Care Home: The Northwood Nursing Home

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What the care home does well The Annual Quality Assurance Assessment (AQAA) states, "The home has a warm friendly atmosphere where users think of Northwood as their home rather than a place to stay. There is an experienced and competent manager who is forward thinking and strives to ensure all stakeholders` needs are met." All the residents who took part in the inspection are happy in the home. They said that they receive a good quality of care in the home, and the staff treat them well. One person said, "Northwood Nursing Home is well run and gives excellent care to residents." A relative said, ""All of the staff treat all residents with kindness, patience, respect and understanding."The people we spoke to said that they know how to make a complaint, and the staff spend time listening to their concerns. As a result of listening to people there are more activities in the home, there have been changes to the menus and bedrooms have been refurbished. The care staff that we spoke to were enthusiastic about their work. People are involved in deciding what care they need, and the care plans provide good information so that the staff know what each person needs and wants. What has improved since the last inspection? People have more choice of things to do during the day. There is a good programme of activities, and a record is kept of what each person does and what they like to do. All the staff have attended essential health and safety training and training in prevention of abuse during the last year. All the staff we spoke to during the inspection were aware of their responsibilities for whistle blowing, and knew what to do if they have any concerns. What the care home could do better: Although the procedures for administering medication are generally strong enough to make sure that people get the medication that they need, we found one error in recording. The manager should ensure that the audit is robust enough to ensure that there are no errors in recording, and that the MAR (medication administration record) chart is not signed until the medicine has been given to the person. We saw some old care plans and daily records in an unlocked cupboard on the top floor. These must be stored securely, so that visitors are not able to see personal information about the people in the home. The manager has not sent notifications to CSCI and other organisations about events that may affect the health and welfare of the people in the home.They are required to do this to ensure that they meet the National Minumum Standards and regulations. At lunchtime we heard staff talking about "feeding" people, and this term is also used in care plans. The use of words such as "feeding" and "being fed" do not respect each person`s dignity and more appropriate terminology should be used. CARE HOMES FOR OLDER PEOPLE The Northwood Nursing Home 24 Eastbury Avenue Northwood Middlesex HA6 3LN Lead Inspector Claire Farrier Unannounced Inspection 28th May 2008 11:30 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 DS0000019581.V365257.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. DS0000019581.V365257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Northwood Nursing Home Address 24 Eastbury Avenue Northwood Middlesex HA6 3LN 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) 01923 826807 01923 841624 M D Homes Norma Vidot Care Home 35 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (19), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (19), Old age, not falling within any other category (35), Physical disability (35), Terminally ill (1) DS0000019581.V365257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate 35 older people who require respite nursing care. Within the overall capacity this home may accommodate a total of 19 people aged 40 years and over with a Mental Disorder, excluding Learning Disability or Dementia. 25th June 2007 Date of last inspection Brief Description of the Service: The Northwood Nursing Home is owned and operated by MD Homes, which is a private organisation, and is registered to provide personal care and accommodation for 35 older people. 19 beds are registered for adults aged 40 years and over with a physical disability who may also have mental health problems. The Northwood Nursing Home is a detached three storey Victorian house situated in a residential area of Northwood. Service users rooms vary in size and some have en-suite facilities. Six bedrooms are currently registered as double rooms. The floors are linked by two passenger lifts and the home is accessible for wheelchair use. There is a well kept garden with a large patio area that is accessible for people in wheelchairs. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The most recent CSCI inspection report is available on request. The current charges are from £735 to £1250 per week. DS0000019581.V365257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. One inspector carried out this unannounced inspection over one day. The focus of the inspection was to assess all the key standards. Some additional standards were also assessed. We talked to as many of the people who live in the home as we were able to and we also spoke to some of the staff. Ten people completed Have Your surveys before the inspection. Seven relatives also completed Have Your Say surveys, and we received further surveys from members of staff, health professionals and care managers. We have used the information from these in this report. The manager sent some information (the Annual Quality Assurance Assessment, or AQAA) about the home to CSCI before the inspection, and her assessment of what the service does in each area. Evidence from the AQAA has been included in this report. We have also looked at the reports of the visits that the operations manager for MD Homes makes to the home. When we were in the home we looked at the home’s records, care plans and staff files, and we made a tour of the premises. We talked to the manager about what we had seen during the day. What the service does well: The Annual Quality Assurance Assessment (AQAA) states, “The home has a warm friendly atmosphere where users think of Northwood as their home rather than a place to stay. There is an experienced and competent manager who is forward thinking and strives to ensure all stakeholders needs are met.” All the residents who took part in the inspection are happy in the home. They said that they receive a good quality of care in the home, and the staff treat them well. One person said, “Northwood Nursing Home is well run and gives excellent care to residents.” A relative said, ““All of the staff treat all residents with kindness, patience, respect and understanding.” DS0000019581.V365257.R01.S.doc Version 5.2 Page 6 The people we spoke to said that they know how to make a complaint, and the staff spend time listening to their concerns. As a result of listening to people there are more activities in the home, there have been changes to the menus and bedrooms have been refurbished. The care staff that we spoke to were enthusiastic about their work. People are involved in deciding what care they need, and the care plans provide good information so that the staff know what each person needs and wants. What has improved since the last inspection? What they could do better: Although the procedures for administering medication are generally strong enough to make sure that people get the medication that they need, we found one error in recording. The manager should ensure that the audit is robust enough to ensure that there are no errors in recording, and that the MAR (medication administration record) chart is not signed until the medicine has been given to the person. We saw some old care plans and daily records in an unlocked cupboard on the top floor. These must be stored securely, so that visitors are not able to see personal information about the people in the home. The manager has not sent notifications to CSCI and other organisations about events that may affect the health and welfare of the people in the home.They are required to do this to ensure that they meet the National Minumum Standards and regulations. At lunchtime we heard staff talking about “feeding” people, and this term is also used in care plans. The use of words such as “feeding” and “being fed” do not respect each person’s dignity and more appropriate terminology should be used. DS0000019581.V365257.R01.S.doc Version 5.2 Page 7 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. DS0000019581.V365257.R01.S.doc Version 5.2 Page 8 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 DS0000019581.V365257.R01.S.doc Version 5.2 Page 9 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): 2, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that the home has sufficient information on residents’ needs and access to appropriate services to enable these needs to be met. EVIDENCE: The Northwood Nursing Home provides a service for older people, and for people with mental health needs. The home applied to CSCI to include dementia care in the categories for which it is registered. This application was refused in August 2007, because the home is not designed or adapted to meet the needs of people with dementia, and a change to the mix of numbers within service user categories and the addition of those with dementia would have an adverse affect the quality of life for all those who live at the home. The Annual Quality Assurance Assessment (AQAA) states that the home has consistently high occupancy and a waiting list. There were 33 people living in DS0000019581.V365257.R01.S.doc Version 5.2 Page 10 the home at the time of this inspection. The home is registered for 35 people, but the intention is to convert the double rooms to single rooms as beds are vacated, and 33 is therefore the maximum number of people that the home can currently provide a service for. Four people are privately funded. The AQAA stated that they all have a written contract that sets out the terms and conditions of their stay in the home, and the services that the home provides for them. Most of the people who completed surveys for this inspection said that they have not received a contract. Copies of the contracts are kept at MD Home’s head office, and we did not see any on this occasion. All the surveys that we received from relatives of the people in the home said that the care home meets the individual needs of their relative. One relative said, “They understand (my relative’s) ways and requirements.” One Social Services care manager said, “Currently they are providing appropriate service to the appropriate persons.” This indicates that people are receiving the service that they expect to receive. But the company should ensure that everyone has a copy of their current contract, or of the service agreement with social services. We looked at three care plan files, and they all contained a detailed assessment that was carried out before the person moved into the home. They include good information on each person’s physical and mental health needs, and assessments form healthcare professionals, such as psychiatrist and occupational therapist. The home requests care plans for certain aspects of health care, for example wound care, before people move into the home, and we saw these in the care plan files that we looked at during this inspection. The manager said that these are not always provided, and in the AQAA the manager identified communication with healthcare providers, for example hospital discharge co-ordinators, as a difficulty. This means that the home does not always get all the information about the person’s specific needs. On several occasions a person has been admitted to the home who has MRSA, but the hospital discharge report has not mentioned this. The surveys that we received from the staff in the home confirmed this. Most said that they usually have the right support, experience and knowledge to meet people’s different needs, but no-one said that this is always the situation. The home is registered to provided care for people with mental health needs. There is no RMN (a nurse with a mental health qualification) employed in the home, but MD Homes employs a RMN who visits the home every week. Training is available in mental health and managing challenging behaviour. DS0000019581.V365257.R01.S.doc Version 5.2 Page 11 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. The people who live in the home are confident that they will receive a good quality of personal care and healthcare. The care plans provide good information so that the staff know how to meet each person’s needs. However on some occasions the staff do not show appropriate regard for the dignity of the people in the home. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) states that in the last 12 months the care planning system has been improved to ensure a person centred approach, and staff have been trained in how best to document care delivered to ensure that all aspects of what is being delivered is also recorded. The home is continually working on care planning. At present they are looking into using electronic tools to create, monitor and review the care plans. We looked in detail at the files of five people who live in the home. The care plans are generally well written, with good details of each person’s personal care DS0000019581.V365257.R01.S.doc Version 5.2 Page 12 needs and healthcare needs. They include assessments for pressure area care and nutritional assessments for each person, and there are good systems for monitoring the risks of pressure sores, falls, and poor nutrition. There are good risk assessments that ensure that people can live safely in the home. The care plans are reviewed every month, and they have been signed by the person or by their relative. One person said that she was involved in writing her care plan, and she agrees with what it says about the help and support that she needs. All the staff who completed surveys for the inspection said that they have good information about each person’s needs. One said, “We are given up to date information about the need of the people we support or care for in a report we have every morning.” Everyone that we spoke to said that the staff treat them well, and we observed a good relationship between the staff and the people who live in the home. Most of the people who completed surveys for the inspection said that they always receive the care and support they need, and everyone said that they receive the medical support they need. The people who live in the home feel that they are treated with respect, and they are able to make decisions and choices about their daily lives. The relatives who completed surveys said that the care home gives their relative the care that they expect. Comments from relatives include, “I am always made aware of any developments of my brother’s care. I have absolutely no concerns or worries about the home or the staff.” “All of the staff treat all residents with kindness, patience, respect and understanding.” “They look after the medical needs of the residents very well. Occupational therapy is good.” The AQAA states, “We provide a service that is individualised to each user, thereby allowing us to meet the specific needs of all users of our service. We have evaluated our care plans to encourage staff to evaluate the person as a whole and consider all aspects of them when looking into how their care can best be delivered. All staff are instructed during induction on how to treat service users with respect at all times.” However we observed some poor use of language, by some members of staff and in a care plan, that could be viewed as disrespectful. The care plan for a person who has poor nutrition has clear guidelines on monitoring how much they are eating and drinking, and how to assist and encourage them. But the guidelines state, “X is totally dependent on staff for feeding. A carer will feed X with their meals and drinks.” At lunchtime a care assistant came into the lounge and said, “Who hasn’t been fed? I’ve done Y, I’ll do Z.” The use of words such as “feeding” and “being fed” does not respect each person’s dignity and more appropriate terminology should be used. The home has sound systems in place for the safe management of medication. We carried out a spot check of a sample of medication records. In most cases there was good administration and recording. Medicines that are only given when the person needs them (PRN) are recorded appropriately, with the reason why the medicine is given on each occasion. One person’s MAR (medication administration record) chart did not tally with the number of DS0000019581.V365257.R01.S.doc Version 5.2 Page 13 tablets that were available. It is likely that on one occasion the nurse signed that the medication had been administered, but it was not. The manager should ensure that the audit is robust enough to ensure that there are no errors in recording, and that the MAR is not signed until the medicine has been given to the person. The home maintains some homely remedies, These are medicines that can be bought over the counter and do not require a prescription, including Gaviscon, Paracetamol and Simple Linctus. The reason why the medicine is needed is recorded each time, and if the person does not feel better after 24 hours they are referred to the GP. These procedures protect the people in the home, but it would be good practice to have written agreement from each person’s GP that these remedies can be given to them when needed. DS0000019581.V365257.R01.S.doc Version 5.2 Page 14 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. People who use the service can be confident that people who live in the home have a choice of individual and group activities during the day that meets their needs and expectations. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) states that there are regular meetings in the home for the people who live there. As a result of listening to people both individually and in the meetings, the home has increased the range of activities to include quizzes and karaoke. The home employs an activities co-ordinator who organises and runs social and physical activities for all users in the home. She was not in the home during visit, and we did not see any activities, apart from the television being on throughout the day in the lounge. Most of the people who completed surveys for this inspection said that the home arranges activities that they can take part in, but one person commented that there are few entertainments, and one said that there is not enough interest during the day. All the relatives and care managers (social workers) who completed surveys said that the home provides support for DS0000019581.V365257.R01.S.doc Version 5.2 Page 15 people to live the life they choose. The relatives said that they are made very welcome in the home whenever they visit. The activities programme has three choices each morning and afternoon, including exercise and mobility, reminiscence, mental stimulation and arts and crafts. There is a record of what each person does each day, and for most people there are three or four different activities recorded each day. The AQAA states that in the next twelve months the activities co-ordinator will try to implement activities that are more creative, such as cooking and painting. The home intends to organise more outings in the spring and summer, including a large group outing to the seaside. There are small tables at one end of the lounge, so that people have a choice of where they eat their meals. However only nine people sat at the tables to have their lunch during our visit to the home, and six people still have their meals at their chairs in the lounge. It was reported that this is their choice. However it would be preferable to make a separate occasion of meals, and to encourage more people to move to a different environment at meal times. Lunch was a relaxed occasion, and the staff assisted those who needed help sensitively. Meals are available to meet people’s cultural preferences. Vegetarian choices are available, and all the meat used is Halal. There is a board in the lounge to display the day’s menus, but it was blank when we visited. DS0000019581.V365257.R01.S.doc Version 5.2 Page 16 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 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are confident that their concerns are listened to and that they are safeguarded from the risks of abuse. EVIDENCE: There is a satisfactory complaints procedure in place. Two complaints have been recorded in the home in the last twelve months, both of which were resolved to the satisfaction of the people who made the complaints. All the residents and relatives who completed surveys for the inspection said that they know how to make a complaint, and who to speak to if they are not happy. The surveys from health professionals and care managers confirmed that the home has responded appropriately if they have raised any concerns. The home has comprehensive procedures for prevention of abuse, including Hertfordshire County Council’s joint agency procedures for reporting and investigating allegations. The Annual Quality Assurance Assessment (AQAA) states that all the staff have had training on safeguarding vulnerable adults in the last twelve months, and that questionnaires from residents showed that they felt the home was safe and secure. All the staff we spoke to during the inspection are aware of their responsibilities for whistle blowing, and know what to do if they have any concerns. DS0000019581.V365257.R01.S.doc Version 5.2 Page 17 There has been one safeguarding investigation, when one person was found to have pressure sores when they were admitted to hospital. An investigation showed that there was evidence that this person had pressure sores when they were admitted to the home, and they had received appropriate treatment in the home. However the home did not inform CSCI about the pressure sores, the admission to hospital, or the safeguarding investigation (See Management and Administration section). DS0000019581.V365257.R01.S.doc Version 5.2 Page 18 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. People who use the service can be confident that the home and gardens provide a comfortable, attractive and safe environment for the people who live there. EVIDENCE: The Northwood Nursing Home is a three storey detached Victorian building, situated in a pleasant residential area of Northwood. There is a well kept garden, and a large patio area outside the conservatory. There is one communal lounge, and a conservatory. The building appeared to be clean and well maintained, and appropriate procedures are in place for the control of hygiene. DS0000019581.V365257.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are supported by a stable staff team who have the experience and training to understand and meet their needs. EVIDENCE: There is a good level of staffing, with three or four nurses and five or six care assistants during the day, and one nurse and two care assistants at night. The company provides a comprehensive training programme that covers all the statutory training, and the training matrix that was seen showed that everyone has attended essential health and safety training and training in prevention of abuse during the last year. There is still a need for appropriate training on mental health for all the staff. One person has had some training in the last year. However one of the nurses is registered to start a mental health qualification this year, and a distance learning programme will be put in place for other staff when the company agrees to the funding. There is also a distance learning programme for dementia care, and it was reported that everyone will do this training when they have completed their NVQ qualification. The induction training programme is based on the Skills for Care induction standards. The manager has experience of assessing and observing people while they complete their induction programme. DS0000019581.V365257.R01.S.doc Version 5.2 Page 20 The surveys from one resident stated, “The staff are amazing – although they have very little English they try to understand, and are never rude.” Two relatives also raised concerns about the language skills of the staff. However the manager reported that there has been a big improvement in the understanding of English amongst the staff. Courses in English are available for them, and two recently recruited domestic staff will do this. All the care staff are encouraged to undertake NVQ qualifications, and there is an expectation that new staff will register for the qualification. They have to pass a test in English language before they can do NVQ training. The home has robust policies and procedures for recruitment. We looked at two staff files. They both contained all the required information, including good references and a satisfactory CRB (Criminal Record Bureau) disclosure. DS0000019581.V365257.R01.S.doc Version 5.2 Page 21 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, 37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be confident that the home is well managed in the best interests of the people that live there. Also that the views of the residents and other involved people are actively sought in order to ensure that a good quality of care is provided. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) states, “The home has a warm friendly atmosphere where users think of Northwood as their home rather than a place to stay. There is an experienced and competent manager who is forward thinking and strives to ensure all stakeholders needs are met.” The manager is a qualified nurse, and she has completed the Registered DS0000019581.V365257.R01.S.doc Version 5.2 Page 22 Managers Award. She has registered with CSCI as manager of the Northwood Nursing Home. A new deputy manager has been appointed, pending CRB checks and references. The operations manager for MD Homes makes regular monitoring visits to the home. The reports of these visits show that the operations manager talks to the people in the home, and checks some of the records. In one, the operations manager concludes, “The home is well run by the Manager. Service users appear well looked after and very happy with the staff and Home.” In another the people who were spoken to are reported as, “All happy with service delivery and staff.” The company also carries out a regular quarterly audit report of all procedures in the home, and questionnaires are sent to the people in the home and their relatives to ask their views of the services provided by the home. Any concerns raised in residents meetings or in one to one discussions are acted on. One person has to spend time in bed due to pressure sores. At their request they have a TV, phone and computer in their room so that they can use their time more positively. Another person asked to have their supper later, and can now have it whenever they want to. As a result of listening to people there are more activities in the home, there have been changes to the menus and some bedrooms have been refurbished. The arrangements for management of residents’ money were inspected and appeared to be accurate. Systems for managing the residents’ finances are transparent and backed up with signatures and invoices. Money is stored safely and adequate records are maintained in order to protect service users from financial abuse. The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. These include monitoring water temperatures and ensuring that there are regular fire drills. Current personal information is stored securely. However some archived information, including old care plans and daily records, were seen in an unlocked cupboard on the top floor. The manager has not sent notifications to CSCI and other organisations about events that may affect the health and welfare of the people in the home. Guidance about notifications is available on the CSCI web site. DS0000019581.V365257.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 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 3 18 X 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 2 2 DS0000019581.V365257.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP9 Regulation 13(2) Requirement To ensure service users safety measures must be put in place to ensure that medication is audited effectively, and that any errors in medication are noted and rectified without delay. To ensure people are treated with dignity and respect at all times care staff must understand the need to use appropriate language when referring to tasks. All personal information must be stored securely in order to protect the confidentiality and privacy of the people who live in the home. Notifications for all incidents that affect the wellbeing of service users must be sent to the CSCI without delay. Timescale for action 31/07/08 2. OP10 12(4)(a) 31/07/08 3. OP37 17(1)(b) 31/07/08 4. OP38 37 31/07/08 DS0000019581.V365257.R01.S.doc Version 5.2 Page 25 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 DS0000019581.V365257.R01.S.doc Version 5.2 Page 26 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. 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