Inspection on 16/08/07 for Adalah Residential Rest Home Ltd

This inspection was carried out on 16th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Adalah Residential Rest Home Ltd 15/12/09

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Adalah Residential Rest Home Ltd 20 Cliff Road Leigh On Sea Essex SS9 1HJ Lead Inspector A Thompson Unannounced Inspection 16th August 2007 10:15 X10015.doc Version 1.40 Page 1 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 Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 2 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. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Adalah Residential Rest Home Ltd Address 20 Cliff Road Leigh On Sea Essex SS9 1HJ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01702 711162 Adalah Residential Rest Home Ltd Mrs Patricia Joan Broughton Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Not applicable – new service Brief Description of the Service: Adalah Residential Rest Home Ltd is a converted and extended house in a residential area of Leigh On Sea close to the seafront. It is a two-storey building with some split-levels on both floors. Service users can access all areas by the use of a shaft passenger lift and stair lifts. There are eighteen single and four double rooms. All but three have en-suite wc and hand basin. Communal areas consist of a lounge and split level dining room on the ground floor and a lounge/dining room on the first floor. There is also a small visitors lounge on the first floor. To the rear of the home is a garden with areas for service users to sit in and a fishpond. The ground floor lounge also has direct access to a patio overlooking the garden. Off road parking for approximately 3-4 cars is available to the front of the home. Limited street parking is also available outside. Adalah is close to a mainline railway station and a short walk (some uphill) to local shops and a bus route. Fees for the home are understood to be up to £495 per week. CSCI inspection reports are available from the home and the CSCI internet website. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Thursday 16th August 2007. This was the first inspection since a change of ownership took place in February 2007. The previous registered manager and staff team have remained in post and there appeared to have been virtually no change in the service provided since the new owner took over. The inspection process was dealt with mainly by the deputy manager with the registered manager in attendance at the beginning of the visit. The content of this report reflects the inspector’s findings on the day of the inspection along with information provided by the service and feedback by service users, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with nine service users, the registered manager, deputy manager, registered provider, three members of staff and seven visitors (including relatives, advocates and health professionals). Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All service users spoken to expressed full satisfaction with the care they received and the accommodation offered. Most were satisfied with the food provided. Visitors spoken with were complimentary of the care and support provided to service users by the staff and manager. Questionnaires were left at the home so that relatives not spoken with on the day had the opportunity to make their views on the service known to the Commission. Staff confirmed they received good support from management. They also confirmed that they had been offered training appropriate to their role. Twenty-seven standards were inspected and the outcomes for service users against twenty-two of these were good, with five adequate. As a result this report includes just two statutory requirements and four good practice recommendations as areas for improvement. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Risk assessments must be in place covering the unguarded garden fishpond. Records need to be in place to confirm that all new staff have received structured induction training to evidence that they received training for their role from the start of their employment. Activities for service users should be provided by staff trained for that role, and records should evidence what activities are actually taken part in by whom. Staff training on medication should evidence the syllabus content covered and a written competency assessment before they take on this role. ---------------------------- 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. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 Quality in this outcome area is good. Admission processes ensure that service users can be confident that the home considers they can meet their needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service user files inspected evidenced that pre-admission assessments are carried out by the manager. Assessment headings included personal and healthcare needs. Completed assessments seen had been signed by the service user and the member of staff involved. Service users and their families/representatives are encouraged to visit the home as many times as they wish before agreeing to admission, which is initially on a month’s trial. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Care plans had been regularly reviewed and provided up to date information on the health, personal and social care needs of service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Three care plans were inspected. Each included background information, personal details and next of kin contacts. There were detailed daily needs recorded and instructions for staff under headings of hair, feet, teeth, vision, hearing, speech, toilet, continence, mobility, washing, dressing, bathing, diet, behaviours, activities, religion and interaction with staff. A record of weight gain/loss had been kept and was seen. Service users had been included in the care planning process and had signed (or their advocates) to confirm they agreed with the plan of care recorded. Plans seen had been regularly reviewed. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 10 The deputy manager advised that none of the current service users had any mobility problems or the need for district nursing services. Risk assessments are completed if any manual handing needs are identified on admission. Day to day risks and prevention measures were identified in care plans. A chiropodist visits the home every eight weeks. If service users require an optician or a dentist they visit community based facilities. This is mainly with relatives support but staff from the home will fill this role if needed. Service users have the choice of two local GP practices to register with. Continence issues were reported as minimal but advice is available from a Commuinity Continence Advisor if needed. The homes medication policy and procedure covered ordering, receipt, storage, safekeeping and returns of unused stocks. There was also detailed guidance seen for staff on the home’s expected procedures for administering medication to service users. The home has a large management team with two care managers to support the manager and deputy manager, and the inspector was advised that it was mainly this team who dealt with medication, all of whom had received certificated training in the safe handling of medicines, evidence seen. However other staff (none senior) are involved in medication administration and their training was reported as being provided in-house by senior staff qualified to do so. Records of this were not available nor was there any record of a competency assessment having been carried out to verify good practice standards by these staff before they undertook responsibility for medication. There is a recommendation on this issue in this report. Medication administration records were inspected no shortfalls were noted. Discussions with individual service users indicated that they were treated with respect by staff, as did observation of staff going about their duties and interactions with service users. Staff on duty were seen to be courteous, caring and professional in their dealings with service users, and service users spoken with said staff were very helpful and considerate. Visitors spoken with were also complimentary regarding staff attitudes and the care provided. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. The home provides flexible routines and a lifestyle that enables service users to make choices. However evidence should be available to confirm their interests are provided for. Service users health and welfare is promoted by the provision of a varied and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home did not have an activities coordinator, instead care staff are expected to undertake this role. Two staff had received some basic training on activities however this needs to be expanded to include all staff who are asked to suggest activities to service users. There is a recommendation on this point in this report, and also that individual activity records are kept for all service users to evidence that their preferences are catered for on this subject. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 12 It should be noted that a weekly activities programme was presented for inspection which showed that quizzes, music, films and bingo are offered and the deputy manager produced evidence that service users had been asked for their views on the activities listed. Local clergy visit monthly to hold a service in the home and there are occasional visits made by a local advocacy service to chat with service users. A visit took place on the afternoon on the inspection. Information on advocacy was also displayed in the home. A hairdresser visits weekly. Service users spoken with were generally positive about the meals provided and confirmed that if they did not want the menued lunch they were provided an alternative. Teas are usually a choice of sandwiches or something hot on toast. The home does not employ a chef or cook, instead members of the management team take turns to do the cooking. Foods stocks seen were good. Service users spoken with confirmed they were satisfied with the choices and options made available to them regarding daily routines. Visitors spoken with said they were always made welcome by staff. Inspection of private rooms confirmed that service users had been permitted to bring their own personal items with them on admission. There was also confirmation of this direct from service users, who told the inspector of the furniture and personal items they had been permitted to bring in with them. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. Practices in the home safeguard service users, and ensure that concerns are listened to and addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure contained guidance on how to make a complaint and who to complain to. Also included were timescales for responses from the home. There had been no complaints since the last inspection so the inspector could not fully judge whether the home’s responses to complaints was adequate. The deputy manager did say that any complaints received would be investigated and records would be kept of the findings, outcomes and response. There was no template for recording complaints or compliments and following a discussion on this point the deputy manager said she would look into formulating such a form. Service users spoken with said they knew who to speak to in the home if they any concerns, and that in the past management had responded positively to any queries/issues they had raised. The homes policy on adult protection was inspected, there was written guidance for staff on recognising and reporting abuse and action to be taken by staff and the person in charge if abuse is suspected. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 14 On site were the local Social Services dept guidelines on adult protection and abuse along with the Essex Vulnerable Adults Protection Committee guidance and training pack. Care staff had been trained on POVA and the management team had received managers guidance training on this subject. Certificates of evidence were seen. The home also had a ‘whistle blowing’ policy which provided guidance to staff on their responsibilities to report any concerns to management. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 Quality in this outcome area is good. Furnishings in the home looked comfortable and the home appeared internally safe and was well maintained, but consideration needs to be given regarding potential risks associated with the unguarded garden fishpond. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 16 The home was clean, tidy and free from unpleasant odours. Those bedrooms seen were comfortable and made homely with people’s personal possessions. The home has sufficient toilet facilities. There were three bathrooms, two of which had fully assisted parker baths fitted. There was also a shower room. One bathroom on the first floor had slight raising of the floor covering, the manager noted this and advised during the inspection that this was going to be replaced and resealed. Also noted by the inspector (and mentioned by the manager before being raised by the inspector) was that the garden fishpond was unguarded. The manager advised that the new owner was intending to fence this off in some way on safety grounds, however until this is addressed this report includes a statutory requirement that a written risk assessment is in place on this potential hazard to try to minimise the risk to service users. The laundry had appropriate equipment for the home’s laundry needs. Communal space is sufficient with two lounges and a dining room. There is a well maintained attractive garden to the rear with another well laid garden at the front. The home has won regular awards for its gardens. Evidence was seen that the fire service regularly visit the home as do the local environmental health dept. There were no outstanding issues noted from these visits. The deputy manager confirmed that radiators were guarded and that hot water supply is regulated with monthly manual checks (records seen) taking place. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. Staffing levels appeared to meet the needs of service users, staff had been trained but induction and medication training needs to be evidenced for all staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s staffing rota was inspected and confirmed that staffing levels are being maintained at three staff on duty throughout the day and two on waking duties at night. The managers hours were supernumery. Staff spoken with felt the current levels are adequate to meet service users needs. In addition, the home employs domestic and laundry staff. Discussion with staff and records confirmed that regular staff meetings are held. Agenda items included training, service users and general issues. These take place every two months. Staff records and discussion with staff evidenced that application forms had been completed, interviews held, written references obtained, written terms & conditions issued and criminal records checks undertaken. Copies of proof of ID and photographs were also on file. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 18 The home had an induction format which was based on the Skills for Care induction standards, however this had not been followed. New staff must be given formal structured induction training to be sure they understand their role. This report includes a statutory requirement on this issue. The deputy manager did say that all new staff are ‘shadowed’ for up to two weeks when they start to induct them, but again no records of this process were seen. Records of staff training and discussion with staff confirmed that staff had been trained in fire safety, manual handling. POVA (adult protection), first aid, food hygiene, infection control, bereavement, communication, mobility, and health and safety. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. The home had been run and managed efficiently. Procedures for gaining the views of service users and relatives were in place to ensure their views were listened too. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been in post for 22 years (21 years as coregistered provider prior to recent change of ownership). The management team comprises a deputy manager and two care managers. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 20 Some service users personal allowance monies were held for safe keeping by the home. A random sample of records of transactions and balances held were inspected, no shortfalls were noted. An annual quality assurance process takes place with questionnaires issued to service users and relatives. Topics covered included environment, staff attitudes, care provided, the food and laundry. The last survey was carried out in June 2007, the summary of responses and of any resulting actions had not yet been formulated. This will be checked at the next inspection. Staff had received recorded 1-1 supervision from the management team, discussion included topics of: service users, training and personal development, with any actions decided. Unfortunately these meetings had not taken place to the recommended timescales. There is a recommendation in this report on this point. Random samples of records required by regulation were checked and found to be in order. Certificates and service records were available for inspection to confirm that the home’s fire equipment, passenger lift, hoists, call alarms, emergency lights, gas supply, portable electrical appliances and electrical installation supply had all been tested/serviced within recommended timescales There was a premises risk assessment in place. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling training, fire safety, food hygiene, first aid and basic training in infection control. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 21 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. 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 X 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 3 Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP19 Regulation 23(2)(o) Requirement A risk assessment must be in place covering the unguarded garden fishpond to ensure that potential risks relating to services users have been addressed. Records must be available to evidence that all new staff have received structured induction training which is based on the Skills for Care common induction modules. Timescale for action 30/09/07 2 OP30 18 30/11/07 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 Refer to Standard OP9 Good Practice Recommendations Training provided to all carers who administer medication to service users needs to include written evidence of the subjects covered, and of a competency assessment to ensure they are trained for the task. Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 23 2 3 OP12 OP30 OP12 Staff who are responsible for offering activities to service users should all be trained for that role. Records should be available for inspection of all activities offered and taken part in by individual service users to evidence that the home meets service users expectations. Records should be available for inspection to confirm that all staff have been offered 1-1 supervision at least six times a year. 4 OP36 Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Adalah Residential Rest Home Ltd DS0000069380.V348939.R01.S.doc Version 5.2 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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