Inspection on 28/07/05 for 39 Harvard Road

This inspection was carried out on 28th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

39 Harvard Road 04/07/06

39 Harvard Road 12/12/05

39 Harvard Road 11/01/05

39 Harvard Road 13/09/04

Similar services:

Ridgemount

Wingham Court

Old Hastings House

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE 39 Harvard Road Ringmer Nr Lewes East Sussex BN8 5HH Lead Inspector Judy Gossedge Unannounced 28 July 2005 1:30 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 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. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 39 Harvard Road Address Ringmer Nr Lewes East Sussex BN8 5HH 01273 812125 01273 814468 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) East Sussex County Council Mr Broderick Sharman Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (OP) 36 of places 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. That a maximum of thirty-six (36) service users are accommodated. 2. That service users must be aged sixty-five (65) years or over on admission. 3. That three (3) places will be available for service users between the age of fifty-five (55) and sixty-four (64). Date of last inspection 11 January 2005 Brief Description of the Service: 39 Harvard Road is run by East Sussex County Council (ESCC) and is a purpose built property on two floors, set in its own grounds in Ringmer, with the village centre nearby. Service user accommodation comprises of thirty-six single bedrooms, one of which can be used as a double bedroom. Situated in three units within the home each with dining and lounge facilities, on two floors with level access facilitated in the home with the provision of a passenger lift. There is a conservatory and garden for service users to access. Two units are for service users receiving respite care or short term care for periods of up to six months. One unit is for service users on the Living at Home Programme, a rehabilitation scheme run by ESCC to work with service users to return home within an agreed timescale of up to six weeks. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five and a quarter hours on 28 July 2005. This is the first statutory inspection of this year. A tour of the home took place including communal areas and service users bedrooms. Rotas and care records were also inspected. Twenty-six service users were resident and eight service users were spoken with individually, two in the lounges and six in their bedrooms. Comment cards were left in the home and one was returned from a service user. Four service users were case tracked as part of the inspection process. Four relatives visiting at the time of the inspection were also spoken with. The Manager was not present, one senior care officer, two duty officers, six care workers one of whom was the activities co-ordinator were spoken with. Since the last inspection the CSCI has sent separate correspondence to the Responsible Individual for ESCC to raise concerns at the recruitment processes and lack of evidence of recruitment documentation in place on site for all its registered services. What the service does well: A Service Users Guide is available to view with other supporting information in each service user’s bedroom. Staff were observed to deliver care with dignity and respect. All the visitors and service user feedback was that they were pleased with the overall care provided in the home. There is a detailed complaints procedure in place which the visitors felt comfortable about using if they needed to. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Staff in the home need to receive assessment information prior to any admission to ensure that service users are appropriately placed and their individual care needs can be met. Recruitment procedures and staff information needs to be held at 39 Harvard Road to evidence that this is in place to meet requirements to ensure the safety and welfare of service users. Some issues relating to health and safety were identified, and an update of training in moving and handling and basic food hygiene provided has been requested to ensure the health safety and welfare of service users. There are still limited opportunities for service users to join in leisure activities to ensure their social care needs met. Hot water outlets accessed by service users do not have fail-safe devices fitted locally to protect service users. Service users should have an area where their privacy is maintained when using the pay telephone. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 3. Although detailed information about 39 Harvard Road is available to be viewed prior to any admission to the home, because of the type of service provided service users have limited choice of placement. Service users are protected by the completion of a written contract/terms and conditions. There are pre-admission procedures in place, which need to be followed to ensure that service users are always appropriately placed at 39 Harvard Road. EVIDENCE: A Statement of Purpose is in place. A copy of the Service Users Guide is kept with other supporting information for reference in each service users bedroom. There are forums for service users and their representatives to give their views on the service received. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 10 ESCC has a written contract to be used between the home and the service user, and a number of signed contracts were viewed. All service users are assessed by staff from one of ESCC’s Social Services Department’s Assessment Teams and have an assessment completed. A copy of this or of the latest review of this assessment is then sent to the home for reference. But the documentation viewed for four new service users did not have this information to reference. One service user and their relatives commented that there had been some difficulties at admission in to the home as it appeared there had been a lack of awareness in the home of all the service users care needs. But that following this the service user felt the issues had been addressed, had settled in well and was happy with the care provided. Fifteen service users have been resident in the home for longer than six months and are really being provided with long term care whilst awaiting ESCC to provide funding for further placements. The Statement of Purpose needs to refer to these service users and how their care needs are to be met. Documentation viewed for one service user who was due to leave the home shortly indicated that their care needs did not meet the registration category for any of the units in the home, and the individual care plan in place did not demonstrate that all this service users care needs were being met. Intermediate or rehabilitative care is provided but not inspected on this occasion. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Staff are not provided with the detailed information they need to ensure that service users’ health, personal and social care needs are met, therefore putting service users at risk. There are detailed policies and procedures in place to manage medicine which need to be followed to ensure the protection of service users. EVIDENCE: A sample of four individual care plans were viewed which varied in detail, and did not always fully describe service users’ care needs or have supporting risk assessments in place. The supporting documentation viewed detailed the following: service users with dietary requirements, assistance required relating to mobility and risk of falls, health and personal care needs, changes in personal care needs during the stay on the unit, all of which had not been included on individual service users care plans. Where service users had been resident for short or long-term care their individual plans did not appear to have been reviewed to ensure that their care needs were still being met. Medication policies and procedures are in place and being reviewed. Staff confirmed they are in the process of receiving further medication training 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 12 arranged by the organisation to fully meet the requirements of this standard. Staff were observed administering medication. The storage and a sample of the recording of the administration of medication was also viewed and was adequate. Where service users are self medicating generic risk assessments were seen to be in place, which did not reflect individual service users care needs. Service users were seen to be treated with dignity and respect. Comments received from service users were “There is only one word to describe this place and that is superb and that also is the word for all the staff and the food is excellent. I am certainly looking forward to coming here again. Truly a wonderful experience in every part of the service here.” “Everyone is greatly interested in each person in the home and the staff are superb in the feelings for residents.” “’Very excellent care, no complaints.” “Staff are very good and caring.’” “Happy with the care provided and commented they were treated well and enjoys coming back.” A requirement was made following the last inspection to enable service users more privacy when making telephone calls using the pay telephone. Staff confirmed this was still being looked in to, but since the last inspection a new emergency call system has been fitted in the home and ways to ensure compatibility of systems to facilitate this are still being considered. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13. There are limited opportunities for service users to participate in activities during their stay, so not all service users social care needs are fulfilled. There is flexible visiting in the home and visitors to the home are welcomed. EVIDENCE: The Inspector met with the activities co-ordinator and was informed of the range of activities in place or being planned to suit service users different interests. Staff are also working on a further activity area in the home which is not yet ready for use. An activity programme is in place, but there is limited frequency and staff spoken with stated there was not always time to provide activities as planned. One service user commented that time in the home can be monotonous and would welcome more activities and especially opportunities to go out. Four relatives commented and service user feedback was that there is flexible visiting, that staff were always very welcoming, and they were able to meet with their relative/friend in private. Standard 15 was not fully assessed on this occasion, but all the service users commented on how good the food was. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16. There is a clear and effective complaints procedure in place, which enables service users and their representatives to raise any concerns that they might have. EVIDENCE: ESCC has a detailed compliments and complaints policy and procedure in place. Any complaints received are monitored through the line management arrangements in place within the organisation. No complaints have been received since the last inspection. The CSCI has not received any complaints in relation to 39 Harvard Road. The visitors confirmed that they would feel comfortable raising any concerns with the staff or the Manager. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 25, 26. The standard of the environment varies within the home and does not always provide service users with a safe, attractive and homely place to live. EVIDENCE: The standard of décor, carpeting and furnishings is variable. A number of bedrooms have been repainted. The décor in the hallways and the dining room on Ballard unit is damaged and the carpet is badly stained. The quality of the furnishings in the bedrooms and communal areas in the home is varied. The driver/handyperson has been redecorating in the home, and the Manager subsequently stated that there is a plan of redecoration and carpet cleaning now in place. There is an attractive garden, which service users spoke of using which has a level access walkway. There is a passenger lift between the ground, and first floor within the home. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 16 There are thirty-six single bedrooms, one of which could be used as a double bedroom. Only two of the bedrooms meet the minimum space requirements. Two bedrooms are above 12 sq.m and could be accessed by a service user using a wheelchair. Service users are able to control the temperature in their own bedrooms. A new emergency call bell system has been installed in the home and there is access to this in all bedrooms. Some of the bedrooms seen reflected a range of individual styles and interests. There are no en-suite facilities, but there are separate toilets on each of the units and close to the communal areas. Two sets of double toilet blocks have now had the dividing walls raised from the floor to ceiling affording greater privacy. Four communal assisted baths are within the home, which is the same ratio as provided at 31.03.02. The bathing facilities should be kept under review to ensure that adequate facilities are available for service users use. Bathrooms were in the process of being painted. Hot water in seven hot water outlets accessed by service users were tested, and all were close to the recommended safe temperature of 43 C. The Manager subsequently confirmed that fail-safe devices have not been fitted as required. The CSCI understood that this work would be completed during the summer 2005 and further assurance that this will be completed has been sought. Confirmation needs to be provided that the Water Supply Regulations 1999 are being met. There is a dining room and lounge areas on each unit. One room is designated for the use of service users who wish to smoke. There was only one member of relief staff undertaking domestic duties in the home. Generally home appeared clean and was free from offensive odours, although there were some bedroom areas where there was a slight odour. The recording of routine fire checks were seen and were adequate. But there was some wedging of doors open in the home, and an Immediate Requirement Form was left to resolve this issue. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29. Adequate staffing levels need to be maintained to ensure that all the care needs, the health safety and welfare of the service users resident are met. ESCC recruitment policies and procedures need to be followed in order to protect service users. EVIDENCE: A staffing rota was viewed. Feedback from staff was that there has been a high reliance on agency and relief staff working in the home since the last inspection. There has been a shortage of housekeeping and laundry staff so that minimum staffing has not always been maintained, and care staff have been helping with the washing of the service users clothes in the laundry. One member of care staff had been designated to do the cooking in the home that day to cover annual leave and days off. Staff confirmed that recent recruitment of new housekeeping staff should help to resolve this issue. On the day of the inspection only one relief member of staff was undertaking domestic tasks in the home. Due to the number of service users receiving respite care and the increased turn around of service users, and the high number of emergency admissions to the home it has been required that the staffing levels are kept under review, particularly on Ballard Unit the largest unit. Although Standard 28 was not fully assessed fifteen percent of staff have undertaken a qualification at NVQ Level 2 in care or equivalent, with thirty 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 18 percent working towards this qualification, and more staff due to commence on the organisations rolling programme. All recruitment is co-ordinated by the Personnel Section at ESCC’s head office, which the Inspector has visited and viewed sample documentation across the organisations registered services to support the recruitment process in place. Some gaps in the required documentation were found which need to be addressed. In future recruitment documentation will need to be available at the home as part of any inspection completed. It was not possible to confirm during the inspection, but the Manager has subsequently stated that all staff have a satisfactory Criminal Records Bureau (CRB) check in place. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Although Standard 38 was not fully inspected, an update of outstanding training requirements has been requested. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 3 3 x x x 2 2 STAFFING Standard No Score 27 2 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 21 Yes Are there any outstanding requirements from the last inspection? 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 3 Regulation 14 (1) (b) Requirement A copy of the initial assessment/review is available for staff to reference prior to admission. That individual service plans in place are subject to further development, to ensure that all areas of care to be provided is detailed, and there are clear instructions for staff to follow in relation to individual service users assessed health and personalcare needs, reflect leisure interests and likes and dislikes. These are subject to regular review. That risk assessments are in place where indicated and reflect service users individual care needs. That the sighting of the service users telephone is reviewed to ensure that service users have privacy when using this facility. This issue is outstanding since 31.03.05. That leisure and social activities are subject to review and further development. This is an outstanding issue since 30.04.05. That a copy of the plan of Timescale for action 31.08.05 2. 7 15 (1) 31.08.05 3. 10 16 (2) (b) 30.09.05 4. 12 16 (1) (m) 30.10.05 5. 19 23 (2) (d) 30.09.05. Page 22 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 6. 7. 8. 9. 19 19 25 25 23 23 13 14 10. 27 18 11. 38 18 redecoration of the home is provided. (4) (a) That advice is sought on the current practice of wedging doors open and acted upon. (4) (a) That the stairwells are not used as storage areas. (4) That evidence is supplied in relation to adherence to the Water Regulations 1999. (4) (a) That hot water outlets which are accessible to service users have fail-safe devices fitted locally to provide water close to 43°C. This issue is outstanding since 31.10.03. Written confirmation will be provided to the CSCI that this work will now be completed. (1) (a) That it is ensured that at all times suitably qualified, competent and experienced persons are working in the care home in such numbers as are appropriate for the health and welfare of service users. ( c ) (i) That the CSCI receives confirmation that staff have received the required updates in moving and handling and basic food hygiene. A system is in place to ensure that staff receive the appropriate update within the required timescale.This issue is outstanding since 31.03.05. 28.08.05 28.08.05 30.09.05 30.09.05 31.08.05 30.09.05 12. 13. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 23 Refer to Standard Good Practice Recommendations 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI 39 Harvard Road H59-H10 S41389 39 Harvard Road V218892 280705 Stage 4.doc Version 1.20 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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