Care Home: Queen Margaret`s Nursing Home

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What the care home does well The home was well equipped with comfortable furniture in both communal areas and in people`s bedrooms. The home was clean and fresh and some communal areas and bedrooms had been redecorated. People`s care needs were assessed prior to moving into the home to make sure that the home could meet their requirements. One person told me they had visited the home before moving in and had been made very welcome on the visit. A relative said `the staff are marvellous they make the people who live here very comfortable. They are all kind and compassionate.` People said they enjoyed the food they were given and said that there was a good choice. One person said `the meals are great, I really enjoy my breakfast, I can have it in my bedroom the staff ask me what I want and bring it for me in my room`. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. What has improved since the last inspection? Since the last inspection a new manager has been appointed to the home. Since she has started she has worked very hard with all the staff to improve the standard of service people receive at the home. All paperwork associated with planning peoples care to make sure they get the care they need and that theyare looked after safely has been updated and a computerised care planning system is now in place and updated properly. The way in which people`s medication is stored and administered has also been improved. New lockable medication cupboards have been fitted to each floor in the home, and the manager and deputy manager now undertake regular medication audits to ensure that medication is stored correctly and that staff are following the homes policy and procedure when administering medication. Staff records are now up to date with all the recruitment and training details completed. The home has undergone some refurbishment. Some communal areas have been redecorated and a bathroom has been converted into an assisted shower room, offering people a choice of a bath or a shower. What the care home could do better: The manager needs to continue with the improvements she has planned for the next year. The planned refurbishment of communal bathrooms needs to continue and the carpet that is taped in the communal areas needs attention, although it is safe it gives the impression that the carpet is really shabby. The provider Mr Davey, confirmed that he was looking into purchasing a new carpet. CARE HOMES FOR OLDER PEOPLE Queen Margaret`s Nursing Home Queen Margaret`s Nursing Home 19 Filey Road Scarborough North Yorkshire YO11 2SE Lead Inspector Bridgit Stockton Unannounced Inspection 21st November 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queen Margaret`s Nursing Home Address Queen Margaret`s Nursing Home 19 Filey Road Scarborough North Yorkshire YO11 2SE 01723 353884 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Hawkfish Limited Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (1), Terminally ill (4) of places Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The category of registration PD, relates solely to one identified service user and registration will be amended to remove this category at such time as the identified service user is no longer accommodated in the home. The registered persons must advise the Commission when this occurs. The bathroom currently located in room 25 must be re-located to a more suitable site on the same floor within eighteen months of registration. Room 44 will cease to be used as a bedroom as soon as vacated by the service user curently occupying the room. All service users` bedrooms must be equipped with a lockable facility, and bedroom doors must be fitted with suitable locks within eighteen months. Rooms 30, 31,32,38,39 and 40 must be occupied only by service users whose assessed needs are that they would not be adversely affected by being unable to see out of the window when seated. 24th October 2007 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Queen Margarets Nursing Home is a care home providing nursing care, personal care and accommodation for up to forty-four older people. The home is owned by Hawkfish Limited. The service is located on the south side of Scarborough, close to shops, the post office and a main bus route. Queen Margarets is a large detached Victorian building. It has a basement plus four floors. These are serviced by two passenger lifts. There are fortytwo rooms in total. All rooms have a wash hand basin. Twenty-seven rooms have a full en suite facility. There is a garden area to the front and side of the property and this is accessible to the service users. There is also a large car park. Information about the services available at the home is made available in the form of a service user guide and the most recent Commission for Social Care Inspection report is available in the home. Individual copies are provided on request. The scale of fees charged on 24/10/07 range from the current NYCC rate to £500 per week. Additional charges are made for hairdressing, chiropody, personal newspapers and outings. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Queen Margaret’s Nursing Home. The methods I used to gather information included a visit to the home, conversations with the people who live there, their relatives, healthcare professionals and the staff. I looked in detail at the care and records of two people, examined other records and looked around the home. I spent four hours at the home. The manager also completed some paperwork for us called an annual quality assurance assessment. This provides valuable information to help me form a judgement about the quality of service offered at the home What the service does well: The home was well equipped with comfortable furniture in both communal areas and in people’s bedrooms. The home was clean and fresh and some communal areas and bedrooms had been redecorated. People’s care needs were assessed prior to moving into the home to make sure that the home could meet their requirements. One person told me they had visited the home before moving in and had been made very welcome on the visit. A relative said ‘the staff are marvellous they make the people who live here very comfortable. They are all kind and compassionate.’ People said they enjoyed the food they were given and said that there was a good choice. One person said ‘the meals are great, I really enjoy my breakfast, I can have it in my bedroom the staff ask me what I want and bring it for me in my room’. There are thorough recruitment and selection procedures in place, to make sure that staff are suitable and safe to work with the people who live at the home. All the staff receive a range of training to equip them with the skills and knowledge they need to do their work properly. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. People’s needs are properly assessed prior to admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans I looked at showed that comprehensive pre-admission assessments had been carried out before offering someone a place. This is to make sure that the home can meet the person’s needs. A senior member of staff (usually the manager) visits the person at home, or in hospital to discuss their care needs. Social Services assessments are also used to determine this as well; these were also available to look at. People are welcome to visit the home before reaching a decision. The home does not provide intermediate care. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. Systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: I looked at two care plans in detail, to make sure that people’s health and personal care needs are being met in the way the person prefers. On the whole the plans demonstrated that people are in receipt of individual planned care and support. A computerised system of care planning is used at the home with only minimal written records kept. The manager told me that people can view and agree the plan of care with the staff via a large television screen that has been linked to the system. The plans are displayed on the large screen and makes reading the plan easier. Since the last inspection new locked medical cupboards have been installed on all of the floors throughout the home. Staff confirmed that this had made medication administration easier and the storage of the tablets much better. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 10 Regular audits of medication now take place. The medication administration records were looked at and found to be completed properly. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. One person said that the ‘girls are nice and kind to us all’, another said ‘ nothing is a bother for the staff they are just great.’ Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. The recreational and social needs of people are well catered for which enables them to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During my visit the atmosphere in the home was friendly and welcoming, with visitors coming and going throughout the day. Some people were enjoying chatting with each other; some were listening to music or else reading. I spoke to the activities organiser who explained that she did group activities and one to one sessions with people. Activities included church services, bingo and cinema afternoons outside entertainers also visit the home. A program of activities was on display in the home. Everyone said the food was good, and a choice of meals were offered. The cook was very knowledgeable about what people liked to eat. People told me they enjoyed the food that they were given and that it was nicely cooked. One person said the food was ‘tip top’ another said ‘the food is always nicely presented, and very well cooked, we get really well fed here’. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. People can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. People who live at the home told me they would speak to the manager or any of the staff if they had any concerns or complaints. Staff told me that training has taken place in the protection of vulnerable adults in abuse. I looked at four personnel files and found that staff recruitment procedures were adequate and staff were employed and deployed following appropriate checks. The manager and staff team were clear and confident in the protection of vulnerable adult procedures. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. People live in a safe, comfortable, well maintained and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is fresh, clean and comfortable. Everyone who commented agreed that the home is always, or usually well kept. One visitor to the home said ‘ it’s always nice and fresh, there is never any nasty smells lingering when you come through the door’. All the bedrooms that I saw reflect the person’s individual preferences and taste. There is a programme of re-decoration for the bedrooms, as well as for the rest of the home. The manager told me that bathroom refurbishments are planned for the new year. Some carpets that were identified during this inspection require replacing. The strips of silver tape placed across the top of the carpets make the home look shabby. A plan is in place to replace this carpet however it remains an outstanding issue from the previous inspection. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. People can be confident that staff are trained and on duty in sufficient numbers to meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas and staff numbers suggest that there are enough staff on duty at all times to meet the needs of the people who live at the home I looked at a selection of staff files. They all included completed application forms and two written references. The files showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks have been obtained. I was assured that no new member of staff starts work until a POVA register check had been completed. Then, if the CRB check had not been received, they would work only under the supervision of an experienced staff member. The manager makes sure that staff have the necessary training to help them do their work as well as possible. There is a wide range of courses available and the records confirmed that the staff are allowed the time to attend. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good The home is safe and well managed and people who live and work at the home can contribute to the decision-making processes. This judgement has been made using available evidence including a visit to this service EVIDENCE: The manager has the qualifications and the skills to manage the home. The home is about to send questionnaires to relatives, in order to gain information about how people view the service and what improvements they would like to see. Policies and procedures are being reviewed and updated by the new manager; this is to make sure they provide relevant information to guide staff on how to act in every situation. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 16 All the regular health and safety checks for the home are carried out in a timely manner. Staff have basic health and safety training, fire training and moving and handling updates. All these measures make sure that the health, safety and welfare of the people who live at the home is promoted and safeguarded. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations The flooring that is taped over in the communal area neds replacing. Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Queen Margaret`s Nursing Home DS0000040909.V373607.R01.S.doc Version 5.2 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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