Care Home: Rushden Park Nursing Home

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What the care home does well What has improved since the last inspection? The requirements made at the last inspection have been addressed. The information received from the home and before the site visit, stated improvements have been made with the residents support plans, `end of life` care, for people that are terminally ill and all now have detailed risk assessments. Information leaflets have been provided on falls and MRSA for staff, and residents and relatives. There have been environmental improvements with the purchase of a new washing machine and dryers. Staff have been recruited to develop the existing social activities provided at the home, for individual and groups of residents. E-learning (electronic learning) facility has been introduced to the staff to enable staff to learn using the computer, specific modules on care practices, for their development and as part of the National Vocational Qualification. The complaints policy has been revised and updated following the appointed of the dedicated Director of Service Improvement within the Methodist Homes for the Aged, who has the responsibility to ensure all complaints, comments and compliments are dealt with promptly and how the complaint can be taken up at a higher level, if required. Rushden Park Nursing Home appointed a new manager to the home. The manager is in the process of submitting an application to the Commission to be the Registered Manager for the home. What the care home could do better: This was a positive site visit and inspection of Rushden Park Nursing Home. There was good evidence to demonstrate that residents and their relatives are informed on important issues that affect them, they have an opportunity to express concerns or make comments to improve the quality of life. Staff showed awareness in ensuring residents are safe and open to receive comments or concerns from residents and relatives. There was good evidence to show concerns are acted upon promptly to improve the quality of life for the individual resident. CARE HOMES FOR OLDER PEOPLE Rushden Park Nursing Home Melloway Road Rushden Northants NN10 6XZ Lead Inspector Rajshree Mistry Unannounced Inspection 7th May 2008 09:30 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 Rushden Park Nursing Home DS0000012639.V364066.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. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rushden Park Nursing Home Address Melloway Road Rushden Northants NN10 6XZ 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) 01933 418777 01933 418666 home.rus@mha.org.uk home.fxg@mha.org.uk Methodist Homes for the Aged Vacant Care Home 64 Category(ies) of Old age, not falling within any other category registration, with number (64) of places Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Rushden Park Nursing Home is permitted to utilise all of its available beds for either nursing or personal care only Rushden Park Nursing Home is permitted to admit up to 8 service users in the category of DE(E) on the first floor only To be able to admit into Rushden Park Nursing Home the 2 named persons of category PD named in variation application number V35111 No one falling within the category OP may be admitted into Rushden Park Nursing Home where there are 64 persons of category OP already accommodated within this home. To be able to admit into Rushden Park Nursing Home the named person of category PD named in the variation application number V38617 dated 5th February 2007 The maximum number of persons to be accommodated at Rushden Park Nursing Home is 64 18th September 2006 Date of last inspection Brief Description of the Service: Rushden Park is a 64 bedded, purpose built home on the outskirts of Rushden and is owned and run by Methodist Homes for the Aged. Rushden Park Nursing Home provides for elderly people requiring nursing or personal care. There are up to eight places for people with dementia and up to six places for people who are terminally ill. Rushden Park Nursing Home is situated in a quiet suburb of Rushden and is easily accessible by public transport. The premises are over three floors with the top floor devoted to a service area including the kitchen, laundry and staff training room. Residents are accommodated on the ground and first floor, which is accessible via the lift and the stairs. The majority of accommodation is provided in single rooms with en-suite toilet and wash facilities. There are 3 double bedrooms. Rushden Park Nursing Home offers spacious communal facilities including lounge and dining areas on each floor. Residents have access to a safe and pleasant garden area. The manager provided the following fees during the site visit on 7th May 2008, which ranges between £534 and £667. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 5 The fees include personal care and nursing care where admitted for nursing care, accommodation, meals and laundry. There are additional charges for services such as Chiropody, hairdressing services newspapers, clothing and personal toiletries. The latest CSCI Inspection Report is available at the home. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 6 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. This is a report of the findings of a thematic inspection. A thematic inspection is a short focused inspection that looks in detail at a specific theme. This thematic inspection looked at how well this service makes sure people are protected from abuse. We looked at whether this service has good procedures and training for safeguarding; how they recognise abuse and respond to allegations to protect the people who use their service. We call this ‘safeguarding systems’. We spoke to people who use the service, the manager and staff members. We also looked at staff recruitment records, training records and policies and procedures. We did this because we wanted to understand how well the safeguarding systems work and what this means for people who use the service. The findings of this thematic inspection will be used as part of a wider study on safeguarding. We will publish this report in the autumn of 2008. You can find further information on this, and thematic inspections, on our website www.csci.org.uk The inspection process consisted of pre-planning the inspection, which included viewing the last Inspection Report and the Annual Service Review carried out in February 2008. We review the information from the Annual Quality Assurance Assessment (AQAA) – the Provider’s self-assessment and the service history of significant events since the last inspection. Surveys were sent from the Commission for Social Care Inspection to service users and their relatives who were identified in the AQAA. The unannounced site visit commenced on the 7th May 2008 and lasted 1 day. The focus of the inspection is based upon the outcomes for the residents. The method of inspection was ‘case tracking’, which involved identifying residents with varying levels of needs and looking at how these are being met at Rushden Park Nursing Home. Discussions were held with the residents living at the home and visiting relatives. Records relating to the care they received were read with their permission. Discussions were held with staff that showed their knowledge and understanding the needs of the residents living at Rushden Park Nursing Home. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 7 Records were read in relation to the staff, training records, team meetings and management records of the home such as assessments of home risks and maintenance records. The CSCI sent out fifty-one surveys to residents, their relatives and fifty surveys sent to the staff. The surveys were not received at the time of producing this inspection report although any surveys received before the publication of this inspection report may include a summary of the survey responses received. Overall, the thematic inspection showed that people were given information about the home, which contains information about how to complain, details of the Advocacy service and the confidential helpline for advice and contact details for the Commission. Residents have named staff at the point of moving to the home who explains in detail the process of expressing concerns or making a complaint about the care home. Residents and their relatives were confident to speak with the staff, nurse on duty or the manager. Staff demonstrated had received training in ensuring residents are safe from abuse, aware of the procedures to report any suspicion of abuse and confident to report to the management team any concerns about unsafe or bad care practices. What the service does well: Rushden Park Nursing Home provides care to people requiring various levels of care and support from prompting to assisting with complex nursing care. Whilst Rushden Park Nursing Home is a Christian based home, they promote the care services for all people according care needs. Residents felt they process of moving into the home was well managed and they were confident the home would meet their individual care needs. The residents and visiting relatives were happy with the level of care and support provided; the variety of home cooked meals and the opportunity to fulfil their social, leisure and religious needs. Rushden Park Nursing Home has welcoming and relaxed atmosphere. The home is well maintained and decorated to a good standard with complimentary décor and furnishings. All bedrooms have en-suite facilities, are bright, light and personalised with personal items such as photographs and pictures that create a homely feel. Staff appear professional in their distinct uniforms and wear name badges to help people identify staff. Staff showed a lot of attention, care and compassion towards the residents and their visitors. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 8 Rushden Park Nursing Home is part of a national organisation with a number care services. The key policies and procedures are developed and reviewed nationally. The home recognises the importance of listening to people who use the service, encouraging people to express their views individually or collectively, express concerns and benefit from the use of the Advocacy service and the confidential helpline. What has improved since the last inspection? What they could do better: This was a positive site visit and inspection of Rushden Park Nursing Home. There was good evidence to demonstrate that residents and their relatives are informed on important issues that affect them, they have an opportunity to express concerns or make comments to improve the quality of life. Staff showed awareness in ensuring residents are safe and open to receive comments or concerns from residents and relatives. There was good evidence to show concerns are acted upon promptly to improve the quality of life for the individual resident. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 9 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. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 10 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 Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 11 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): 1 and 3. Standard 6 intermediate care is not provided. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive information about the service and are involved in the assessment process to ensure their needs can be met by the home. EVIDENCE: All prospective residents and relatives are given a copy of the home’s brochure with information about Rushden Park Nursing Home. The information is well written, providing good information about the different services it offers, the process of moving into the home, the range of staff skills to look after people and includes range of social activities. The range of fees is set out and key policies and procedures, which include the complaints procedure. The information is available in large print. The residents and relatives said they received information about the home and had an agreement in place. This was consistent with the information received Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 12 from the home before the site visit stating that all residents receive a comprehensive residential agreement on or before they move into the home. Four residents spoken with and a visiting relative said they had heard about the home and were involved in choosing the home. Two residents said they did visit the home on several occasions, and another said their relative visited to make sure their care needs would be met. Residents records viewed confirmed there was a thorough assessment of prospective resident’s needs is carried out before the admission to the home. The information gathered enabled the manager to decide whether the needs could be met by the home. Additional information was gathered from the prospective residents, their family and health staff as the resident prospective resident was in hospital. Comments received from the residents and relatives, indicated that they were involved in the assessment of their needs and the move to the home. The information received in the AQAA before the site visit to the home stated the Service User Guide is in an easy read style. The home’s satisfaction survey indicated that many residents would recommend Rushden Park Nursing Home to people. The Home is not registered to provide intermediate care. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 13 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ individual personal and health care needs are met safely through trained staff and systems for managing medication. EVIDENCE: The information received from the home before the site visit stated that every resident has an individual ‘support plan’ tailored to the individual care needs. The support plan gives guidance to staff as to how the resident wants the care to be provided. Residents and a visiting relative said they have been involved in drawing up their individual support plan, which has taken account of their health and care needs and their wishes. The support plans read for the residents tracked were personalised and comprehensive from caring for a resident with minimal care needs to complex health care needs, taking into account the resident’s Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 14 diversity and observance of their faith. The support plans showed the wishes of residents and included comments such as: “Likes her hair washed and set by the hairdresser” “Likes her teeth cleaned using an electric toothbrush” “. . . wishes to be presentable at all times” All the support plans read had a record of the assessment of risk carried out, which formed the basis to guide the staff providing the care. These included assistance with personal care, mobility, use of bed rails, oxygen cylinders, falls nutrition (monitoring food and fluid intake) due to problems with swallowing and pressure area care for a resident that remains in bed. Where residents are terminally ill, the support plans include ‘end of life’ plans, which have been developed with the resident’s wishes, family wishes and input from the GP’s and other health staff. These plans are written in a sensitive manner that respected the dignity and wishes of the resident. The care files for the residents also contained a record of visits made by General Practitioners, Parkinson Nurse and the District Nurse. Both care staff and registered nurses demonstrated a good awareness of the residents needs, aware of individual wishes and the level of support they required, consistent with the support plans. This showed the residents independence was promoted and they were making decisions. This was further supported by the comprehensive daily records made by the staff about the physical and emotional wellbeing of the resident. Residents and the visiting relative said they felt the care provided ‘could not be faulted’ for them. Residents said they were treated well and staff were always polite. The relative said that the staff were vigilant and when necessary have called the GP and informed the family. Comments received from the relative: • • • • “The staff are very good, thorough and would act quickly as they did when she became unwell and we were also told immediately”; “It’s a very good home, we only have praise” and “ . . ., nurse had concerns about my health and called the GP straightaway and the next thing I know I was admitted into hospital but I’m glad to be back at home” “Nurse acted really quickly when she started loosing weight” The medication is stored securely in the medication room on the first floor for all the residents on the first floor. Medication is pre-packed by the pharmacist in blister packs. The Home had a Pharmacy inspection in February 2008, which highlighted the issue of over stocking of medication. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 15 Residents said they would get their medication on time. One resident said she would count the number of tablets for the morning and lunchtime just to make sure. A comment received from a resident, “get my tablets on time but wasn’t asked from the usual pain-killer this morning”. The Inspector spoke with the registered nurse about the medication process. The registered nurse said they have specific responsibilities in that the senior carer are responsible for the giving medication to the residential clients and the registered nurses are responsible for the nursing clients. On checking the records for medication given out for three residents (nursing and residential), the records and medication for two residents were accurate. However, all but one medication, a painkiller, (to be given as and when) had not been given to the resident and marked on the record with the code ‘F’. From discussion with the registered nurse, it transpired that the medication had run out the previous day. The registered nurse was unable to confirm whether the medication had been re-ordered and the system for ordering repeat medication. The manager later confirmed that the prescription had been collected from the Pharmacy and she was is in the process of developing a robust system for ordering of repeat prescriptions. The manager demonstrated that she has already introduced Medication Competency for Nurses and this would be done in line with the review of the medication procedure. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 16 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ experience and enjoy a lifestyle that suits them; encouraged to pursue leisure and social interests; receive visitors and have a healthy choice of meals. EVIDENCE: On the day of the site visit residents were seen relaxing in various lounges within the home, or in their bedrooms. Some residents were seen receiving visitors and others were making their way to the ground floor lounge for the Church service. The atmosphere within the home was relaxed and residents were moving about the home freely or with some assistance from the staff. There is an Activities Organiser who is responsible for planning and arranging activities to suit the interests of the residents living at the home. There are two notice boards; one for the residents and another for relatives/visitors. The boards had photographs of social events that had taken place and also detailed the various activities provided at the home ranging from the Church service, Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 17 Bible reading, film shows, yoga, bingo and Garfield (chair aerobics) including residents and relatives meetings. The support plans contained details about the resident’s interests and hobbies. Residents said they enjoyed living at the home, felt they were able to continue with their individual interests such as Bible reading, doing quizzes and puzzles whilst able to participate in group events or social evenings. Another resident was looking forward to going out in the local shops with a member of staff after lunch. It was evident that the residents were making decisions about their day from what they wish to eat to how they wish to spend the day. Resident said a hairdresser visits the home and she likes her hair done by her in the salon. Visitors were seen welcomed into the home and greeted in a friendly manner by staff. A relative said they visit daily at various times of the day and usually go to the Church service with the resident on a Wednesday morning. Many of the residents spoken with said they felt part of the community and enjoyed having their family and friends visit. The residents spoke positively about the choice of meals provided at the home. The Chef said he meets with the new resident to find out what type of meals they enjoy, dislike and special dietary requirements such as diabetic or soft food. All the meals were seen being served at the dining table although residents can have their meals in their bedrooms. Staff were seen sensitively assisting individual residents with their meals. Comments received directly from the residents and visiting relatives about the social life at the home and meals supported the information received in the AQAA before the site visit. Comments received included: “Meals are nice, you get the menu choice for the next day” “Didn’t go to the service this morning because I wasn’t having a good day” (due to poor health) “A carer suggested she would take me for a short trip out for a little while after lunch and I’m quite looking forward to that” “I enjoy the church service this morning, the yoga, Bingo, Bible reading usually with . . . . and . . . ., although . . . . speaks very softly” “We now have film shows and I enjoy reading, television and quizzes” “The food is very good everyday” “I had lamb and trifle today and the lamb was beautiful” Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 18 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ are protected by good concerns and complaints process, and staff that are aware of their responsibilities for protecting the people in their care. EVIDENCE: The complaints procedure is clearly displayed at the entrance to the home and on the relatives’ and residents’ notice boards. The manager has introduced and placed a suggestion box outside the office and residents, relatives and staff can make comments anonymously. The manager said that she has received comments and made improvements for the individual or the way the home is run. Residents and relative said they were informed of the process to make a complaint or express concerns about the provision of care provided at Rushden Park Nursing Home. Residents said they had not experienced any problems or had any concerns about home. The residents and relatives were confident that the manager would act promptly if they had a concern. The complaints log showed that the service had received 3 new complaints, all were investigated and resolved with involvement from social services and the family. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 19 The information received from the home before the site visit stated there is a clear prevention of abuse policy and procedure for dealing with any allegations or suspicions, including a whistle-blowing policy which has 2 freephone confidential 24 hour lines (one for staff, and one for residents) both run by external agencies. The safeguarding adults policy for Rushden Park Nursing Home has a policy on safeguarding adult is in place, refers to the local multi-agency protocols and training provided during the staff induction. There is the Director of Improvements within the organisation, who is responsible for complaints about the care home and the contact details are displayed on the notice boards. Staff demonstrated knowledge, awareness and responsibilities in reporting concerns, allegations or any suspicions of abuse and were confident to whistle-blow poor or bad care practices. Comments received from the residents and relatives during the site visit included: “Doesn’t have anything to complaints about the home or the care he receives generally” “Never had to formally make a complaint because all you need to do is tell the staff, nurse or the manager” “I’ve spoken to staff before when I’ve not been happy” “I’m sure they would do something about it although I’ve not had a concern” Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 20 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and well-maintained home providing a pleasant environment to suit their needs. EVIDENCE: Rushden Park Nursing Home is situated in a residential area. The home is easily accessible for people using walking aids or wheelchairs, bright and welcoming reception area. Information about the home and other publications related to care services is located in the reception, which visitors can help themselves to, including tea or coffee. There are a number of communal lounges and dining rooms are on the ground and upper floor, furnished to a high standard with complimentary décor Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 21 pictures and fresh flowers. All the lounges have modern entertainment equipment: flat screen televisions and music systems. Residents’ bedrooms were personalised with pictures, photographs and ornaments to the resident’s taste. The décor in the bedrooms are colour coordinated with the soft furnishing and furniture. All the bedrooms have ensuite facilities. Additional bathroom and shower rooms are on both floors, which are equipment with hoists and shower chairs. Residents said they viewed the bedrooms before agreeing to move to the home. One resident was very happy with the bedroom as it over looked the garden and they could see the area where the family home was. Another resident and relative said they were happy with the bedroom, large enough to accommodate equipment and close enough to the nurses, in case of an emergency. The manager said the home has ensured couples are able to live together and have their privacy respected. The information received from the home before the site visit stated that there was a programme of maintenance and all staff receive training in infection control and health and safety. On the day of the site visit the maintenance person was seen replacing the smoke alarm. Throughout the site visit domestic staff and care staff were seen working in specific areas within the home. Staff were seen wearing gloves and aprons when assisting people with personal care, meals and handling residents laundry. Staff demonstrated good knowledge and practice to prevent the risk of cross infection and training records supported this. The manager said a representative from the management team within the organisation conducts monthly visits. A report of the last monthly visit showed that the environment is audited and identifies the areas for improvement. Comments received directly from the residents and relatives included: “Things have improved since . . . . (manager) has come in, you get your laundry on time” “The room is cleaned and the laundry is done – what more does one need” Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 22 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ are protected by good recruitment processes; staff trained and supervised, to care and support the people using the service. EVIDENCE: Residents and the visiting relative indicated that there were sufficient numbers of staff on duty: domestic staff, care staff and nurses. Residents spoke highly about the staff who assist them with the personal care. Residents appeared confident with the staff helping them with their daily care needs. A relative said staff were helpful, appeared to be trained and were confident when helping the residents with complex health conditions. The manager said that staffing levels have been increased and the ratio currently provided is 1 care staff to 5 residents, which was evident on the day. There is a trained registered nurse on each floor at all times. The staff rota is displayed in the reception area on the notice board for residents and relatives. All staff were seen wearing uniforms and name badges, which helped both residents and visitors to the home. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 23 Rushden Park Nursing Home has a robust recruitment procedure, based on equal opportunities policy. Four staff personnel files, indicated staff were appointed upon receipt of two satisfactory references, Protection of Vulnerable Adults (POVA) first check, Criminal Records Bureau (CRB) check and ‘Professional Identification Number’ (PIN) for registered nurse. This was consistent with the information received before the site visit and from discussion with staff on duty. The manager said since taking up the position as the manager, staff files have been audited to ensure that pre-employment checks were received and the training matrix is being developed to ensure staff training is up to date. Staff confirmed they underwent a programme of the home’s induction in line with the Skills for Care Foundation guidelines and the needs of the residents living at the home. Several staff are benefiting from e-learning, which is computer based learning recently introduced to the staff. Several staff have completed training on-line and spoke postively about the training provided. The staff training matrix showed the range of training provided to staff from Protection of Vulnerable Adults in March 2008; medication training; moving and handling, infection control tissue viability, personal care, peg feed, pallative care, dementia awareness, health and safety and fire risks. The manager said all registered nurses are having medication competency and further training would be identified as a result. The manager confirmed 80 of the current staff have attained or completing National Vocational Qualification level 2 and above in care. Staff spoken with confirmed they have received supervision and minutes of the meetings are kept on the individual staff files. This was supported by the information received from the home before the site visit and the plan of supervision and appraisals dates seen during the site visit. Staff confirmed they have staff meetings; senior staff meeting, care staff and night staff. The minutes of the last meetings were read. Staff said they could approach senior staff and management team for advice and support. The comments received directly from residents and relatives on the day included: “I’ve found the staff always treat me well, are polite and always know my name but I sometimes forget there’s” “ . . . she has not had to take the oxygen since being back as the temperature in the home is stable and staff keep a close eye on her”. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 24 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): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home, having opportunity to express and contribute their views that measure the quality of the service. EVIDENCE: Rushden Park Nursing Home has a new manager in post who has experience of managing a care home. The manager said she is in the process of submitting her application to the Commission to be the Registered Manager for the home. The management of home was evident by the way the staff were organised, indicated staff had clear roles and responsibilities. The management and Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 25 staffing level for the home was reflected in the staff rota viewed and the staff on duty. The information received from the home before the site visit indicated that all policies and procedures are updated and reviewed regularly. Staff demonstrated awareness of the policies, procedures and their responsibility. Staff were confident that the manager or the deputy manager would be available if there was an emergency. Residents and relative confirmed that they are encouraged to express themselves views, ideas and opinions that would improve the quality of lifestyle provided. The residents meetings have been held after the Church service and the dates of the next relatives meeting is planned on 16th June 2008, when guest speakers also attend to share information on particular topics of interests such as dementia. The information received from the home before the site visit stated that the organisation had conducted a quality assurance audit. The findings from the audit were provided to the Commission after the site visit, which indicated that the overall standard of care provided at Rushden Park Nursing Home in 2007 was close to the national average across all the homes within the Methodist Home for the Aged. The satisfaction survey looked at the provision of care, meals, social and leisure interests and the home environment such as cleanliness. Residents spoken with indicated that they have individual arrangements. Residents either they manage their own money, some with the support of their families and others prefer to have their money held in safe-keeping by the home, for which records of the expenditure and balances are kept. The information received from the home before the site visit stated that the servicing and testing of equipment; gas and electrical testing are carried out at annually. Risk assessments are in place for the home, service users and staff. Rushden Park Nursing Home has a planned programme of maintenance and record of checks carried out are kept up to date. Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 26 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 3 X 3 X X N/A 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 3 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 Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 27 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. Refer to Standard Good Practice Recommendations Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Rushden Park Nursing Home DS0000012639.V364066.R01.S.doc Version 5.2 Page 29 - 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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