Care and Social Services Inspectorate Wales

Transcription

1 Care and Social Services Inspectorate Wales Care Standards Act 2000 Inspection Report Capel Grange Nursing Home Pillgwenlly Newport NP20 2FG Date of publication 13 July 2012 You may reproduce this Report in its entirety. You may not reproduce it in part or in any abridged form and may only quote from it with the consent in writing of Welsh Ministers

2 Introduction Capel Grange is a purpose built nursing home which is located in a residential area of Newport. The home is registered with the Care and Social Service Inspectorate Wales (CSSIW), to provide nursing care for up to 72 individuals with either general or dementia nursing needs. The home is built over three storeys and is divided into five units. Three units provide general nursing care and two units provide dementia nursing care. There is a large car park to the front of the home, which provides sufficient car parking for both visitors and staff. The home has a large conservatory and garden space for the residents to access in clement weather. On the day of the inspection visit there were 72 people accommodated at the home. The home is owned and managed by LINC Cymru Ltd. The responsible individual is Mr Hugh Irwin and the registered manager is Mrs Catherine Divers. The reason for this inspection and focussed visit to the home undertaken on the 24 May 2012 between 9.25am and 4.30pm. was as a result of a concern made to the CSSIW regarding pet rabbits being kept at the home. Inspection methods The information in this report was obtained from: A review of the Self Assessment documentation received by the CSSIW prior to the inspection visit An unannounced visit to the home Discussions with people living at the home, relatives, and staff Discussions with the registered manager and responsible individual The review of three service user care files Consideration of completed and returned residents and staff questionnaires A partial tour of the home Summary of inspection findings What does the service do well? The management team at the home are continually looking into ways in which the outcomes and life experiences of the service users could be improved, and were in the process of introducing a new ethos to the home, which was built on the Eden Alternative principle. What has improved since the last inspection? A new call bell system has been installed within the home, the announcer panel located in the manager s allowed her to observe the time taken for staff to answer calls, and the length of time of each call. The registered manager confirmed that the number of bank and agency staff used had reduced as the home had continued to recruit and retain their own staff. The registered providers had started to investigate ways in which Capel Grange could develop a less clinical feel, e.g.nurse stations had been replaced by seating areas. 1

3 What needs to be done to improve the service? There is no non compliance notice issued with this report. However, the registered persons were asked to notify the CSSIW of the action they intended to take with regard to complying with the comments contained in the body of this report, within the timescales specified. The registered providers to ensure that sufficient staff are working at the home at all times to ensure that individual needs are met in a timely manner The registered providers to ensure that people living at the home and their relatives are kept informed of any future plans for the home The inspector would like to thank the manager, staff and service users for their cooperation and for making her feel welcome during the inspection. 2

4 Quality of life On the day of the inspection visit there were 72 people living at the home. Capel Grange is divided into five self contained units. There are two designated dementia care units known as Mallard and Swallow and three general care units Kestrel, Nightingale and Kingfisher. There is also a large communal space on the ground floor. The registered manager confirmed that the home was beginning to introduce a new ethos within the home based on the Eden Alternative. The rationale for this was to provide the people living at the home with a more homely environment which included the introduction of small animals to the home. Three pet rabbits had been purchased and were currently accommodated in the main communal area, Swallow and Mallard units. We observed that there appeared to be a different atmosphere within the two dementia units. There was more interaction between staff, relatives and people living at the home within one unit compared to the other unit. This was discussed with the registered manager during the inspection visit. We had received two concerns regarding the rabbits. It was reported by the registered manager that environmental health had visited the home and made some recommendations which had been implemented. During the inspection visit we received mainly positive comments regarding the rabbits. Residents appeared to enjoy interacting with them. The care planning documentation reviewed by the CSSIW had improved greatly since the last inspection visit. The files seen were neat, tidy and well presented. The service plans were based on the concept of person centred planning and demonstrated continual reassessment. There were appropriate risk assessments in place ensuring people were kept safe from known and avoidable risks. These were regularly updated. There was evidence that individuals and their families had been invited to provide information for life histories, thus enhancing the staff s understanding of the individual s personality, hobbies and interests. There was evidence to indicate that residents were given a choice regarding the gender of the care staff, this was confirmed in discussions with people living at the home. Relatives confirmed that they were welcome to visit the home at any time, positive comments were received regarding the new tea station which had been built in the downstairs conservatory. Documentary evidence was available, suggesting that a variety of health professionals visited the home. Records were kept of these visits people were also supported to access other NHS services. The home employed two activity co-ordinators, people spoken with during the inspection visit stated that although there were some activities available, they would welcome more which was of more interest to them. The CSSIW observed that it took time to bring the residents from the various units to the large communal area, and that the activity was time limited because of this. The CSSIW received mixed comments regarding the activities on offer. It was noticed that two people accommodated in one unit were receiving one to one supervision it was observed that there was little interaction between the care assistant and the individual. This was brought to the manager s attention. 3

5 We observed the lunch time meal being served. People were offered a choice of meal. Individuals were observed to be assisted to eat in a caring and appropriate manner. Comments received from individuals and their relatives confirmed that the food provided at the home was tasty and was served in good quantities. One relative stated that she had waited several weeks for her loved one to be admitted to the home as they had to wait for a room to be available. The registered manager confirmed that the home had a number of individuals waiting to be admitted. 4

6 Quality of staffing Capel Grange has a comprehensive recruitment process in place. Staff personnel files were not checked on this occasion as they had been scrutinised during previous inspections. The registered manager confirmed that a named administrator ensured that all pre employment documentation was in place. The registered manager confirmed within the SAS documentation that all staff completed a comprehensive induction programme. The CSSIW were informed that the staff turnover within the home had reduced and the use of agency staff was kept to a minimum. Staff confirmed that they normally worked on the same unit. This enabled them to get to know the residents well. Residents also commented that they knew the names of the regular staff. The CSSIW was informed the number of staff working at the home had increased, and that there were adequate numbers of staff on duty to safely meet the needs of the service users living at the home. However, people living at the home and their relatives confirmed that they would like to see more care assistants/activity organisers employed to assist in providing a stimulating environment for the individuals. The registered providers are to ensure that sufficient staff were working at the home at all times to ensure that individual needs are met in a timely manner, and are to evidence that this has been addressed by 31 August

7 Quality of leadership and management The registered manager Mrs Catherine Divers has been employed as the manager of the home for approximately two years. Mrs Divers has the necessary qualifications to manage the care home and is registered with the Care Council for Wales. Mrs Divers is not a nurse, and the home employs two registered nurses who work supernumerary as clinical leads. The CSSIW was informed that a new manager had been appointed from within the organisation. People living at the home and relatives spoke positively about the new manager, although she was on holiday during the inspection visit. The registered manager confirmed that the home continued to consult with residents, relatives and staff regarding the quality of service provided by the home. Relatives confirmed this, however comments were received regarding the number of people at the meeting, and suggested that two meetings were held, one to reflect the dementia units and one for the general nursing units. The registered providers are to agree the best way to keep relatives informed of the service. The CSSIW had, prior to the inspection, received a concern about the introduction of pet rabbits. The providers informed the CSSIW that they were proposing to change the ethos of the home to follow the Eden Alternative. It was hoped that this new concept would reduce the boredom and loneliness felt by some people when they move into a care home. The introduction of the rabbits to the home provided mixed comments from visitors. WE received positive and negative comments. The CSSIW advised the providers to ensure that residents and relatives were kept informed of decisions made by the management team regarding the running of the home. All their personal information relating to residents is held securely. Records were seen to be stored in locked cupboards. Individuals and their relatives had access to their own information upon request. 6

8 Quality of environment Capel Grange is a large purpose built care home located in a residential area of Newport. The home has seventy two en suite single occupancy bedrooms. All areas within the home were tastefully decorated and personalised to reflect the individuality of the resident. The home had a pleasant garden which was being accessed by people living at the home during the inspection. The home is fitted with hand rails to promote independence throughout the home. There is a large central passenger lift providing access to all areas of the home. Access to the dementia units were via a fob. Discussions with some relatives indicated that they would like to purchase these to prevent them from having to wait for access. The CSSIW was informed that the management team were investigating different ways in which regular visitors could access the access the home more easily. We were able to evidence that CCTV was in operation to the exterior of the home. People living at the home have access to electric profiling beds as standard and appropriate pressure reduction mattresses and cushions should they require them. The furniture viewed during the inspection visit was suitable and specialist seating was readily available. However, it was noticed that the arms of some chairs required deep cleaning. People living at the home can feel assured that the accommodation is kept clean, tidy and free from offensive odours. The CSSIW were informed that there is an on going maintenance and refurbishment programme in place. 7