Care Home: North Road Care Homes

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up detailed plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly and safely. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends, who say they are always made welcome in the home. One relative said, "We are very pleased with the care that my relative is receiving, we find the standards within the home are high, we have no complaints at all". Service users are also encouraged to take as much control over their own live`s as they are able, and make their own decisions. Service users are very complimentary about the food, and there is a balanced diet, with a choice included. Complaints and concerns are taken very seriously and are responded to properly. The home is kept clean, hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? Several areas throughout the home have been refurbished and this provides a more comfortable place for service users to live. The requirements from the last key inspection visit have been met. What the care home could do better: The first floor nursing unit needs improvements made to the environment, and this will create a more attractive , homely and comfortable place for the service users. Orientation boards and better signage will help to improve the orientation of those service users with memory loss. Improvements to the main entrance to the nursing home will make this area more welcoming to prospective service users and visitors. To avoid potential errors, all handwritten entries in the medication charts must be double signed and avoid recording (As Required or As Directed). Inspecting for better lives Key inspection report Care homes for older people Name: Address: North Road Care Homes 192-194 Hollywood Avenue Gosforth Newcastle Upon Tyne NE3 5BU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jim Lamb     Date: 0 8 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: North Road Care Homes 192-194 Hollywood Avenue Gosforth Newcastle Upon Tyne NE3 5BU 01912131215 01912131221 northroad192@ukonline.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northumbria Nursing & Residential Care care home 54 Number of places (if applicable): Under 65 Over 65 49 5 dementia old age, not falling within any other category Additional conditions: 0 0 Up to 5 service users may be aged 60 - 64 years old at any time, category DE. Date of last inspection Brief description of the care home North Road is a care home with nursing that provides care for older people with enduring mental health needs by Registered Mental Nurses supported by care staff. The home is owned and managed by Northumbria Nursing & Residential Care, which specialises in providing services for people with mental health needs and problems. It is situated in Gosforth in the city of Newcastle upon Tyne close to local shops and good public transport links. The building has mainly single bedrooms some of these having en-suite facilities. There are separate bathroom and toilet facilities and, a number of lounge and dining rooms. The home has two laundry rooms and a single kitchen, also a garden area to the interior. The philosophy of care is to support the residents in their activities of daily living and to provide for their physical and mental Care Homes for Older People Page 4 of 27 Brief description of the care home health needs. Fees range from 435.00 to 452.00 per week this does not include the costs for hairdressing, toiletries and chiropody. The homes statement of purpose and inspection reports are available in the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements,to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Care Homes for Older People Page 6 of 27 Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the deputy manager, and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable,and checked what improvements had been made since the last visit. We told the manager/provider what we found. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 27 Several areas throughout the home have been refurbished and this provides a more comfortable place for service users to live. The requirements from the last key inspection visit have been met. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: The care records for four service users were looked at. These showed that the manager makes sure that a full assessment of a new service users needs is carried out by the persons social worker before they come into the home. The manager also carries out her own assessment, to be doubly sure that the home can meet all of the new persons needs. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk, of nutritional needs, social needs, Care Homes for Older People Page 11 of 27 Evidence: moving and handling needs and of behavioural needs. A dependency rating scale is also completed. Skin care assessments are also carried for those at risk of developing pressure sores. As a result of all these levels of assessment, the manager can clearly demonstrate that all the service users are in a home that can give them the care that they need. The homes service users guide is available in large print. All are provided with a contract explaining the homes terms and conditions, and fees. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: A comprehensive range of assessments is completed to identify each service users current health, personal and social care needs. This information is used to devise and update individual care plans. Service users are involved in planning their care and have a key worker who monitors and helps to update care plans. A sample of four service user care plans were examined. These addressed physical health, personal hygiene, continence, memory and cognition, skin integrity, communication, social and spiritual needs. The recording was detailed, specific and personalised to the persons requirements. The plans demonstrated care and support to be provided by staff and what the person can do independently. There were also good examples of plans that showed how risks to the person are managed or minimised. Care Homes for Older People Page 13 of 27 Evidence: Service users said they always receive the care and support they need, and that the staff always treated them with respect and maintained their privacy and dignity. One service user said, This is a smashing place, the staff are very good. My family live close by and i am able to see them most days. Another said, My son visits quite often, i have no complaints and i like the staff very much. Service users have a choice of local GP practices, and the residential side of the home has an allocated District Nurse. There are arrangements for an optician, dentist and podiatrist to make home visits. Service users also receive input, if required from mental health care professionals, physiotherapist and occupational therapists. All contact with health care professionals is well recorded. Service users have their moving and handling, nutrition, continence, and pressure sore risk needs assessed. Falls assessments are also completed. There were some good examples of care plans linked to specific health care needs and medical conditions. Where identified these incorporated appropriate aids and equipment used. All staff who administer medication undertake relevant training. A sample of medication charts was examined. These were appropriately recorded and have service users photographs for identification purposes. The staff team were reminded that all handwritten entries in the medication charts must have two staff signatures, and that they must always avoid recording (as required or as directed) All personal care and medical examination/treatment is carried out in private. Service users confirmed that staff treated them with respect and personal care is always carried out in a dignified manner. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: Each service user has a social skills assessment carried out. All service users and their representatives participate in this process. The completion of the skills assessment assists staff to implement more detailed social care plans. There are daily activities available, and entertainers frequently visit the home. The activities programme is based on service users interests and choice. Activities include favourites such as reminiscence sessions, bingo, carpet bowls, quizzes, crafts, baking, dominos and cards. There is a weekly film shows and weekly pamper days(hairdressing and manicures). There was evidence that service users receive lots of one to one interactions with the staff however, this was not reflected within the social care records kept. Detailed records are not currently kept to show which activities people are involved in. The activities programme should be displayed in large print within each unit of the home. To help orientate service users, particularly those with memory loss, it is also recommended that orientation boards are displayed Care Homes for Older People Page 15 of 27 Evidence: depicting: Date, time of day, weather, season, and the names and perhaps photographs of the staff on duty. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. The homes menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. The menus are varied and well balanced. The chef had good knowledge of the service users dietary needs. Special diets are provided when necessary. Many service users require assistance with their meals, staff were observed to assist service users discreetly and sensitively. There was emphasis on making mealtimes an enjoyable experience for the service users. All those spoken to said that the meals were very good and that they were always offered a choice. A religious service which is open to all denominations, is held in the home every four weeks. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: There is a complaints procedure. The procedure is written in a way that ensures service users fully understand its contents. One service user said that she had been given a copy of the procedure and that staff always listened to any concerns and always dealt with them fairly. The home keeps a record of complaints. The home has a Whistle Blowing policy, the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Healths document, NO SECRETS. Staff are aware of these procedures and have easy access to them. Since the last inspection visit, there has been one complaint received, this was referred to the local safeguarding team for investigation, and was satisfactorily resolved. Safeguarding adults training is ongoing for all staff. Service users can deposit cash for safe keeping and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately Care Homes for Older People Page 17 of 27 Evidence: recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are obtained for purchases and numbered to crossreference to the transaction. Weekly checks of balances and cash are carried out. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there. Evidence: The home was very clean, most areas are well decorated and well maintained. The grounds were safe, attractive and accessible, although the entrance to the nursing home was not very inviting, there were weeds and nettles growing in a border and several empty milk crates were left here. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. During the last year, there has been some improvements made to the environment, there are new carpets in several areas, many bedrooms have been refurbished and decorated, and communal areas have been decorated. The ground floor lounge and dining areas within the residential and nursing units were highly attractive and very homely. However, the first floor nursing unit appears stark and uninviting, the whole area lacks appropriate signage for service users with memory loss, the colour scheme is bland, there are few pictures displayed, and there is a distinct lack of soft furnishings. It would be hugely beneficial for the service users Care Homes for Older People Page 19 of 27 Evidence: on this unit to have an orientation board and good clear signage that will help them to become more orientated within the unit. Sterling university provide excellent information and advice to providers regarding design and colour schemes that are appropriate for service users with memory loss. Service users can see visitors in private in their own rooms. all bedroom furnishings and fittings were domestic in design and in good condition. Several bedrooms have got en-suite facilities. All rooms were highly personalised and decorated to a high standard. Lighting was bright and domestic in design. All doors have privacy locks and room sizes meet the required standards. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users bedrooms have opening windows and restrictors are in place where needed. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There was emergency lighting throughout the home. The kitchen was clean and well organised. Water is stored at over 60C. Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was spotlessly clean and free from any offensive odours. The laundry facilities are very well organised. The washing machines have the specified programme to meet disinfection standards. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good match of well-qualified staff, who are appropriately recruited and supervised. Evidence: Staff levels on the day of the inspection met the agreed level for the number of service users. On the day of the inspection there were 47 service users. In addition to the manager, the required numbers of staff were on duty: on the first and second floor nursing units there are 2 qualified nurses and 7 care staff between 8am and 2pm, 5 care staff after 2pm until 10pm. The residential unit has a manager and 3 care staff. Both units Combined, there are 5 carers and a qualified nurse between 10pm and 8am. The home has a full time administrator. There are enough domestic, laundry, maintenance, and catering hours. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. Care Homes for Older People Page 21 of 27 Evidence: The homes training programme meets the National Training Organisation requirements for the first six months. Staff receive at least three days paid training each year. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The service has a good staff training and development programme in place. All statutory training was up to date and 85 of the staff team has completed NVQ level 2/3. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The registered manager has the required qualifications and experience to run the home. There is a range of quality systems in the home. There is an annual survey of the views of the service users and their families. The findings are collated and an action plan drawn up to address any areas of concern. There are also regular meetings held with both the service user groups and with the staff group. These are minuted in good detail and action points listed. Care Homes for Older People Page 23 of 27 Evidence: Both individual and central supervision records were studied. These records show an appropriate bi-monthly pattern of supervision, with an annual work performance appraisal. All staff receive annual health and safety training. This is good practice. Checks of the fire log book showed that all the required checks and tests of equipment and systems take place at the proper intervals, as does fire safety training. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. Servicing and maintenance records are comprehensive and well maintained. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Handwritten entries in the medication charts must always be signed by two people, and always avoid writting (as required, or as directed). The routines and social activities should be displayed within each unit, and this will inform service users and their visitors of the activities available each day. Good quality orientation notice boards and improved signage should be displayed, this will help those with memory loss to become more orientated in their environment. The first floor nursing unit needs to be designed, decorated and furnished in a way that will wholly meet the collective needs of the service users, and create an attractive and comfortable place for them to live. 2 12 3 12 4 19 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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