Care Home: The Hurst Nursing Home

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The Hurst is a small nursing home that provides individualised care to everyone living there. Each person has their needs assessed before a decision is made about them moving in and a detailed plan of their care is then drawn up. There is an induction and training programme and more than 50% of the care staff have achieved a National Vocational Qualification (NVQ) at level two or above. The staff spoken with said that the staff team work well together and feel well supported. There is a programme of activities for people to enjoy. The home uses local suppliers for food and all meals are freshly cooked on the premises; people said that they enjoy the food. People we spoke with said that they receive the care that they need and that the staff are very good. What has improved since the last inspection? The recruitment process has been improved and all the required checks are carried out before people start work to make sure that people living in the home are protected. The programme of activities has been reviewed to make sure that people have the lifestyle they would choose. All staff have completed training in safeguarding vulnerable adults and are confident about their responsibilities to report any concerns that people may be at risk of harm. The providers carry out Regulation 26 visits and provide a written report as part of the quality assurance process. What the care home could do better: A new manager has been appointed and the group manager said that she would make sure that an application for registration with the Commission would be made without delay. Key inspection report Care homes for older people Name: Address: The Hurst Nursing Home 1 Mill Road Worthing West Sussex BN11 4JR     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: Annette Campbell-Currie     Date: 1 4 0 5 2 0 1 0 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 25 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Hurst Nursing Home 1 Mill Road Worthing West Sussex BN11 4JR 01903236935 01903236566 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Lotus Care 1 Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 22 The registered person may provide the following category of service only: Care home with Nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following catergories: Old age, not falling within any other category - (OP) Date of last inspection Brief description of the care home The Hurst is a care home offering nursing and personal care for up to 22 older people. It is situated in a quiet residential area of Worthing. It is a detached corner property with a well-maintained garden. Accommodation is available on three floors and there is passenger lift access. One room is accessed from a mezzanine between floors and there is a stair lift available. Two rooms are shared. All areas are well decorated in a homely manner. Care Homes for Older People Page 4 of 25 Over 65 22 0 0 4 0 1 2 0 1 0 Brief description of the care home The registered providers are Lotus Care. There is currently no registered manager in post. The fees are from £600 to £730 per week. Care Homes for Older People Page 5 of 25 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 quality rating for this service is two star. This means that people who use the service experience good quality outcomes. The previous key unannounced inspection took place on 4th January 2010, at that time the home was assessed as providing poor quality outcomes for people living there. Four requirements were made including an immediate requirement regarding the need to ensure that the recruitment process protects people living in the home. We requested an improvement plan and the provider sent us a detailed plan of how and when improvements to the service would be made. During this visit we found that all the requirements have now been met. We (the Commission) carried out the site visit over three and a half hours. The registered manager left the home at the end of April. The acting manager and group manager for the company assisted with the inspection. There were eighteen people Care Homes for Older People Page 6 of 25 living in the home at the time of the visit. Before the inspection in January we sent out surveys to find out what people think about the home. The comments that people made have been used to help make an assessment of the service. During the site visit we spoke with four people living in the home, one relative who was visiting the home and two members of staff including the cook. We saw the communal areas of the home, the toilets, laundry room, sluice room and four bedrooms. We read the following documents: the case records for three people, the complaints policy, menus, staffing rotas, samples of medication records and storage, the recruitment records for two staff who have been appointed recently and training records. The outcomes for people have been assessed in relation to twenty-one of the thirtyeight National Minimum Standards for Care Homes for Older People; including those considered to be key standards to ensure the welfare of people living in the home. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 have the information that they need to help them to make a decision about moving to the home and an assessment of their needs is carried out before they move to make sure that their needs could be met at The Hurst. Evidence: At the previous inspection we found that there was up to date information available to people to help them make a decision about moving to the home. We also found that each person has an assessment of their physical and emotional needs before a decision is made about whether or not the staff team has the knowledge and skills to provide their care. The home also obtains assessments for people referred through the care management process. People can spend time in the home on a trial basis to see if they would like to live there. Everyone who moves to the home is provided with a contract. On this occasion we looked at the case records for three people living in the home. Care Homes for Older People Page 10 of 25 Evidence: There were copies of pre-admission assessments carried out by a registered nurse. There was information on the form about each persons medical and personal care needs. Peoples spiritual needs had been noted and there was also information about their interests and preferred lifestyle. The home does not provide intermediate care however respite care is provided. Care Homes for Older People Page 11 of 25 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 have their person and healthcare needs set out in a plan of their care that is kept under review. The medication policies and practices protect people from harm. Evidence: We looked at the case records for three people. A detailed assessment had been carried out for each person on admission to the home and a plan of their care needs had been drawn up. There was guidance to staff about the way to provide care. A member of staff said that the care staff know people well and understand their needs. If they have any concerns the registered nurse on duty provides help, guidance and support. Risk assessments had been carried out for all aspects of physical or emotional risk. Guidance was provided to staff about the way to prevent risks and it was clear that the care plans and risk assessments had been kept under review. There were risk assessments for mobility and the risk of falls and the preventative measures to be put in place. Care Homes for Older People Page 12 of 25 Evidence: A number of people in the home have high care needs and some people are cared for in bed. Skin integrity had been assessed and turning charts provided for people. Fluid and food charts had been drawn up for people where a nutritional risk had been identified. We saw completed forms in peoples bedrooms that showed that staff were monitoring care and following guidance provided by the acting manager. Two people in the home have pressure wounds and we looked at the records for their wound care. It was clear that the registered nurses were providing the agreed wound care and that the acting manager is keeping this under review. The acting manager said that new profiling beds are being purchased and pressure relieving equipment is available for people who need it. All the staff are made aware of how to monitor pressure relieving mattresses so that people are protected. The owner said that the home has a good relationship with the local primary care team and that people receive the specialist care that they need in a timely fashion. The case records showed that people have appointments with healthcare specialists when they require additional support. One person said that he has visits from the GP when he needs this. Guidance provided by the GP was noted on the case records. The acting manager is a registered nurse and has the expertise to ensure that people have the physical and health care that they need. There are medication policies and procedures in the home and the storage facilities are suitable. Medication is administered by the registered nurse on duty. Samples of medication records were up to date and in order. There were photographs of each person on the medication records to help prevent any errors in the administration of medication. Staff are provided with guidance about how to protect peoples privacy and dignity as part of their induction and ongoing supervision and training. During the day people were being treated with courtesy and respect and all people spoken with said that the staff are very good. Care Homes for Older People Page 13 of 25 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 have the lifestyle that they choose and are supported to make some choices in their daily lives. People are supported to maintain contact with relatives and friends in the community. A varied and nutritious diet is provided and people enjoy their meals. Evidence: We saw information about peoples backgrounds and interests in their case records. There is a programme of activities; some provided by people who visit the home and others by care staff during the afternoon. A number of people were sitting in the lounge and the atmosphere was lively with some people doing individual activities of their choice. One person being cared for in bed said that staff come to spend time with her and she enjoys listening to the radio. Games and puzzles suitable for people with limited mobility have been purchased recently. There is musical entertainment in the home once a month and special events are celebrated. At Easter time people enjoyed watching new born chicks hatching out. A newsletter is provided every two months to keep people informed of planned events. Visitors to the home are made welcome and people are supported to maintain contact with their relatives. The case records included the names and contact details of close Care Homes for Older People Page 14 of 25 Evidence: family members. The visitor spoken with said that staff are always welcoming. The group manager said that following feedback from people she is planning to set up some outings during the spring and summer. People are supported to make some choices in their daily lives. The case records included details about peoples preferred routines at bed time and in the morning. The menu is planned on a four week cycle. The food is of a high standard with fresh, local produce used including fresh fruit and vegetables. There are two choices of meal at lunch time and special dietary needs are catered for. Some people require a soft diet and their meals are presented in an appetising manner. The chef talks with everyone late in the morning to ask which meal they would prefer for lunch. People spoken with and those who returned surveys said they enjoy the food. The cook is aware of everyones likes and dislikes. Nutritional assessments are carried out and each person has their weight checked once a month to make sure that people are receiving the nutrition that they need. The records we saw showed that this is the case. Care Homes for Older People Page 15 of 25 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. There is a complaint policy and people feel their complaints would be listened to and acted upon. There are policies and procedures in place to help protect people from harm or abuse. Evidence: There is a complaints policy and procedure and everyone is provided with a copy when they move to the home. There is a system for recording any complaints that are made. One complaint has been received since the previous inspection and the records we saw showed that this had been recorded and investigated to the persons satisfaction. Residents meetings are held so that any issues or concerns could be raised and then would be addressed. The group manager said that people make comments at these meetings and any concerns are addressed with them. The home follows the West Sussex multi agency safeguarding policies and procedures on safeguarding vulnerable adults; there is also a whistle blowing policy available to staff. The group manager said that all staff have completed training in safeguarding procedures. A member of staff from West Sussex Adult Services department has recently run a workshop session in the home to ensure that all staff are confident about their responsibility with regard to safeguarding people living in the home. There have been no safeguarding issues reported in the home since the previous inspection and the group manager said that new quality assurance systems are in Care Homes for Older People Page 16 of 25 Evidence: place including spot check visits to the home at night to help to ensure that people are kept safe. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a safe and well maintained environment that is kept clean. Evidence: The Hurst Nursing Home is well maintained and comfortable. There is a programme of ongoing maintenance to make sure that repairs are carried out promptly. The sluice room is in need of refurbishment although a new sluice machine has been fitted recently. The home meets the requirements of the fire officer and environmental health department. People are encouraged to bring some personal items for their room. People are provided with the equipment they need, new hoisting machines have been purchased recently. There is a call bell system in place. The lift does not provide access to all rooms due to the layout of the building; other adaptations are available to help people who have poor mobility. There is a garden available for people to use in good weather. A planning application has been made for a conservatory to be built at the side of the building; this would provide more communal space. Housekeeping staff are employed to keep the home clean and staff have completed training in infection control. The group manager said that a company has been employed to provide the home with further advice and guidance about infection control. The home was clean and fresh during the site visit. Care Homes for Older People Page 18 of 25 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 are supported by staff who are competent, well trained and supported. The recruitment procedure helps to protect people from harm. Evidence: We looked at the staffing rotas and discussed the staffing levels with the acting manager and the group manager. Four care staff are on duty in the mornings plus one person who works from 8am until 11am to help with personal care. Two care staff work from 2pm until 8pm in the evening with an additional person working from 4pm until 8pm. There is always a registered nurse on duty. Tasks are allocated each day and care staff work with colleagues in certain areas of the home to make sure that each person has the care that they need. People spoken with said that staff are good and that they provide the care that they need. The group manager said that the recruitment procedure and record keeping has been reviewed following the previous inspection to make sure that people are protected from harm. We saw the recruitment records for two members of staff who have been appointed recently. There was evidence to show that two written references had been obtained and that the home had received an enhanced Criminal Record Bureau (CRB) check. An Care Homes for Older People Page 19 of 25 Evidence: Independent Safeguarding Authority (ISA) check is carried out before anyone starts work in the home. The registration number for the registered nurse had been checked to make sure that it is up to date. The home has produced a check list and risk assessment for newly appointed staff to ensure that the recruitment process is more robust. There is an induction programme that meets the Skills for Care standards. There is an ongoing programme of training that includes the mandatory training and also some specialist topics. The manager is committed to ensuring that staff have the training that they need and all the staff spoken with and those who returned surveys said that they have good training opportunities. More than 50 of the care staff have achieved a National Vocational Qualification (NVQ) at level two or above. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home that is well run. Peoples views are sought in the development of the service and there are quality monitoring systems in place. Health and safety policies and procedures help to protect people living in the home and staff. Evidence: The registered manager left the home at the end of April and an experienced nurse is responsible for management duties until the newly appointed manager begins work in the next few weeks. Some hours are allocated each week for the person managing the home to work on shift; the group manager said this will be discussed with the newly appointed manager when she begins work. The group manager also said that an application for registration with the Commission will be made without delay. The quality assurance systems in the home have been reviewed to ensure that they are more robust. An external advisor has also been providing some advice and guidance about ways to keep the quality of service under review. The group manager is carrying out monthly audits of the environment and record keeping in the home. Care Homes for Older People Page 21 of 25 Evidence: The provider carries out Regulation 26 visits and provides a written report of the findings so that required improvements to the service are noted and action can be taken. We looked at samples of Regulation 26 reports that showed that shortfalls in the quality of service are being noted and addressed. Peoples views are sought every year and any issues that arise are dealt with quickly. Residents meetings are held and the group manager said that a number of people attend and give feedback that can be acted upon. People spoken with said they felt their concerns or ideas would be listened to and addressed. The owners are in regular contact with the home and have put systems in place to make sure that people are receiving a good service at The Hurst. The home does not support people with their finances; this is done by family members or solicitors. There are policies and systems in place for health and safety issues in the home. The records we saw showed that staff have all completed updated training in health and safety matters. Incidents and accidents are appropriately recorded and there is a system for monitoring incidents so that measures can be put in place to keep people safe where possible. Care Homes for Older People Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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 non-commercial 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. Care Homes for Older People Page 25 of 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!