Inspection on 01/07/05 for Biffins

This inspection was carried out on 1st 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

Biffins 02/07/08

Biffins 07/08/07

Biffins 13/07/06

Biffins 06/12/05

Biffins 15/12/04

Biffins 20/09/04

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 Biffins 18 Thorpedene Gardens Shoeburyness Essex SS3 9JB Lead Inspector Christine Bennett Unannounced Friday 1 July 2005 10:30am st 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. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Biffins Address 18 Thorpedene Gardens Shoeburyness Essex SS3 9JB 01702 292120 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) sjoomun24@yahoo.co.uk Mrs Bibi Sehnaz Bano Joomun Mr Mohammed Fazial Joomun CRH Care Home 14 Category(ies) of OP Old Age (14) registration, with number of places Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of service users not to exceed 14. 2. Service users to be older persons over the age of 65 years. 3. Both Mr and Mrs Joomun to attend a course on Adult Protection based in Southend-on-Sea Adult Protection Multi-Agency Procedure 2002 within 3 months from the date of registration. 4. Mrs Jooman to obtain training in good care practice in care homes for older people and attend relevant staff training during the first 12 months of registration. 5. Door wedges to be replaced with devices that will cause corridoor fire doors to close automatically in the event of a fire within 3 months of registration to meet the Care Homes Regulations 2002, Regulation 23.4(a). 6. The proprietor to submit an action plan to the local office within 3 months of registration that meets with the Care Homes Regulation 2002, Regulation to 23.2 (1) and ensures that service users have a room to meet visitors in private. 7. All service users to be provided with lockables bedroom doors and a lockable facility to store personal items and valuables within 6 months of registration to meet with the Care Homes Regulations 2002, Regulation 23.1 (a) Date of last inspection 15th December 2004 Brief Description of the Service: Biffins is a care home for older people over 65 years of age and can accommodate 14 people. It is situated in a residential area of Shoeburyness with easy access to shops and other amenities. There are good bus and train links to the area. The home has accommodation on two floors and there is a passenger lift to enable access to both floors. There are 8 single bedrooms and 2 twin bedrooms, although only 1 resident is occupying each of these rooms. The home has a large lounge/dining area and a large garden. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 1st July 2005 over 8 hours. The inspection process included discussion with the assistant manager, the supervisor, 2 care staff, a visiting GP, a District Nurse, and 2 visitors. The day was spent with the residents who live in the home, and discussion with 3 residents who were able to give their opinions. A tour of the premises was undertaken and an inspection of sample records and policies. What the service does well: What has improved since the last inspection? What they could do better: The home provides little to keep the residents occupied, and as a result most of them appeared to sleep throughout the day. The home does not employ any domestic help or cook and the staff confirmed that they are always busy and do not have the time to sit and chat to residents very often. One resident said that she was bored and “would like something to do”. There is not enough staff to take residents out and one resident said she cannot sit in the garden, as there are no parasols to protect her from the sun. Staff need to be updated on their training for the protection of vulnerable adults to make sure the residents are not put at risk, and other specialised training and supervision needs to be put in place. A staff record was not in the home and could not be examined. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 6 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. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,6 The home operates a thorough pre admission assessment with care and attention being given to ensure that individual needs can be met. EVIDENCE: Documentation in the care plans showed a thorough pre admission process to ensure that a resident’s care needs would be met. Visitors said that they had viewed the home before the admission of their relative and the manager had visited them to ensure the home was appropriate for their needs. This was followed up by a review after 4 weeks to make sure that the home was a suitable choice. The home does not offer intermediate care. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The development of care plans will set out the residents’ health, personal and social care needs, enabling staff to give optimum care. The health needs of residents are well met with good multidisciplinary working taking place. EVIDENCE: The manager is in the process of developing care plans to improve the understanding of individual needs and delivering optimum care to residents. This is good practice as he has recognised that his existing means is not adequate and has sought to redress this situation. It is important to involve residents and relatives in the updating and ongoing reviews of the care plans. Daily records were brief and gave no detail as to how the resident had spent their day. Nutritional records must be developed to give information on amounts eaten. The GP and District Nurse were both visiting the home and were complimentary about the care given. One resident attends the local hospital on a regular basis and the chiropodist visits the home every 6 weeks. The residents and visitors were complimentary about the staff and how they were respected as individuals. One resident has had Sky TV installed in his room and another has her own telephone. Three residents have the daily paper delivered and a visitor confirmed that her mother receives her post Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 10 unopened. One resident praised the manager saying, “he has the right outlook, he does everything to suit the residents” and said he encouraged him to do anything he wanted to his room to make it personal to him, and another resident was very pleased that she had been able to bring in her own furniture to make her room more homely. One resident confirmed that he is able to have a glass of red wine with his lunch and had been asked by staff if they could call him by his Christian name. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 The home has made limited progress to improve the provision of activities to stimulate the residents. The home promotes contact with relatives and friends but there is poor contact with the local community. EVIDENCE: The home has 11 residents and although they share meals in the dining area of the lounge, the majority of them return to there own rooms at other times. Lunch was observed and there was no interaction between residents, no music and the staff were busy in the kitchen washing up. A member of staff confirmed that one resident did not like any noise and made it unpleasant for other residents if there was noise in the communal areas of the home. This also meant that no activities take place in the home and as a result most residents appeared to sleep all day. One resident who had recently come to live in the home, refused to leave her room for tea, as the atmosphere was uncomfortable. She also said, “I like to talk but nobody here talks. I would like something to do”. Staff and residents confirmed that the home has not arranged any outings, however relatives are able to visit the home at any time. One lady said she would spend more time in the garden but there is no parasol to protect her from the sun. Two residents confirmed that they get library books delivered to the home, and one man had had Sky TV installed in his room to watch the sport. The manager must explore ways to stimulate individual residents and occupy their day. He must ensure people are not isolated in their room because of intimidation by other residents. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 12 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) 16,18 The complaints process in the home needs to be more robust to evidence that residents’ views are listened to and acted upon. Lack of staff knowledge and understanding of Adult Protection issues could place residents at possible risk of harm or abuse. EVIDENCE: The home has had no complaints since the last inspection. However the complaints procedure is not clearly displayed, but is in the service users’ guide in a folder in the hall. Staff confirmed that there is not a complaints book but an occurrence book. One staff member described a situation when an item of clothing had gone missing and the steps that had been taken to retrieve it, and the outcome but this has not been documented. Staff spoken with had varied knowledge of different forms of abuse, but all were unclear about the action that should be taken if they observed abusetaking place. Records did not show any recent training in adult abuse. All the residents spoken with confirmed that they felt safe in the home, and had never experienced any unkindness or rough treatment from staff. There have been no POVA issues in the home in the past twelve months. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 13 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 Areas of the home need attention in order to make it a safe environment for residents. Some improvements to décor have been made. EVIDENCE: Since the last inspection, two bedrooms have been redecorated and one has had a new carpet fitted. Other areas still need attention in particular the carpet in the lounge. Staff confirmed that where it has been cleaned it has stretched and not only looks unsightly but could be a trip hazard to the residents. This carpeting must be repaired or replaced to ensure safety. The manager is in the process of fitting automatic closures on the doors but he must complete this task to conform with fire regulations. Also there was one wedge holding open the door of the staff sleeping room, which must be removed immediately. The upstairs bathroom has been refurbished and a hoist has been fitted. Water temperatures are still too hot in communal washbasins and action must be taken to ensure the safety of residents. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 14 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) 27,29,30 Omissions in staff files do not offer protection to residents. The deployment and staff numbers at certain times of the day is not sufficient to meet residents’ needs. Training and training records must be developed to enable staff to do their work. EVIDENCE: The staff file for the most recently employed member of staff was not in the home. Staff files for two other members of staff were examined. Although details of application and interview were on file, neither of them had a photo and one did not have any references. Care staff are required to do the cooking, cleaning and laundry in the home. The manager also covers 3 afternoons as a carer, and maintains the home and the garden. Residents were seen to spend long periods on their own whilst staff are busy with other chores. In the morning, one staff member is in the kitchen preparing the lunch. During lunch, residents were unattended while the care staff were in the kitchen washing up. Two care staff are on duty in the afternoon and while they were upstairs giving care to a resident, the residents downstairs and in the rest of the house were unattended. The pharmacist rang the doorbell to deliver medication but the care staff were unaware, as they could not hear. One visitor commented, “the staff are always busy, I don’t see much of the manager” The manager must look at the needs of the residents and ensure there are appropriate levels of staffing to meet changing needs, and that care staff have enough time to fulfil their caring role. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 15 The home has a stable staff compliment and do not use agency staff. None of the staff work excessive hours or long shifts. This is good practice and benefits the residents in the home. The manager must put all his working hours on the duty rota and identify the role he undertakes e.g. hours as a carer, gardener, handyman, and manager. Four members of staff are at present doing NVQ level 2 and are due to finish in September 2005. The manager has recently subscribed to Mulberry training programme and staff are to receive training in manual handling in the middle of July 2005. Individual staff training records are not up to date and do not evidence training undertaken. Staff confirmed that some residents in the home had specific conditions i.e. catheter, challenging behaviour, incontinence and training must be sought to enable staff to give optimum care. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 16 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) 33,36 Quality assurance processes are being developed to enhance the day-to-day lives of the residents. Lack of staff supervision could mean needs are not identified. EVIDENCE: The manager was not present at the inspection, but residents, visitors and staff all spoke positively about him, saying he was approachable and they felt that any concerns would be sorted out. He is a registered nurse with management experience in the NHS. The manager has now started to have meetings with residents but minutes of these meetings were not available. The internal auditing system remains outstanding, and when completed must be made available to CSCI. Formal staff supervision has lapsed although staff felt that the management team are approachable at any time. This must be reinstated 6 times per year. Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 x x 2 x x 2 x x Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 18 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 7 Regulation 15 Requirement The registered person must prepare a written plan with consultation with the resident as to how their needs will be met The registered person must consult with residents about their interests and provide a programme of activities and facilities for recreation This is a repeat requirement The registered person shall enable residents to engage in local, social and community activities. The registered person must make arrangements to prevent residents from being abused. This refers to training of staff The registered person should keep the home in a good state of repair. This refers to the lounge carpet, water temperatures and door closures. This is a repeat requirement The registered person shall ensure there is a duty roster with all persons working in the home and ensure that at all times there are staff in such numbers appropriate for the welfare of residents, including Timescale for action 1/10/05 2. 12 16(2)(m)( n) 1/10/05 3. 13 16(2)(m) 1/10/05 4. 18 13(6) 1/9/05 5. 19 23(2) 1/9/05 6. 27 17,18 1/9/05 Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 19 7. 8. 29 30 17(3)b 18(1)c 9. 33 24, 26 10. 36 18(2) managers details and staff doing cleaning and cooking. The registered person must keep staff recruitment records in the home for inspection The registered person must ensure that staff receive training appropriate to the work they perform The registered person must maintain a quality assurance system for reviewing and improving the quality of care provided This is a repeat requirement The registered person must ensure that persons working in the home are appropriately supervised 1/9/05 1/10/05 1/11/05 1/9/05 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. 2. 3. 4. Refer to Standard 16 29 30 22 Good Practice Recommendations The complaints procedure is prominently displayed and a complaints book accessible All staff files should contain a photo of the staff member Individual staff training profiles are accurate and up to date Ensure staff receive a copy of the homes prevention of abuse policy Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG 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 Biffins I56 I06 S44339 Biffins V232429 010705 Stage 4.doc Version 1.30 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!