Inglewood Nursing Home
Extract from the latest CSCI Inspection report on the 25th May 2007.
The complete report is available for down loaded above or by visiting: www.csic.org.uk
Brief Description of the Service:
Inglewood is a registered care home providing nursing care for sixty residents, who meet the registration category of elderly and physically disabled. The accommodation offered consists of fifty single rooms of which twenty seven have an en-suite facility, five double rooms one of which has an en-suite facility. There are ample communal bathrooms with specialist equipment to ensure the safety of residents whilst bathing. The home has the necessary specialist equipment required to meet the varied needs of residents, including
hoists, air mattresses and cushions. There is level access to all parts of the home by passenger lifts. The home is well maintained internally and externally, with well-tended gardens that are accessible for wheelchair users.
The home is situated in a residential area of Hampden Park, near to an attractive park and the local shops. There are public transport amenities close to the home. Inglewood is set back from the road and has parking facilities to the front for approximately ten cars.
SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out on the 25th May and took place over six and a half hours. The inspection included a tour of the home, a review of pre-admission assessments, care plans, staff records and training, medication records,
activities, and menus. There were 58 residents at the home during the inspection. Twenty six of the residents were spoken with and four visitors to the home were happy to discuss the support provided at the home.
The manager, registered nurses and the staff on duty discussed the care and support they provide at the home. The Annual Quality Assurance Assessment (AQAA) was downloaded by the manager from the CSCI website and following discussions with the Commission the manager advised that it is being completed. It is a new assessment format and will take time to complete. The reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term service user to describe those living in care home settings. However for the purposes of this report those living at Claremont House will be referred to as residents.
What the service does well:
The atmosphere at the home was relaxed and the residents were able to choose to spend their time in the lounge or in their own rooms. Communication between residents and staff was friendly and reflected the
staffs understanding of their needs and the support they require. The residents spoken with were positive about the care provided saying the staff are ‘very good’ and offer the care they need. Visitors were equally
positive saying the home is very good and the staff know what support and care the residents need and want.
What has improved since the last inspection?
One requirement was recorded following the last inspection report concerning the discrepancies between the care plans kept in the offices and those in the residents rooms. The manger advised that a new care planning system in being developed to address this.
What they could do better:
There are no requirements listed in this report however some concerns were noted. These were discussed with the manager during the inspection and have been included in the body of the report. These include staff following the homes infection control procedures and the completion of fluid charts.
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.
Choice of Home:
JUDGEMENT – we looked at outcomes for the following standard(s): 3.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Information about the services offered at Inglewood is available for all prospective residents. Pre admission assessments are completed to ensure the home can meet the needs of prospective residents, and they are encouraged to visit the home.
EVIDENCE:
Pre admission assessments are completed for all prospective residents before they are offered a room at the home. Those examined contained details of the resident medical and social history, as well as information about their interests and support needs, and identifies the risk assessments that will need to be carried out. The assessments are completed with the resident and their relatives, two residents said they were to make sure that the home could give them the right support. A number of residents said that they knew people who had stayed at Inglewood and had visited them so felt ‘sure the home was the best place’ for them, and other residents said that the home had been recommended.
Health & Personal Care
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.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care planning system ensures that appropriate support and care is provided for residents, and they are protected by staff following the home’s procedures for medication.
EVIDENCE:
The resident’s medical, nursing and social needs are recorded in the care plans in sufficient detail to enable the staff to offer appropriate care and support. The specific needs of residents were identified and staff were able to discuss how these are met and what additional support may be required, including hoists and pressure relieving mattresses. Risk assessments are carried out and these include moving and handling and nutritional assessments linked with the monthly weights. The care plans are reviewed on a regular basis and there was evidence that residents and relatives are involved in this process.
There was some confusion regarding the use of a fluid chart for a resident, in that was it required. But it was with the residents when she was sitting in the lounge and staff had not completed it appropriately. A folder is kept in the residents rooms to provide care staff with information about the residents support needs, and they record the care they offer over each twenty four hour period. These should be reviewed monthly with the care
plans but it was noted that some were not done on a regular basis. The care staff who were spoken with said they did not read the care plans that are kept in the office and therefore rely on the information in residents rooms. This was identified as a concern at the last inspection and the care planning system has been reviewed to address this. The information included in the care plans and the folders will be combined and placed in folders in the residents rooms. The manager explained that they will be starting to use this new
system with new residents, and then extend it to include all residents as the staff become more familiar with the change. There are policies and procedures in place for the receipt, storage and administration of medicines. During the inspection the monthly supply of medicines had been delivered they, and the medicine administration records (MAR) charts, were being checked and arranged for the following month. To ensure that the records are up to date and correct an audit is carried out regularly, and the MAR charts that were examined during the inspection were completed correctly. Residents at the home said staff looked after them ‘very well’ and this was supported by relatives who also felt that the ‘home is very good’ and they know what support and care the residents need and want. Communication between residents, visitors and staff was relaxed and friendly with staff chatting to residents as they assisted them, asking them what support they wanted and if they were comfortable.
Daily Life and Social Activities
JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about all aspects of their day to day lives, and the meals a the home are good, offering choices and meeting residents specific dietary needs.
EVIDENCE:
A varied programme of group and individual activities has been developed for the residents at the home. A group of residents were sitting in the small lounge doing exercises to music after lunch, and some of the residents spoken with said, the staff do a very good manicure with a choice of nail varnish. Residents said that they are able to choose what they want to do and take part in activities if they wish. The previous day a trip had been arranged and several took advantage of a tour around Eastbourne by minibus, with a stop at Beachy Head for ice cream. The weather had been ‘lovely’ and ‘we really enjoyed ourselves’.
Visitors are welcome at any time, those spoken with said they feel comfortable visiting their relatives and friends, they are sure ‘they are well looked after’, and feel that they can talk to the staff if they want to know anything or have any concerns.
The staff said residents are encouraged make choices about all aspects of their day to day lives, and a number of residents said they are able to choose how they spend their time, in their own room or in one of the lounges, and the staff are there to help them if they need it. They meals at the home are good, choices are available, the home caters for specials diets, and staff are available to assist residents if required. Residents spoken with said that the food is very good, they can have something to eat any time they like, and their relatives and friends can stay for meals if they wish. On the day of the inspection a resident was celebrating a family member’s birthday in the lounge, with balloons and a birthday cake.
Complaints and Protection
JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to record and investigate complaints. Training in adult protection is provided for staff to protect residents from abuse.
EVIDENCE:
There are appropriate procedures in place for dealing with complaints. The manager explained that complaints are recorded, investigated within a twenty eight day timescale and acted upon if necessary. Residents spoken with said they are able to talk to about anything with the staff and feel that their concerns are acted upon.
There are opportunities for residents and relatives to discuss any aspect of the services and care provided at the home during the residents and relatives meetings, these are organised four weekly and quarterly respectively.
Staff spoken with said they have attended training in adult protection and were able to demonstrate an understanding of abuse and where quite clear that they would discuss any concerns with the Sister on duty.
Environment
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.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service.
Inglewood provides residents with a homely and comfortable environment with communal rooms and a shaft lift that enables them to have access to all parts of the home. Training in the control of infection is provided for staff to protect residents.
EVIDENCE:
There are five double and 50 single rooms at the home, these are homely and comfortable with furniture that is appropriate for the residents individual nursing needs. The residents are encouraged to bring their own possessions with them, and many have furnished their rooms with small pieces of furniture, pictures and ornaments. There is an ongoing maintenance programme at the home, with repairs carried out when the need arises. There are two lounges, with one attached to the conservatory, and a separate dining room. Residents have access to the attractive gardens to the rear and some were taking advantage of the warm weather during the inspection. Training in controlling infection is provided for staff and there are policies and procedures for staff to follow. The appropriate use of aprons was discussed during the inspection and the Sister on duty talked immediately to staff members who were not following the policies.
Staffing
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 and 30.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Robust recruitment procedures are in place to protect residents, and staff training ensures they are aware of their roles and are able to provide the support and care the residents need.
EVIDENCE:
The staffing levels were adequate and those spoken with said they have time to spend chatting with the residents and their relatives. Residents said they are well looked after and they do not have to wait long when they need assistance from the staff. The home has robust recruitment procedures, which require completed
application forms, two references and Criminal Registration Bureau (CRB) checks. Four were examined during the inspection and all but one had two references.
All staff are required to attend mandatory training including moving and handling, fire training, infection control, in addition to induction training that is in line with Skills for Care. Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the manager.
Management & Administration
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 and 38.
People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management approach at Inglewood is open and encourages residents, relatives and staff to be actively involved in decisions about the services provided at the home. The health and safety of residents is protected through an ongoing training programme for staff.
EVIDENCE:
Residents, relatives and staff are encouraged to participate in discussions about the services provided at the home. There are regular meetings that they can attend if they wish, and questionnaires are sent out to residents and relatives following admission to the home. The manager confirmed that feedback is sought from all groups and individuals who have any contact with the home, as part of the quality assurance system, and monitoring of all aspects of the care and support provided is carried out on a regular basis. The comments from residents and relatives during the inspection were very positive, and there were no suggestions as to how they service could be improved from anyone, including staff. Training required by legislation, including moving and handling, fire training and infection control is provided for all staff to protect the health and safety of residents.
The complete report is available for down loaded above or by visiting: www.csic.org.uk