. A photo of each resident should be placed on file to confirm identity. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Visitors and relatives are made welcome at all times. A varied activity programme is in place. EVIDENCE: Care plans viewed showed that residents’ likes and dislikes had been assessed. Following recent surveys completed by the residents requesting more activities. The activity programme has been improved to include – quiz, art classes, book club, flower arranging. Residents spoken with confirmed they enjoy the activities. Some residents said they would like the activities to Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 16 involve trips out and staff support to access the community for walks, personal shopping as they often feel confined in the home. Some residents have family who often take them out. This was discussed with the manager and recommended in the report. Residents’ comments include – “There are weekly quizzes, exercises”. “ I would like to get out more”. “My daughter visits and takes me out. Great therapy”. The visit was conducted during the breakfast and lunch time period. A small number of residents have their breakfast in the dining room, however the majority have their breakfast in their own rooms. Residents spoken with confirmed that this is their choice as they like to get up in their own time. The dining room is pleasant and tables are set with napkins. New dining furniture has been purchased since the last visit. Residents were observed to have their lunch in comfortable surroundings and staff were attentive at all times for those who need assistance. The food was attractively presented. The main meal of the day was roast lamb with fresh rosemary and trifle. Fresh produce is delivered regularly and discussion with the visiting supplier and viewing of food storage areas confirmed this. Lunch and evening meals are served at set times and a menu is displayed. Drinks and snacks are served during the day. Resident’s food likes, dislikes and dietary needs are recorded in their care files. The cook who has worked at Netherfields for thirteen years said that the “Residents can have what they want”. The kitchen is clean and well organised. Since the last visit a weekend cook has been employed and a kitchen assistant seven days a week. This has improved the service in the kitchen as it relieves care staff from kitchen duties enabling them to concentrate on the care of the residents. Residents spoken with made both positive and negative comments regarding the food the lack of alternatives offered. The service should review this in consultation with the residents. Their comments are included in the section ‘What could be improved’. Relatives were observed to call at all times of the day and provided positive comments on the care and support provided. Comments include – “I can’t speak more highly of the place. The staff have been great and have given my Mother lots of support and the family too”. – “ I looked at all the home’s in Southport, read all the CSCI reports and picked this one. It is lovely and not an institution. Very homely. The staff are very pleasant and easy to talk to if there is a problem”. The residents are encouraged to handle their own financial affairs were possible. Viewing of personal allowance records showed that the Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 17 manager/deputy manager record pocket monies for residents. A balance is maintained and receipts obtained for all transactions made. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are aware of how to make a complaint and feel their complaint will be listened to and acted upon. Abuse policies and procedures should be updated in line with local ‘Safeguarding Adults’ procedures. EVIDENCE: The AQAA reported that three complaints had been received by the service since the last visit. Records showed that these complaints had been dealt with through the complaints procedure and upheld. The service has a complaints policy and procedure in place and residents and relatives are aware of who to complain to. Records are kept of all complaints and outcomes. The complaints procedure is contained in the statement of purpose and service user guide and is displayed in the home for visitors and residents to access. Comments include “I know who to talk to if I have a problem “ Relative. “I would speak to Annette (manager) if I needed to”. Resident. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 19 Staff spoken with were aware of the procedures should any allegations of abuse occur and commented; “I wouldn’t hesitate to tell the manager”. A copy of Liverpool and Sefton’s ‘Safeguarding adults’ policy is available for staff reference. The services policy and procedure needs to be updated to reflect the ‘Safeguarding Adults’ procedures for Liverpool and Sefton and this is recommended within this report. Training in abuse is recommended for staff. The service deals with thirteen residents pocket monies only. All residents finances are recorded, receipts obtained and signed by both the deputy and manager to balance the account. Staff are recruited following the correct procedures to ensure the safety of the residents. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in pleasant, safe, comfortable and well-maintained surroundings. EVIDENCE: All the communal areas, laundry, kitchen, basement and some of the residents’ rooms were viewed. All areas viewed were found to be comfortably furnished, clean and provide a homely environment for the residents to live. Radiator covers and handrails are in place throughout for residents’ safety. A passenger Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 21 lift and a stair lift are in place for residents to access the upper floors. Residents who use this are risk assessed and records were seen to confirm. Two couples occupy two of the double rooms available. All other rooms are of single occupancy. Ramped access (with the exception of the front porch steps) is available to the exterior via the front entrance. The owners are presently looking into improving this and confirmed that plans have been drawn up. Toilets and bathing facilities are accessible to the residents and fitted with aids for the residents use. Residents’ rooms were found to contain personal items. One resident had recently moved in the previous evening had brought personal furniture and possessions and staff were assisting her to unpack and settle in. The resident commented, “The staff have been very helpful”. Since the last visit new carpets have been fitted throughout in all communal areas and some resident’s rooms. New dining room furniture purchased and the dining area provides a pleasant place for the residents to eat their meals. The tables are set with napkins. Refurbishment takes place in private rooms when they become vacant. It is recommended that a maintenance person is employed to respond to day-to-day repairs and ongoing maintenance programmes. A number of improvements were noted and these are recommended within the report and discussed with the manager and owner during the visit. Residents, visitors and relatives spoken with provided positive comments on the environment. “I looked at all the home’s in Southport, read all the CSCI reports and picked this one. It is lovely and not an institution. Very homely”. Relative. “The home is always clean”. Relative. “I am satisfied with the home in general. Cleanliness good”. Resident. The laundry system was organised to ensure the residents wear their own clothes and residents were seen to be clean and tidy in their appearance and well cared for. Residents spoken with confirmed that laundry is washed, ironed and returned appropriately. Two couples occupy two of the double rooms available. All other rooms are of single occupancy. There are sufficient communal areas for the residents to sit with relatives to talk or use their own private rooms. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of appropriately trained and experienced of staff care for the residents. EVIDENCE: A pleasant atmosphere was present throughout the visit. Some staff have worked at Netherfields for many years and have continued to do this since the change in ownership and new management thus resulting in continuity of care for the residents. The staffing levels at the time of the visit were sufficient to meet the residents’ needs and included – Three care staff, the manager, a cook, a kitchen assistant and two domestics. Two waking night carers provide night cover. Comments received from residents and relatives spoken with during the visit and surveys received were varied regarding the staff employed. Comments include – “The staff are very helpful”. Resident. “Staff seem too busy to give that bit extra”. Resident. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 23 “The staff don’t have enough time to spend with the residents”. Resident. “Staff always listen to me”. Resident. “Staff are always available”. Resident. “The staff are always very pleasant”. Relative. “I can’t speak more highly of the place. The staff have been great and have given my Mother lots of support and the family too”. Relative. Staff are recruited following the correct procedures this was confirmed in two staff files viewed. 50 of the care staff have a qualification in at least NVQ Level 2 to ensure they have the skills to perform their duties. The manager/or deputy manager provided alternative weekend cover to support to the staff and residents and ensure that management support is available over the weekend periods. It is recommended that a maintenance person should be employed to respond to day-to-day repairs as staff commented that this takes time. The staff spoken with demonstrated their commitment to providing a good service and confirmed they strive to provide the care and support to the residents. “We have a good team”. “We all work together and communicate well”. Staff were observed to be attentive and pleasant to residents and visitors at all times throughout the day. A training matrix is needed to show training needs and keep records up to date. The manager confirmed training in infection control and food hygiene are to be updated for all staff. Training in abuse is recommended for staff in addition to the information provided in ‘Safeguarding Adults’ procedures in place. The abuse policy and procedures are to be up dated in line with ‘Safeguarding Adults’ procedures. Staff spoken with provided positive comments on the training provided. “The service keeps us up to date on mandatory training”. Induction is in place for staff and recommended that they use ‘Skills for Care’. Staff commented “My induction was very clear and helpful”. All staff are instructed to read the Equal Opportunities policy and put this into practice in their work. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are trained in safe working practices and certificates for services are up to date. The residents are consulted regarding the running of the home. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 25 EVIDENCE: The new manager Annette Worrell has been in post since the last visit. She has demonstrated her commitment to making improvements and has made progress to meet all the requirements and has maintained continuity of the staff employed. Annette is yet to complete her NVQ Level 4 and to apply to CSCI to become registered. The staff, residents and visitors spoken with provided positive comments on the support and direction given. There was a pleasant, relaxed and comfortable atmosphere present throughout the day of the visit. Comments – “Annette is always there if I need her. She is very supportive”. Staff. “I have had recent supervision with my manager regarding medication and this was very useful”. Staff. “We have a good team. We all work together and communicate well”. Staff “My induction was very clear and helpful”. Staff. “My manager is very helpful, caring and understanding. I am grateful to my manager she makes working at Netherfields a more happy place to be”. Staff. “The staff are always very pleasant. I visit every day to visit certain residents and the atmosphere is always very pleasant and there are plenty of staff on duty who are always there to help”. District nurse. There is always a lovely atmosphere and the staff are very nice”. Visitor. “I can’t speak more highly of the place. The staff have been great and have given my Mother lots of support and the family too”. Relative. Residents and their representatives complete quality assurance surveys twice a year to obtain their views on the service delivered. The provider completes monthly visits to monitor progress. Residents, staff and relatives commented that they do not see the owners enough and would like this to improve. Comments – “We never see the owners”. Staff. “The owners never show their faces”. Staff. The residents are encouraged to handle their own financial affairs were possible. Viewing of personal allowance records showed that the manager/deputy manager record pocket monies for residents. A balance is made and receipts obtained for all transactions made. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 26 Records viewed and discussion with staff showed that supervision and staff meetings take place. Care staff are assessed for competency in their work by the manager and records made. The AQAA recorded that all certificates for services are up to date. This was confirmed during the visit. The fire service are visiting the service on 27th February 2008 to assess the building and to provide an up to date fire service report and fire risk assessment. –The manager confirmed a copy of these will be sent to CSCI. All accidents and injuries are recorded and seen during the visit. A training matrix is needed to show staff training needs and keep records up to date.(As mentioned in the staffing section). Training in infection control and food hygiene to be updated for all staff. This was discussed with management at the visit. Training in abuse to be provided for staff in addition to the information provided in ‘safeguarding adults’ procedures in place. The abuse policy and procedures are to be up dated in line with ‘Safeguarding Adults’ procedures. COSHH (Control of hazardous substances) assessments should demonstrate assessments of hazardous substances are in place. Induction is in place for staff and recommended that they use ‘Skills for Care’. Emergency lighting records checked monthly should show date recorded. Fire tests should be recorded weekly and dated. “Annette is always there if I need her. She is very supportive” “I have had recent supervision with my manager regarding medication and this was very useful” “We have a good team. We all work together and communicate well” Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 27 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 X 2 X 3 3 4 X 5 X 6 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 3 22 3 23 3 24 3 25 3 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 2 32 3 33 3 34 X 35 3 36 X 37 X 38 3 Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 28 No Are there any outstanding requirements from the last inspection? 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 OP7 Good Practice Recommendations All care records and risk assessments should be dated and signed on completion and clearly outline residents needs, action to be taken by staff and preferred outcomes. A photo of each resident should be on file to confirm identity. Medication risk assessments should be completed for all residents to show that they have been assessed to self medicate safely. The manager should complete competency assessments for all staff who administer medication to residents. The procedure for administering controlled drugs should be accessible to staff who administer medication and kept in the medication file for access. The service needs to extend their activity programme to provide trips out and staff support to enable residents to access the community i.e. walks, personal shopping. DS0000067616.V348839.R01.S.doc Version 5.2 Page 29 2 OP9 3 OP12 Netherfields Rest Home 4 OP15 A survey of the residents should be conducted regarding meals times, service delivery and alternatives offered in view of the comments made in the report. 5 OP19 Repairs should take place to the external security lighting and potholes in the car park. The basement door should be made secure. 6 OP22 Improve disabled access for the benefit of the residents. 7 8 OP27 OP30 A maintenance person should be employed to respond to day-to-day repairs. . The induction process should be in line with ‘Skills for Care’ model. The manager should to apply to be registered with CSCI and obtain Level 4 in NVQ. The owners should visit the service more often as comments were received from both staff and residents regarding their lack of presence. Emergency lighting checks and fire checks should be recorded in line with the guidance from the Fire Department. A copy of the up to date fire report and fire risk assessment should be forwarded to CSCI on receipt. COSHH assessments should demonstrate assessments of hazardous substances are in place. 9 10 11 OP31 OP33 OP38 12 13 OP38 OP38 Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Liverpool L22 0LG 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. Netherfields Rest Home DS0000067616.V348839.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!