The Haining Nursing Home Care Home Service Adults Vellore Road Maddiston Falkirk FK2 0BN Telephone: Inspected by: Leigh Ferguson

Transcription

1 The Haining Nursing Home Care Home Service Adults Vellore Road Maddiston Falkirk FK2 0BN Telephone: Inspected by: Leigh Ferguson Type of inspection: Unannounced Inspection completed on: 2 April 2014

2 Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 12 4 Other information 25 5 Summary of grades 26 6 Inspection and grading history 26 Service provided by: The Haining Nursing Home Ltd Service provider number: SP Care service number: CS Contact details for the inspector who inspected this service: Leigh Ferguson Telephone enquiries@careinspectorate.com The Haining Nursing Home, page 2 of 29

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 4 Good Quality of Environment 4 Good Quality of Staffing 4 Good Quality of Management and Leadership 4 Good What the service does well The service provides a warm, friendly environment for residents. The manager has been in post for over a year now and has brought stability to the service which is appreciated by staff and residents. What the service could do better By looking at care plans we could see that residents belongings were not routinely inventoried after admission. We saw from care plans that six month reviews were not always being held in good time. A couple of areas within the home were looking a bit tired and in need of refurbishment and this was discussed with the owner during feedback. What the service has done since the last inspection The service introduced new care plans last year and these are now well established and provide a good basis for providing appropriate and responsive care to residents. The entry road to the service has been resurfaced since the last inspection and is now in good condition. Conclusion The service is operating at a good level. The Haining Nursing Home, page 3 of 29

4 Who did this inspection Leigh Ferguson Lay assessor: Ms Linda Riley The Haining Nursing Home, page 4 of 29

5 1 About the service we inspected The Care Inspectorate regulates care services in Scotland. Information in relation to all care services is available on our website at This service was registered in July 2011 with Social Care and Social Work Improvement Scotland (SCSWIS). SCSWIS is now referred to as, the Care Inspectorate. Requirements and recommendations If we are concerned about some aspect of a service, or think it needs to do more to improve, we may make a recommendation or requirement. - A recommendation is a statement that sets out actions the care service provider should take to improve or develop the quality of the service based on best practice or the National Care Standards. - A requirement is a statement which sets out what is required of a care service to comply with the Public Services Reform (Scotland) Act 2010 ("the Act") and secondary legislation made under the Act, or a condition of registration. Where there are breaches of Regulations, Orders or conditions, a requirement may be made. Requirements are legally enforceable at the discretion of the Care Inspectorate. The overall aims and objectives of the service are: 'To provide a commitment to good quality care in a responsive and understanding atmosphere'. The people who use this service prefer to be known as 'residents', therefore, the term resident will be used throughout this report. The Haining Nursing Home Ltd is part of a group of homes. The owner has four other care services in Scotland. This home is located on the outskirts of Maddiston village and can accommodate up to thirty older people. The accommodation is provided in a large traditional old building. The bedrooms are single with some double rooms. The service accesses local amenities by providing transport to support residents to get to places and undertake what they want to do. Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade Quality of Environment - Grade The Haining Nursing Home, page 5 of 29

6 Quality of Staffing - Grade Quality of Management and Leadership - Grade Inspection report continued This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. The Haining Nursing Home, page 6 of 29

7 2 How we inspected this service The level of inspection we carried out In this service we carried out a medium intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection We inspected this service over two days, on the 1 and 2 April The visits took place during day time. We provided feedback to the owner on the afternoon of the 1 April The inspection was carried out by Leigh Ferguson, Care Inspectorate. Inspection Volunteer Linda Riley also supported the inspection. As requested by us, the service sent us an Annual Return. We received ten completed Care Service Questionnaires from people using the service and their relatives/carers. During Inspection, evidence was gathered from a number of sources, including: Discussion with the deputy manager and 4 members of staff. Discussion with 2 relatives Discussion with 10 residents. A review of a range of policies, procedures and records and other documentation included the following: Service Information Complaints Procedure Residents handbook Registration Certificate Health and safety audit 5 Personal Care Plans Minutes of staff meetings Accident and Incident records Timetable of activities Review meetings Staff training records Internal quality assurance audits Questionnaires The Haining Nursing Home, page 7 of 29

8 All of the above information was taken into account as part of the inspection process and used to assess the performance of the service in relation to the chosen quality statements. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at The Haining Nursing Home, page 8 of 29

9 What the service has done to meet any requirements we made at our last inspection The requirement The service must follow robust recruitment procedures aligned to best practice guidelines. This is to comply with SSI 210 Regulation 4 1 (a) Welfare of Users and Regulation 9(1)Fitness of Employees. Timescale 24 hours from receipt of report. The Haining Nursing Home, page 9 of 29

10 What the service did to meet the requirement Only one person has been recruited since the last inspection and safer recruitment guidelines were seen to be followed. The requirement is: Met - Within Timescales The requirement The service must ensure that safe practice in relation to recruitment of staff is achieved. This is in order to comply with Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011 Regulation (4 ) (a), welfare of users. Regulation (9 ) (1), Fitness of employees. In making this requirement, the following National Care Standards were taken into account: National Care Standards, Care Home for Older People, Standard 5 Staffing. In making this requirement, the following good practice guidance was taken into account: Safer Recruitment Through Better Recruitment (2007) from Timescale for implementation: Within 8 weeks of publication of this report. What the service did to meet the requirement As above. The requirement is: Met - Within Timescales What the service has done to meet any recommendations we made at our last inspection There are no recommendations outstanding. The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. The service submitted a self assessment as requested by the Care Inspectorate. This contained a good level of detail regarding both the strengths and areas of improvement of the service and assisted the inspection process. The Haining Nursing Home, page 10 of 29

11 Taking the views of people using the care service into account These are expressed in the main body of the report. Inspection report continued Taking carers' views into account We received five completed Care Standards Questionnaires from relatives/friends of people using the service. These were generally very positive about the service. Comments included the following: "We are highly satisfied with the care and attention given to our mother in The Haining care home. The staff are always on hand to help with my mother's needs. The nurse on duty will phone me or my brother to inform us about any change in mother's condition. The manager is also a very approachable person who always keeps us informed" "Since my dad has went into the care of staff and manager at the nursing home he has came on leaps and bounds, the staff are so nice and caring, always ready to help and communication is so good with them. The manager is very good, her door is always open. I have went there looking for my dad and he is in her office, sitting yapping with her. Gives him respect. They stop what they're doing to give resident's care. Very good nursing home" "Myself and all my family are regular visitors to the home, everyday one member of our family are here. Very satisfied with care. Sometimes toilets are a bit messy, that's my only complaint". "My mother has only been in the home a few weeks but I can honestly say that the home, staff, food, everything is excellent, she has gained weight, her overall appearance has improved along with the mental side of things, she hasn't once said " I wish I was dead". My old mother has returned, thanks to the wonderful staff". The Haining Nursing Home, page 11 of 29

12 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service strengths The service has implemented a service user participation policy. This aims to ensure service user involvement in identifying and providing improvements to service provision. Service user and relatives questionnaires were recently distributed and the information gathered from these was collated and used to identify areas requiring improvement. From these questionnaires a Food Forum group was set up where residents can contribute to the menus within the home. Regular service user meetings continue to be held with feedback from particpants being acted upon. For example residents have had discussion regarding the home's annual Gala Day, with their views and ideas being actioned. Relatives meetings have not been being held regularly due to poor attendance, however relatives may attend resident meetings and feedback from the questionnaires found relatives stating " the management team take time to talk about my sister to me which is a great improvement over past years " and " the manager's door is open at any time, also very helpful". Service users and relatives are encouraged to attend regular care reviews. The service has their own newsletter which gives residents and relatives updates regarding the life of the home. This includes activities, staff news and photographs of outings which residents have participated in. There is a dedicated activity coordinator and a diary of activities within the home. Additionally residents are supported to attend activities within the local community if they wish. The Haining Nursing Home, page 12 of 29

13 Service users have access to local advocacy agencies with three service users at present benefiting from this service. Leaflets from the local advocacy agencies are displayed within the Home. The service have agreed with the local advocacy agency to allow one of their volunteers to act as a spokesperson for the agency within the Care Home. The service have introduced different communication aids for both people with dementia and people who have difficulties with communication. Staff have started using these aids, such as an adapted "toolkit for dementia" and "speak your mind" book. The inspection volunteer commented thus: Residents were happy with the care and support they received. Comments were: * You can get a bath when you want * There's a whole team that wash your clothes for you. It's very satisfactory * They allow you to get up in your own time * This is my home now. I feel fine about that * I enjoy it. I like it here * Okay * Its fine here * I'm getting on fine * Not bad - not your own house * Very good * I could rise at 2 or 3 in the morning and go to the smokehouse. Nobody is on my tail Relative's comments: * Seems to have settled in fine. Just need to look at him to see he's well looked after * They get the doctor out if any problems The majority of residents were happy with the food. Comments were: * Foods good. Very excellent meals. The chef is excellent, very good. You get a choice of one of the other. No supper but tea and biscuits at bedtime * They give you choice. The food is lovely. Just normal food. No fancy stuff. * Enjoy the meals * You get enough to eat * It's alright. I'm satisfied. One person commented: * Not asked about what you like. The Haining Nursing Home, page 13 of 29

14 When asked whether they had brought this issue up with staff, their response was they "don't listen" A relative commented that their family member enjoyed getting a particular flavour of milk shake which they enjoyed. Comments about activities: * Staff get books for me. I like reading * Some entertainment - it suits some people * Concerts - not so much in the winter * I've been out on trips * They get me my paper * I just sit around * I read and watch television * Do jigsaws, watch TV. Don't like activities. We went to the cinema to see War Horse- was good. Don't get out much. We had lunch with residents in the dining room. Tables were nicely set out with place mats, salt and pepper, and napkins. A few people woke clothes protectors. Lunch was a choice or fruit or soup to start, followed by cheese toasties or a variety of sandwiches. Fresh orange or pineapple juice was offered. Residents has tea or coffee after the meal and some requested biscuits. Lunch was relaxed and people seemed to enjoy the food. Staff chatted with residents during lunch. Areas for improvement We found that six month reviews were not always being held timeously. The service should address this. Grade awarded for this statement: Number of requirements: 1 Number of recommendations: 0 Requirements 1. The service should ensure that six monthly reviews are held timeously. This is to comply with SSI (2)(b)(iii) Personal Plans Timescale: Immediately on receipt of report. The Haining Nursing Home, page 14 of 29

15 Statement 3 We ensure that service users' health and wellbeing needs are met. Service strengths From an examination of the evidence we found that the home had a good performance in relation to this statement. Staff supported residents to be smart and tidy in their appearance. This contributed to the residents overall health and wellbeing. A training matrix has been drawn up for the next year, covering both mandatory training and training. In addition to this, group supervision sessions have been carried out within the home. Recent topics covered include the safe use of sensor pads, reflective practice, MUST, nutrition and hydration. We found that there was an audit system for care plans. We sampled care plan audits and found that where further work was identified, this had been addressed within the identified timeframe. We sent Care Standards Questionnaires to the service for residents, their carers/ friends and staff. We found that 10 Questionnaires had been returned by residents, their carers/friends. We found that Care Standards Questionnaires 'strongly agreed' or 'agreed' with the statement: -'Overall, I am happy with the quality of care'. We looked at a sample of care plans. These provide a sound base for staff to assess and review the care planning for all residents. From these care plans it can be evidenced that the staff at the home involve the wider multi-disciplinary team as they need to. It was clear that service users and carers and other relevant individuals could participate in a six monthly review of care. A record is kept of these meetings. The service appropriately records and seeks permission from residents or relatives when using restraint. Accidents and incidents and falls are recorded and audited by the service. This information is used to inform the manager if procedures require to be put in place to prevent further accidents, incidents or falls taking place in the service. We saw that the service recorded distressed reactions using ABC charts and found that one incident of a resident displaying challenging behaviour was dealt with effectively. The service has policies and procedures in place which support staff in their practice, these policies reference the multi disciplinary team as appropriate. A medication audit was done during the inspection and this was found to be accountable. The Haining Nursing Home, page 15 of 29

16 Areas for improvement We saw in one care plan that a DNA/CPR form was overdue for review. The service should address this. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued The Haining Nursing Home, page 16 of 29

17 Quality Theme 2: Quality of Environment Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service strengths Please see the evidence presented under Quality Theme 1, Statement 1 which also has relevance for this statement. The quality assurance questionnaires recently distributed by the home seek feedback from residents and relatives with regards to the quality of the environment. The feedback was very positive. The inspection volunteer commented thus : Residents spoke to were happy with the environment. Comments were: * The garden out here is lovely * It's comfortable. I've got everything I need * I find it fine, comfortable. I was out in the garden only once. I don't get about so well/. * I have my photographs in my room * You've got everything you need Bedrooms were saw were of a very good size. People had clearly personalised them with lots of their own furniture including a sofa in one and large cabinets. They looked very comfortable, well decorate and homely. The lounges and dining rooms were large with lots of big windows and were light. Furnishings and floor coverings were of a good quality. A shop display was being set up in the corridor area with memorabilia. The Haining Nursing Home, page 17 of 29

18 Areas for improvement The manager wishes to draw up a new information pack and brochures and improve the quality of the information therein, and she intends to involve the residents and relatives in that process. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued The Haining Nursing Home, page 18 of 29

19 Statement 2 We make sure that the environment is safe and service users are protected. Service strengths We found the home was clean and fresh and free from odours. The home has a secure entry system in place. The service has processes and methods in place to protect residents from harm, such as for example; staff attended training on health and safety matters. Staff spoken with confirmed to us an understanding of the services' policies and procedures on health and safety. We sent Care Standards Questionnaires to the service for residents, their carers/ friends and staff. We found that 10 Questionnaires had been returned by residents, their carers/ friends. We found that completed Care Standards Questionnaires 'strongly agreed' or 'agreed' with the following statements: -I feel safe and secure in the care home -I am confident that my relative/friends is safe and secure in the care home We looked at maintenance records and found that regular checks were carried on moving and handling equipment; staff call system, window restrictors, wheelchairs, water quality and water temperature records. We found that portable appliance tests were carried out when new electrical goods were purchased or brought in by residents and/or their carers/friends. We had a discussion with the cook and found that Cooksafe had been fully implemented in the kitchen. Areas for improvement We found that the service should continue to work with residents and their carers/ friends obtaining their views in relation to the environment. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 The Haining Nursing Home, page 19 of 29

20 Quality Theme 3: Quality of Staffing Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths Please see the evidence presented under Quality Theme 1, Statement 1 which also has relevance for this statement. The Inspection Volunteer commented thus: The majority of residents spoken to were positive about the staff. Comments were: * Girls are very attentive and friendly. Didn't find that in other places. They put themselves out for you * I just need to say to them, I need the toilet or if I need help, they're straight there * They are the greatest, they help you. You don't need to complain. Everything is done great for you. They treat you like your own people. The young staff are good. I enjoy their company. They treat you normally. * There's enough staff. Never need to wait * Staff are okay * Get on fine * I get on with them quite well. Most of them they try their best. One male member of staff treats the patients quite rudely. * Staffs awful nice. I get on fine with them * People are nice, fine. * Get on with them all. They get on with me. If I need help, I get it. Relative's comments: * Lovely staff, very nice The Haining Nursing Home, page 20 of 29

21 Areas for improvement The service could better evidence the involvement of residents and relatives in the recruitment process. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 Inspection report continued The Haining Nursing Home, page 21 of 29

22 Statement 3 We have a professional, trained and motivated workforce which operates to National Care Standards, legislation and best practice. Service strengths Staff turnover in the service is low which helped to provide continuity of care to residents and their families. Staff spoken with told us they enjoyed working in the service. They said the manager was very approachable and they could go to her with any concerns or suggestions. Relevant policies were available and the effect of these supported staff to understand good practice and what was expected of them. We saw evidence that an annual training programme is in place. We found that the service had a system in place to support staff as part of supervision and appraisal. We looked at a proforma which was completed in relation to the role of named nurse or Senior nurse care assistant. We found that this assisted in discussion in relation the staff member's role, where the staff member performs well and areas where further training/support would be advantageous. We looked at staff records and found that staff members had the opportunity to discuss training and support needs and comments on their role within the service. The service had developed the key worker role, with staff members allocated to provide support. Staff were supported through staff meetings. These were used for updates regarding the home, best practice guidance and for the cascading of information. Handover meetings take place on a shift basis. Staff told us that these meetings help them to provide consistent and responsive care for residents. We sent Care Standards Questionnaires to the service for residents, their carers/ friends and staff. We found that 10 Questionnaires had been returned by residents, their carers/ friends. We found that completed Care Standards Questionnaires 'strongly agreed' or 'agreed' with the following statement: -I am confident that staff have the knowledge and skills to care for me (my relative/ friend). Areas for improvement We sent Care Standards Questionnaires to the service for their residents, their carers/ friends to complete. We found that two completed Care Standards Questionnaires 'disagreed' with the following statement: -Staff treat me politely at all times. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 The Haining Nursing Home, page 22 of 29

23 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service strengths Please see Quality Theme 1, Statement 1 which also has relevance for this statement. The Inspection Volunteer commented thus: Resident's comments about management: * The lady of the house looked after me when I was sick. They're quite good that way. Got me tablets * I admire the way they run it * I have no complaints * The head one is very nice. I cannot complain * (Commenting about the manager) I know her but she's on holiday. I get on alright with her. Areas for improvement The service should continue to develop ways in which service users and carers can assess and improve the quality of management within the service. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 The Haining Nursing Home, page 23 of 29

24 Statement 4 We use quality assurance systems and processes which involve service users, carers, staff and stakeholders to assess the quality of service we provide. Service strengths We found that the service had a Quality Assurance system in place, with a number of quality audits relating to medication, nutrition, falls and care plans. We found that audits were completed by members of the management and staff team. We noted that where concerns were identified, an action plan was completed to address concerns. We found, through discussion with residents and their carers/friends that the management team were available to discuss any concerns which there may be. Resident and their carers/friends advised that they felt able to approach the manager, nursing or senior staff to discuss any issues. We looked at notifications made to the Care Inspectorate, accident/incident and other information. We found that the service had notified the Care Inspectorate of relevant accidents and incidents and other events. We spoke with staff in relation to their understanding about Adult Support and Protection and training in this area. We found that staff members had an understanding of Adult Support and Protection and what action should be taken if concerns were found. There is a complaints policy and procedure. Copies are displayed around the Home and are incorporated into the information pack. Areas for improvement We found that the service should continue to develop its quality assurance systems to assist in identify any concerns. We found that the service may wish to consider involving residents and their carers/ friends in any audits, where appropriate. Grade awarded for this statement: Number of requirements: 0 Number of recommendations: 0 The Haining Nursing Home, page 24 of 29

25 4 Other information Complaints No complaints have been upheld, or partially upheld, since the last inspection. Enforcements We have taken no enforcement action against this care service since the last inspection. Additional Information Action Plan Failure to submit an appropriate action plan within the required timescale, including any agreed extension, where requirements and recommendations have been made, will result in the Care Inspectorate re-grading a Quality Statement within the Quality of Management and Leadership Theme (or for childminders, Quality of Staffing Theme) as unsatisfactory (1). This will result in the Quality Theme being re-graded as unsatisfactory (1). The Haining Nursing Home, page 25 of 29

26 5 Summary of grades Quality of Care and Support - Statement 1 Statement 3 Quality of Environment - Statement 1 Statement 2 Quality of Staffing - Statement 1 Statement 3 Quality of Management and Leadership - Statement 1 Statement 4 6 Inspection and grading history Date Type Gradings 20 Jan 2014 Unannounced Care and support Environment Not Assessed Staffing 2 - Weak Management and Leadership Not Assessed 26 Apr 2013 Unannounced Care and support Environment Staffing 3 - Adequate Management and Leadership 24 Apr 2012 Unannounced Care and support Environment Staffing Management and Leadership The Haining Nursing Home, page 26 of 29

27 29 Nov 2011 Unannounced Care and support 5 - Very Good Environment Staffing Management and Leadership 5 - Very Good 29 Aug 2011 Unannounced Care and support 5 - Very Good Environment Staffing Management and Leadership 5 - Very Good 24 Nov 2010 Unannounced Care and support Environment Not Assessed Staffing 3 - Adequate Management and Leadership Not Assessed 8 Jul 2010 Announced Care and support 2 - Weak Environment Not Assessed Staffing 2 - Weak Management and Leadership Not Assessed 22 Mar 2010 Unannounced Care and support Environment Not Assessed Staffing Management and Leadership Not Assessed 21 Aug 2009 Announced Care and support Environment Staffing Management and Leadership 24 Mar 2009 Unannounced Care and support Environment Staffing Management and Leadership Not Assessed 5 Sep 2008 Announced Care and support Environment Staffing 3 - Adequate Management and Leadership 3 - Adequate The Haining Nursing Home, page 27 of 29

28 All inspections and grades before 1 April 2011 are those reported by the former regulator of care services, the Care Commission. The Haining Nursing Home, page 28 of 29

29 To find out more about our inspections and inspection reports Read our leaflet 'How we inspect'. You can download it from our website or ask us to send you a copy by telephoning us on This inspection report is published by the Care Inspectorate. You can get more copies of this report and others by downloading it from our website: or by telephoning Translations and alternative formats This inspection report is available in other languages and formats on request. Telephone: enquiries@careinspectorate.com Web: The Haining Nursing Home, page 29 of 29