Care Home: The Shrubbery Nursing Home

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Annual service review Name of Service: The Shrubbery Nursing Home The quality rating for this care home is: The rating was made on: two star good service 2 8 1 0 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Sally Seel Date of this annual service review: 0 6 1 1 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: 27 Shrubbery Avenue Worcester Worcestershire WR1 1QN 0190528916 01905610986 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia old age, not falling within any other category physical disability Conditions of registration: Dove Care Homes Ltd Number of places (if applicable): Under 65 Over 65 3 0 36 0 36 0 The maximum number of service users who can be accommodated is: 36 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 3, Old age, not falling within any other category (OP) 36, Physical disability (PD) 36 Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service The Shrubbery Nursing Home occupies a prominent position in Shrubbery Avenue in central Worcester. The Home is easily accessible from the city centre via The Tything and Barbourne Road. The home can be reached by public transport. A large car park is Annual Service Review Page 2 of 8 2 8 1 0 2 0 0 8 situated behind the home. The home has three floors serviced by two lifts, and provides single and double accommodation. The Home can accommodate up to 36 residents. Communal facilities include a large lounge / dining area, another large lounge primarily used for activities and two smaller lounges. The Home is registered to provide twenty-four hour nursing and personal care. The registered manager, Mrs Sandra Mayne, who is a first level registered nurse, oversees the day-to-day running of the home. The reader is referred to the provider for information about fees. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? - The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. - Information we have about how the service has managed any complaints. - What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. - The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. - Surveys returned to us by relatives, staff and from other people with an interest in the service - Relevant information from other organisations. What has this told us about the service? The registered manager has completed an annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us some of the information we asked for with practice examples to illustrate what has improved and further improvements that are being made. It is reflected in the AQAA that people who live in the home that the registered manager operates an open door policy so that people who live in the home are able to express any issues and or concerns they may have. The AQAA also tells us that people living in this home have the opportunity to influence the facilities and services to meet their individual needs and aspirations. The examples to show how this shapes practices within the home are noted in the AQAA as follows: - choice of meals and menus - residents meetings with the activities coordinator to explore activities choices - monthly newsletter which has information about events together with welcoming new people who come to live at the home, celebrates birthdays and sad partings of people who lived at the home where appropriate - continued improvements in relation to redecoration and refurbishment of the home - person centred care plans which focus upon individuals needs and how these can be met in each persons preferred choices, by whom and at times to suit each individual. It is also confirmed there is a proactive approach in supporting individuals to make their own decisions within the home and community to reach their goals and aspirations. The registered manager states, Continued improvements in care plan documentation and giving residents as much control over their lives and choices as we possibly can and will continue to strive to achieve higher care standards. It is noted in the AQAA that individuals are given support to be as independent as possible and one area that the registered manager has highlighted for improvement is to develop a Annual Service Review Page 4 of 8 family and employment history of each person who lives in the home. We are told that there are no restrictions placed upon family and friends visiting the home. Visits from pat dog are enjoyed by people who live at the home and individuals are supported to practise their religions and beliefs with visiting clergy. In one staff survey it said, Not enough activity sessions, although there is an activity person, more could be incorporated, maybe day trips, shopping trips etc and in another staff comments were, Maybe a bit more entertainment at Christmas, Easter etc. In another survey received from a relative it said, When weather permits I would like to see able residents to be taken into the garden. We asked people in our survey, What do you think the home does well? They said; Co-operation amongst staff. Treating all residents special. A really lovely atmosphere and superb nursing skills. Pleased with the quality of care by nurses and all other members of staff. The home is always clean and tidy. The staff are very welcoming and helpful. The grounds are immaculate - except for potholes in car park. 100 happy with quality of care. The registered manager has told us that care plans have been rewritten and are now more person centered. Staff are friendly and caring ensuring high standards of care are provided to all people who live in the home. When required health and social care professionals guidance is sought to keep individuals healthy and well. The registered manager measures the care provided to individuals by utilising audits in care plans, weight recording, infection control, pressure problems and skin. The AQAA confirms that feedback from a tissue viability nurse tells us that the provision of skin care and reduced risk of tissue breakdown. These practices should make certain people who live in the home can be confident that their care and health needs are being met with all risks minimised. Following the last inspection a recommendation was made to make sure that the homes complaints procedure was accessible to all in communal areas of the home. The AQAA tells us that the complaints procedure is on display in the front hall and for people who live in the home it is in their statement of purpose folder in individuals rooms. This should make certain that visitors to the home have knowledge around how to raise any complaints and or concerns they may have. We are told in the AQAA that there is an ongoing programme of redecorating and maintaining the home so that people live in a homely and comfortable environment. For example, in the last twelve months the visitors room has been decorated and new carpet laid. Lounge and dining room have been decorated with a new carpet. Also new pictures have been bought to display on the walls. Also the registered manager tells us that there are a range of comfortable chairs for people to choose to sit in and individuals rooms are personalised with favourite possessions. Some equipment in the kitchen has been updated to include, new dishwasher, fridge, bai marie and toaster. The environmental health officer has visited the home and awarded four stars. The health and safety inspector has also visited the home and the outcome of this was good. The registered manager is clear that they want to continue to maintain the homes environment to a high standard and confirms, To continue to invest in the fabric of The Shrubbery to ensure a comfortable, safe and well maintained nursing home for our residents to live in. In response to, What could the service do better?, one relative survey stated, Sometimes the atmosphere could smell sweeter. The registered manager has confirmed within the AQAA that they are committed in ensuring staffing promotes good outcomes for people living at the home. For example, Annual Service Review Page 5 of 8 in response to Our evidence to show that we do it well, the registered manager lists the following: - training matrix (lists all staff training needs and acts as a planner) - supervisions - training files and personnel files - mandatory training - duty rota and evidence of skill mix - induction training - training relevant to the job that is being done. The AQAA confirms staff are receiving regular training in manual handling, fire training, health and safety, malnutrition and infection control. Kitchen staff have received training in food hygiene and nutrition awareness. The AQAA confirms that fifteen staff are employed to work at the home on a permanent basis. Eight members of staff have completed their National Vocational Qualification (NVQ) Level 2 and two are in the process of completing this qualification. This shows that staff working at the home should have the skills and knowledge to meet the needs of people who live there. What staff surveys told us in response to, What the home does well?: Cares for everybodys needs. I think the home is well prepared for everyones needs. Happy atmosphere lovely food catering for different needs. I can say nurses do their best to give good nursing needs to the clients. Homely and friendly atmosphere. We give good nursing care, well we do our best. Staff surveys also told us What the home could do better: The introduction of staff meetings on a regular basis may also be beneficial. When employing new staff induction should be more in-depth. There are times when we struggle to manage. Although we have the correct ratio of staff for numbers of clients, the level of care they require stretches the number of staff. Home needs more training and seminars to the staff especially carers. Annual Service Review Page 6 of 8 It is anticipated that the registered manager will consider these comments when making further ongoing improvements. The registered manager continues to let us know about the things that have happened since our last key inspection and they have shown that they have managed issues well. They work well with us and have shown us that their service continues to provide good outcomes for the people who use it. The AQAA confirms that the home have received one complaint in the last twelve months. What are we going to do as a result of this annual service review? We are not going to change our inspection plan, and we will do a Annual Service Review by 28th October 2011. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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