Care Home: Northfield House

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What the care home does well The home provides a comfortable and homely environment that is well maintained, clean and hygienic. Peoples needs are well assessed before they move into the home and people always have the opportunity to look around before they move in if they choose. The home provides a good variety and standard of daily and weekly activities for people to participate in if they choose. People living in the home are positive about the staff team and said they were treated with dignity and respect and that their personal care and health needs were well met. The staff team are provided with training opportunities and there has also been relatively low staff turnover. The home has a number of senior staff who have worked at the home for many years. The home communicates well with relatives and liaises appropriately with outside professionals. What has improved since the last inspection? Further improvements have been made to the care planning system which is now computer based and there have also been additional training for staff. A new form of quality assurance is being introduced by the new Providers. Formal supervision is being provided for the staff team. What the care home could do better: No major shortfalls were identified during this visit. The new quality assurance process is still being implemented and it needs to be demonstrated how this process will contribute to plans for the development and improvement of the service. Key inspection report Care homes for older people Name: Address: Northfield House Northfield House Folly Lane Glos GL5 1SP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Simon Massey     Date: 0 3 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 24 Information about the care home Name of care home: Address: Northfield House Northfield House Folly Lane Glos GL5 1SP 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northfield Care Limited Name of registered manager (if applicable) Mrs Diana Tunnicliffe Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 25. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (Code OP) Date of last inspection Brief description of the care home Northfield House is a Victorian property, which has been converted and extended to provide accommodation for up to 25 older people who require personal care. The home is in a residential, which is close to the center of Stroud. There are bedrooms on the ground, first and second floors, with a passenger lift available. The domestic areas are on the lower floor, away from the residential accommodation. There are communal rooms on the ground floor and first floors, with Care Homes for Older People Page 4 of 24 Over 65 25 0 Brief description of the care home views overlooking the homes grounds. Information about Northfield House and the services provided is available in the homes Statement of Purpose. A copy of the last inspection report is available in the home. The range of fees at the time of this inspection were between 400 and 550 pounds per week. There are some additional charges, which include hairdressing, chirpody and dry cleaning. Care Homes for Older People Page 5 of 24 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: This inspection was undertaken and on the 03/12/09 and lasted for approximately 7 hours. The Inspector met with the newly registered manager, the senior staff, members of the care staff, ancillary staff and also a volunteer. A number of people living in the home were spoken with and also some of their relatives who were visiting on the day of the inspection. A quantity of surveys were circulated to staff, relatives, residents and outside professionals and the majority of these were returned to the Commission. Records relating to care planning, medication, health and safety, maintenance and staff recruitment and training were examined. An inspection of the environment was also carried out. This inspection was undertaken within 12 months of the previous visit due to the fact that the home had been sold to a new Provider. The new owners were not present at the time of the inspection visit but they are involved in the day to day running of the Care Homes for Older People Page 6 of 24 home. Overall there appears to have been a smooth transition with the continuity of good quality care being maintained by the management and staff team. Changes and improvements are being introduced gradually and there was evidence of plans and effort to improve standards further. The Inspector was grateful to the people living in the home and the staff for their cooperation and input to the inspection process. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? 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 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 8 of 24 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 9 of 24 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. People receive good detailed information prior to admission and the home completes assessments that ensure that needs can be met. Evidence: Information from surveys and interviews with people living in the home confirmed that people had sufficient information about the home before moving in. Some people also said that they had come and had a look around before making a decision. All the files checked had contracts in place. Records showed that initial assessments were completed and then further information gathered after admission as the service gained greater knowledge and insight into peoples needs. The service had an up to date Statement of Purpose and Residents Handbook. People living in the home spoken with explained how that they understood what services were available and how the home was run. One relative spoken with explained how they had had a look around and asked a number of questions before making a Care Homes for Older People Page 10 of 24 Evidence: decision, in conjunction with their relative. Care Homes for Older People Page 11 of 24 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. People living in the home and their relatives were positive about the care and support they received and felt they were treated with respect and dignity. Evidence: People living in the home spoken with were very positive about the personal care they received. People said they were treated with dignity and that there privacy was respected at all times. Feedback from relatives was also positive about the personal care being delivered and the monitoring and meeting of health needs. The home has introduced a new computerised care planning system which is used to produce large and detailed care plans, hard copies of which are kept in individuals rooms for reference for staff and people living in the home. The records showed that plans were regularly reviewed and some of the plans examined had recently been updated to reflect some changing needs. Input and advice from medical professionals was clearly recorded and people spoke with said they received the medical input and support they required. The Commission received completed surveys from the medical practice involved with the home and Care Homes for Older People Page 12 of 24 Evidence: these made positive comments about the care and support and the liaison and communication with the home. All medication was correctly stored and recorded. All staff who administer medication had completed some training though not all had been accredited training and it is recommended that this be incorporated into the homes policy that all staff should complete accredited training before they administer medication. Regular medication audits were being undertaken and any issues that were identified were being followed up. Care Homes for Older People Page 13 of 24 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. People are given choice and opportunities in terms of the routines within the home and are supported to maintain contact with friends and families. Evidence: At the time of the Inspection visit people were undertaking a variety of activities. These included watching television in their rooms, spending time with relatives, cooking with the activities co-ordinator, reading and socializing in the communal lounges. People explained how they had the option to take part in activities and attend some of the entertainment that was occasionally provided. Everyone spoken to said they were provided with sufficient options and choices. There were opportunities to go out on group trips and also on an individual basis. The home has a volunteer worker who has worked at the home for many years, and who is available on a daily basis to take people out into the community if they wish. People said they were afforded privacy if they wished to spend time in their rooms. There were several relatives visiting on the day of the inspection and two people were spoken with. They were both positive about the activities and choices provided for their relatives. Care Homes for Older People Page 14 of 24 Evidence: Feedback from the surveys was generally positive about the food provided, as were people spoken to during the inspection. People commented that there was good variety and quantity and that they could eat in their rooms if they chose to. As part of the quality assurance process in place in the home, peoples views were sought on the food and also on the content of the menu. Care Homes for Older People Page 15 of 24 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 procedures and policies in place promote a safe environment in which people are protected and are confident that complaints and concerns will be responded to. Evidence: The home has received no complaints since the last inspection and the Commission has received no complaints or expressed concerns in respect of this service. People who live in the home and relatives spoken with said they understood how to make a complaint or raise a concern and were confident about doing so if the need arose. Staff also explained how they would raise a concern and that they were confident that the management would respond appropriately. Information about how to make a complaint was displayed within the home. Staff and management have undertaken training in safeguarding and staff spoken to demonstrated their awareness of these issues. There have been no safeguarding adults investigations during the past 12 months and no referrals made to the Protection of Vulnerable Adults list in this time. Care Homes for Older People Page 16 of 24 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. People living in the home are provided with a homely and comfortable environment which is well maintained and safe. Evidence: A tour of all parts of the building was undertaken and the environment was seen as well maintained with ongoing decoration being planned and completed. The home was clean and hygienic with fittings and furniture being in good repair. There were comfortable communal areas for dining and watching television. People spoken with expressed satisfaction with their rooms and several people had brought their own furniture with them to the home. A number of en suite facilities were seen and these were clean and hygienic. Two people living in the home said it had a homely and comfortable atmosphere and it was observed that people generally appeared relaxed in their accommodation. Records relating to the maintenance of essential equipment were examined and seen to be up to date with equipment being serviced and correctly maintained. The home employs a maintenance supervisor who has a well organized system for ensuring that maintenance is planned and that safety checks are completed and recorded. The service is committed and organized to providing a safe environment for the people living in the home. Staff and people living in the home confirmed that any repairs once reported were dealt with promptly and correctly. Care Homes for Older People Page 17 of 24 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. Peoples needs are being met a staff team who are well supported and committed to providing good quality care and support Evidence: At the time of the inspection visit there were sufficient staff on duty and the rotas confirmed that these levels were being maintained. There was also an activities coordinator working during the day as well as two cleaning staff and also a volunteer worker. The volunteer did not undertake personal care tasks and supported people to do activities or took people out into the community. People living in the home were very positive about the staff, though two people commented they would like to have more time to sit and talk with the care staff. Staff spoken with also said that at times they were very busy and did not have enough time to spend with people on a one to one basis as they would like, though they also said there were times when they could participate in some activities. People said the the staff treated them with respect and dignity and respected their privacy. Staff were observed communicating appropriately with people and staff interviewed demonstrated a good understanding of peoples needs and their own responsibilities. A system of formal supervision has been introduced and staff spoken to were positive about this, as this was being undertaken by the one of the new owners for the home. Staff also receive informal supervision and guidance from the senior staff on duty and Care Homes for Older People Page 18 of 24 Evidence: people said they thought they worked well as a team and were supportive to one another. A sample of staff files were examined and found to contain the required references and pre-employment checks. The staffing files checked showed that people were up to date with required statutory training, however it is recommended the home introduces a training matrix system for planning training which will make it easier monitor and plan. Care Homes for Older People Page 19 of 24 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. People living in the home benefit from a service that is being effectively and efficiently managed. Evidence: The home has been bought and taken over by a new Provider since the last Inspection and there is also a new Registered Manager in place. The new manager was previously the deputy and has worked at the home for several years. They are a qualified nurse and have also completed the registered managers award. A new system of quality assurance was being introduced with surveys and feedback being completed and collected. The process was still being developed at the time of this inspection but it does involve the people living in the home. The new owners are involved in the running of the service, usually spending two days a week at the home. The manager explained how a number of administrative changes are being implemented by the owners and that other aspects of the business processes were being reviewed and updated. Managers and staff spoken with were positive about the Care Homes for Older People Page 20 of 24 Evidence: changes and people also commented that the new owners were approachable and responsive to issues or concerns that were raised. They have taken on the responsibility for some staff supervisions and have also been completing regulation 26 reports, copies of which are stored in the home. The maintenance staff have the responsibility for ensuring safety checks are completed and recorded and all equipment is serviced. A sample of these records were seen and were up to date. All fire safety checks had been completed and recorded and all fire equipment had been serviced and maintained. Care Homes for Older People Page 21 of 24 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 22 of 24 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 2 9 30 All staff should complete accredited medication training before undertaking this task. The home should introduce a training matrix system for monitoring, planning and recording staff training. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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. 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