Care Home: Retired Nurses National Home

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What the care home does well The relationship between the Registered Manager and her new management team is positive and enthusiastic and one of openness with the Commission. The home continues to improve the quality of furnishings and decoration within the home, with the purchase of new equipment and furniture being evidenced at this inspection visit. The implementation of a thorough risk assessment process was clear throughout the home and in both the home`s records and service user records. The home manages and cares for those service users who have become frail, dependent or have temporary nursing needs particularly well. Service users receiving a high level of care spoke very highly of the staff and of the care they have received. Good methods of barrier nursing and intensive care packages was observed for a service user who is receiving palliative care. Service users have a strong voice in this home and are actively involved in decisions about the running of the home, and there is an active gardening group/committee in place. What the care home could do better: Whilst touring the premises some white substance in an unlabeled box was found in a laundry room. We were told that this was washing powder. Whilst this laundry room isonly used by those people living in a supported living unit attached to the home, this room is still within the walls of the residential unit, and as such can be entered into by the service users. This is clearly a risk, and following discussion with the head of care, the Registered Manager gave assurances that this would be rectified immediately. Discussions were held with the senior management team, about the further inclusion of service users and their relatives in the decisions about running the home. Some suggestions were made about a relatives meeting and developing the role of a service user committee and allowing service users to chair the resident meetings. Whilst most care plans were comprehensive, a couple of examples were discussed with the Head of Care and Registered Manager, whereby the level of detail required could be improved. One example of this was where the care plan states a service user has `poor hearing`. The care plan does not state however, what the service user requires in terms of care and support, do they have a hearing aid, or require things written down for them for example. Random inspection report Care homes for older people Name: Address: Retired Nurses National Home Riverside Avenue Bournemouth Dorset BH7 7EE three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sharon Goldsworthy Date: 2 9 0 6 2 0 1 0 Information about the care home Name of care home: Address: Retired Nurses National Home Riverside Avenue Bournemouth Dorset BH7 7EE 01202396418 01202302530 rnnhoffice@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elaine Brace Type of registration: Number of places registered: Conditions of registration: Category(ies) : Trustees, Retired Nurses National Home Limited care home 52 Number of places (if applicable): Under 65 Over 65 52 old age, not falling within any other category Conditions of registration: 0 One named person (as known to CSCI) under the age of 65 may be accommodated to receive care. Date of last inspection Brief description of the care home The Retired Nurses National Home is a long established care home located in a purpose built building on the outskirts of Bournemouth. The home enjoys a semi-rural situation, yet is within half a mile walking distance of a local superstore (food, clothing, electrical goods, newspapers/magazines) Local buses are also available approximately half a mile from the home, travelling to Bournemouth, Christchurch and beyond. The home stands within extensive attractive grounds offering numerous seating areas. Car Care Homes for Older People Page 2 of 9 Brief description of the care home parking is available for visitors. The home is registered to accommodate up to fiftytwo older people. Ramps are available to assist access to the home. Accommodation is arranged on the ground and first floors, with a passenger lift and stairs between floors. All bedrooms are for single occupancy; thirty-five bedrooms have en-suite facilities. There are sufficient communal bathrooms and WCs available on each floor. There is a spacious dining room and two sitting rooms. The home has its own chapel, reading room and hairdressing salon. The Retired Nurses National Home is a registered charity and has recently extended the criteria for permanent admissions to include some other medical professions, as well as nurses. The home also provides short-term or respite care, including for those who are not from a nursing or allied professional background. Trustees have overall responsibility for the functioning of the home, which is managed on their behalf by Mrs. Elaine Brace. 24-hour personal care is provided, as well as all meals, laundry and domestic services. A range of activities is available to provide stimulation and interest for residents. Occasional outings are arranged. All meals are prepared and cooked within the home. Special diets can be catered for. The fees for the home, as confirmed to the Care Quality Commission (CQC). Care Homes for Older People Page 3 of 9 What we found: We visited the Retired Nurses National Home on the 29th June 2010 at 10am. This visit was unannounced and took place over four hours. Mrs Elaine Brace the Registered Manager was present throughout this inspection visit. We were also introduced to persons in the recently recruited posts of Head of Care and Policy and Training Coordinator. Both members of staff have worked in the home for many years. These posts support both the manager and staff. This new management team were enthusiastic and keen to talk about the changes that have been implemented since the last inspection and taking up their new posts and both played a positive role in this inspection visit. The purpose of this inspection was to review the care in the home to look at the environment, recent records relating to health and safety, complaints and safeguarding, staff recruitment and to have discussions with staff on duty and a small selection of service users. Two files were examined for people living in the home. Each file held comprehensive details ensuring all staff were fully aware of the needs for each person. Records relating to the care a service user has received, were detailed and accurately reflected the level of need. Food and fluid records are implemented on the recommendation of District Nurses. We spoke to one very dependent service user in their room. This particular service user is currently being nursed in bed. She was complimentary of the care she receives. She looked well kept and her room was clean, fresh and well maintained. A drink was on her bedside table, with a cup suitable for her needs, and she was able to reach this and take fluids on her own when required. Staff were observed carrying out regular checks and records demonstrated a good level of care being provided. We spoke to another service user who had required some hospital care and had recently returned to the home following a short admission. She spoke highly of the staff at the home and the care and attention she had received since returning home. We observed mealtime briefly in the main dining room. The atmosphere was very calm and relaxed and service users were seen to be offered choices, and those requiring assistance were being given this discreetly. We looked at and found the most recently recruited staff members records were robust and complete. They included a completed enhanced Criminal Record Bureau check, a copy of the persons ID, two proofs of address, two references and contract of employment. A comprehensive induction programme exists and these were found to be in progress for the most recently recruited members of staff. A tour of the premises and discussion with the Registered Manager confirmed that the home is well maintained. Bedrooms occupied were found to be personalised. There is a discreet system in place of labeling bedroom doors where a service user has an acquired infection such as MRSA. In these rooms were aprons, gloves and suitable hand wash and lotion for barrier nursing. We were fully informed of these where appropriate and offered appropriate guidance from the Head of Care when entering these rooms to speak with Care Homes for Older People Page 4 of 9 service users. There have been a number of new nursing beds, hoists and wheelchairs purchased for the home. Appropriate risk assessments were seen to be in place for this new equipment. The home offers facilities for relatives to stay overnight within the home. There is also a dedicated hairdressing room and chapel. One of the lounge rooms has several computers for service user use and a large TV screen. The large gardens are well kept, with plenty of suitable seating, raised garden beds and the service user gardening group has just purchased a greenhouse. The accident book was examined and showed that all accidents recorded were also followed up in individuals daily records with medical intervention if required either by the GP or local hospital. The homes insurance policy is up to date, as were all relevant health and safety checks. The home keeps comprehensive records of all checks carried out and detailed and comprehensive risk assessments are in place. The home now has a health and safety committee that reviews and monitors all issues and recommendations made as a result of risk assessments carried out. A complaints procedure was seen in the main hallway and is included in the homes statement of purpose and service user guide. There have been no complaints or safeguarding alerts since the last inspection. The Registered Manager was able to demonstrate through resident meeting and staff meeting minutes that all suggestions and minor complaints are taken seriously and dealt with promptly. The Registered Manager attends all resident meetings and reported that she spends time in the home with service users as often as she can. What the care home does well: What they could do better: Whilst touring the premises some white substance in an unlabeled box was found in a laundry room. We were told that this was washing powder. Whilst this laundry room is Care Homes for Older People Page 5 of 9 only used by those people living in a supported living unit attached to the home, this room is still within the walls of the residential unit, and as such can be entered into by the service users. This is clearly a risk, and following discussion with the head of care, the Registered Manager gave assurances that this would be rectified immediately. Discussions were held with the senior management team, about the further inclusion of service users and their relatives in the decisions about running the home. Some suggestions were made about a relatives meeting and developing the role of a service user committee and allowing service users to chair the resident meetings. Whilst most care plans were comprehensive, a couple of examples were discussed with the Head of Care and Registered Manager, whereby the level of detail required could be improved. One example of this was where the care plan states a service user has poor hearing. The care plan does not state however, what the service user requires in terms of care and support, do they have a hearing aid, or require things written down for them for example. 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 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 38 13 Ensure that all cleaning materials are kept in their original packaging, and are stored securely. To ensure that service users are not placed at risk of harm when using substances that may cause harm. 29/07/2010 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 15 24 Further expand the level of detail in care plans to reflect the actual level of care or support required by an individual. Continued consideration be given to expanding the role of both service users and their relatives in meetings concerning the running of the home. Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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