Care Home: Northfield House Residential Home

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What the care home does well There was a homely atmosphere at the service, people living at the home appeared relaxed and comfortable. Staff had a good knowledge and understanding of peoples individual needs. A staff training and development programme was ongoing. Ninety five percent of care staff had completed National Vocational Qualifications in care at level two. What has improved since the last inspection? Since the last inspection the alarm call system has been updated. Thermostatic valves have been fitted to all hot water sources, this minimizes the risk of scalding for people living at Northfield House. What the care home could do better: Care records should contain information for staff regarding all assessed needs and peoples individual preferences, this is to ensure that all needs are met and people receive care that meets their expectations and preferences. More staff training is required about safeguarding adults so that staff follow national and local policies and procedures about safeguarding, this is to keep people safe and protect them form abuse. At the time of this inspection there was not a separate fridge for storing medicines that require refrigeration. This is required in order to comply with regulations and to ensure safe storage and management of medicines. Some attention is required to the decor in corridors and in some peoples personal rooms, this is to ensure that all parts of the home are of an acceptable standard for people living there. A door must be fitted to the downstairs toilet in order to ensure that peoples privacy and dignity is maintained. Advice should be sought regarding signage around the home which would support people with dementia. Key inspection report Care homes for older people Name: Address: Northfield House Residential Home 1362 Melton Road Syston Leicester Leics LE7 2EQ     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: Debbie Williams     Date: 2 2 0 7 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 Residential Home 1362 Melton Road Syston Leicester Leics LE7 2EQ 01162607107 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): muniramawji@hotmail.com AMAFHH Care Homes Ltd Name of registered manager (if applicable) Mrs Elizabeth Pickersgill Type of registration: Number of places registered: care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 19. The registered person may provide the following category of service only: Care home only, Code PC to service users of the following gender:Either whose primary care needs on admission to the home are within the following categories Old age, not falling within any other category, Code OP Dementia, not falling within any other category, Code DE Physical; disability, not falling within any other category, Code PD Date of last inspection Brief description of the care home Northfield House is a care home for older and is registered to accomodate up to 19 people requiring care because of old age, physical disability or dementia. The home is Care Homes for Older People Page 4 of 24 Over 65 0 19 0 19 0 19 Brief description of the care home situated on the outskirts of Syston and is close to local shops and amenities. Accomodation is over two floors. There are two lounges and a dining room on the ground floor. Information regarding weekly fees, terms and conditions of residency can be obtained form the registered provider. A copy of the last CQC inspection report was available at the home. 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: The main method of inspection used was case tracking this meant selecting three residents and tracking the quality of their care through checking records, discussion with them and observation of care practice. We also looked at the providers Annual Quality Assurance assessment which they sent us, this provides information about what has happened at the service since the last key inspection. During this inspection we spoke with four people who live at the home and one visitor. We also spoke with care staff and with the registered provider. Care Homes for Older People Page 6 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 7 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 8 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 moving into Northfield House have their needs assessed and are provided with the information they need to make an informed choice. Staff have the skills required to meet peoples specialist needs. Evidence: The providers have produced a Statement of Purpose and a service users guide. These documents set out the the aims and objectives of the service and provide prospective residents with the information they need to make an informed choice. The service users guide states that the service does not discriminate against people on the grounds of ethnicity, religion or culture. A needs assessment is completed before people move in and this ensures that the service can meet peoples needs. People moving into the home are offered a one month trail period before deciding Care Homes for Older People Page 9 of 24 Evidence: whether to move in permanently. A contract setting out terms and conditions of residency is provided to people after this time. An assessment of needs is included within care records and this includes risk assessments. Assessment records seen set out peoples basic needs and potential risks but could be more detailed so that staff have a fuller picture of the person moving in and can therefore meet their needs. This is particularly important for people who have dementia who may be less able to communicate their needs and preferences. Staff employed at Northfield house have the skills required to meet the specialist needs of people living there. Ninety five percent of care staff have achieved a National Vocational Qualification in care. Care staff have also completed training in caring for people with dementia. Care Homes for Older People Page 10 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 at Northfield House have their health and personal care needs met. Care planning and medication storage procedures need to meet national minimum standards. Evidence: We case tracked three people living at Northfield house and looked at their care records. Care plans were in place and while they did specify some individual preferences, they did not address all assessed needs and were limited in detail. However, we spoke with care staff and observed care practice and it was evident that staff knew residents well and were aware of their individual needs. It was evident form care records and from speaking with people living at Northfield House and their relatives that people had good access to health care services such as GPs, community nurses, opticians and hospital appointments. People spoken with said that staff called out the GP or took them to the GP surgery whenever this was necessary. Care Homes for Older People Page 11 of 24 Evidence: We looked at medication administration records and storage areas and found that records appeared accurate and up to date. Staff responsible for administering medication had received appropriate training. People spoken with said their medication was managed effectively and staff brought it to them at the correct time. Medication was reviewed by a GP on a regular basis. Interactions observed between residents and staff appeared positive and respectful. People spoken with said that staff were always pleasant. Care Homes for Older People Page 12 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 living at Northfield House are able to exercise choice and control over their lives and have their individual needs and preferences met. Evidence: People spoken with said they were able to make choices about how to spend their day and that staff were flexible in order to meet their needs. Care plans seen stated how people preferred to spend their time. There are no restriction on visiting and people said their visitors were made welcome and offered a cup of tea. People spoken with said they were happy with the range of activities on offer. It is recommended that staff formulate individual care plans for peoples social and recreational needs. For people with dementia, information collected from individual social and life histories could be used to find appropriate meaningful activities. People living at Northfield house were able to observe their religious practices.The notice board outside the lounge provides information regarding advocacy services, activities on offer and the days menu. A notice stated that tea or coffee was available 24 hrs a day. We observed the lunch time meal that was served during this inspection, the meal appeared appetizing and nutritious, staff were seen assisting residents in a Care Homes for Older People Page 13 of 24 Evidence: sensitive manner. The dining room was congenial and the atmosphere was calm and relaxed. People spoken with told us they were satisfied with the quality and quantity of the meals provided. Care Homes for Older People Page 14 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. People living at Northfield House were confident that staff would listen to any complaints and take appropriate action. Evidence: People spoken with said they would feel confident raising concerns with the acting manager or owner and felt they would be listened to and appropriate action taken. People spoken with were aware of the providers complaints procedure. Care plans were not in place for managing aggressive behaviour. However, staff spoken with were aware of how to respond in such circumstances in order to keep people safe. Staff spoken with had received training in safeguarding vulnerable adults and were able to demonstrate a good understanding and awareness of safeguarding adults polices and procedures. Not all incidents of unexplained injury were fully investigated or referred to the appropriate social services safeguarding team. The provider had attended the safeguarding training provided by the local authority and said they planned to disseminate this to all staff. A recommendation was made that the acting manager also attend this training in order to ensure that all potential safeguarding concerns are managed effectively in line with national safeguarding policy. Care Homes for Older People Page 15 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Northfield House provides a clean and comfortable environment but some parts of the home were not decorated to an acceptable standard. Evidence: We undertook a partial tour of the premises and looked at the private rooms of people we case tracked. The home has two lounges and a separate dining room on the ground floor. All communal areas were accessible to people with disabilities. The lounge and dining areas were decorated and furnished in a homely way and provided a comfortable and attractive environment for people living at Northfield House. Some general redecoration was required in communal areas in order to bring the environment up to an acceptable standard for people living at Northfield house.The provider told us an ongoing programme of maintenance and redecoration was in progress. One of the communal toilets on the ground floor did not have a door and a shower curtain was used to provide privacy, a requirement was made that a door be fitted. All areas of the home were found to be clean and fresh and people spoken with said their rooms were cleaned daily. Staff had received training in infection control this minimized the risk of cross infection for people living at Northfield House. Care Homes for Older People Page 16 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. People living at Northfield House were looked after by well trained and competent staff. Evidence: Residents and staff spoken with felt that staffing numbers were sufficient to meet peoples needs. A staff training and development programme was ongoing. All new staff have to complete induction training when they first commence employment. We looked at staff training records and found that staff attended regular training courses. Ninety five percent of care staff had achieved a National Vocational Qualification level two in care and seventy five percent a level three. Training to meet the specialist needs of people living at Northfield House was also provided as was training in the safe management of medication. People living at Northfield house and visitors spoken with felt that staff were trained and competent. We looked at staff records and found that all relevant Criminal Record Bureau checks and references had been obtained for all care staff employed. Care Homes for Older People Page 17 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. The health, safety and welfare of people living at Northfield House was protected. Evidence: At the time of this inspection there was an acting manager in charge of the home. The acting manager was skilled and experienced and had a good understanding of peoples needs. Staff spoken with said they were supported by the manager and owner. The provider told us they undertook quality assurance audits and this included sending out satisfaction questionnaires to residents and relatives. Staff working at Northfield House had received all mandatory training required to promote health and safety. The providers told us that all routine maintenance and safety checks had been carried out. We looked at records for fire safety and equipment testing and found that all necessary checks and maintenance had been carried out. Since the last inspection, the Care Homes for Older People Page 18 of 24 Evidence: alarm call system had been updated and thermostatic control valves had been fitted to all baths and basins in the home, this is to reduce the risk of scalding. Care Homes for Older People Page 19 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 20 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 1 7 15 Care plans must be in place for all assessed needs. Care plans should be generated from a detailed needs assessment and should include peoples individual preferences. Care plans and risk assessments should be evaluated at least monthly and staff should include any actual changes or occurrences instead of just signing. Daily records should also be more detailed as to the actual wellbeing or otherwise of the resident. 30/10/2009 This is to ensure that staff understand and are able to meet peoples individual needs. 2 9 13 Medication must be stored securely and in line with guidance from the Royal 20/11/2009 Care Homes for Older People Page 21 of 24 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 Pharmaceutical Society. A separate fridge for the storage of medication which requires refrigeration must be available. This is to ensure the safe storage and management of medicines in order to keep people safe. 3 18 13 National safeguarding policies and procedures must be adhered to. All incidents of unexplained injury must be referred to social services for investigation. This is to promote safety for people living at Northfield House. 4 18 13 Staff must be given clear instruction within individual care plans regarding the management of challenging behaviour. This is to promote safety for people living at Northfield House. 5 20 23 A door must be fitted to the toilet on the ground floor. This is to protect the privacy and dignity of people living at Northfield House. 01/11/2009 30/10/2009 30/10/2009 Care Homes for Older People Page 22 of 24 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 6 20 23 Some general redecoration is required in some of the communal areas of the home. This is to ensure that all areas of the home are of an acceptable standard. 20/11/2009 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 3 A more thorough and detailed needs assessment would provide more information for staff about peoples needs and preferences. A life profile which includes peoples social and life histories would assist staff caring for people with progressive communication difficulties. It is recommended that staff formulate individual care plans for peoples social and recreational needs. For people with dementia, information collected from individual social and life histories could be used to find appropriate meaningful activities. The acting manager should also attend the local authorities safeguarding training and ensure that all staff are aware of what action to take to keep people safe. It is recommended that the providers seek advise about signage within the home to support people with dementia. This is to support people with dementia to orientate themselves within the home. 2 12 3 18 4 19 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. 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. 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