Inspection on 13/07/06 for Biffins

This inspection was carried out on 13th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 06/12/05

Biffins 01/07/05

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 Key Unannounced Inspection 13th July 2006 09:15 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 Biffins DS0000044339.V304457.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. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Biffins Address 18 Thorpedene Gardens Shoeburyness Essex SS3 9JB 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 292120 faizaljoomun@yahoo.co.uk Mrs Bibi Sehnaz Bano Joomun Mr Mohammed Faizal Joomun Mr Mohammed Faizal Joomun Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Total number of service users not to exceed 14. Service users to be older persons over the age of 65 years. Date of last inspection 6th December 2005 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 10 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. The home has an updated Statement of Purpose, Service User Guide and a copy of the last inspection report in the entrance hall. The current scale of charges as at July 2006 is between £352 - £425 per week. Extras charged are for hairdressing, chiropody and newspapers. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key site visit was unannounced and took place on 13th July 2006 over a nine hour period. At this inspection all the key standards and the progress since the last inspection were assessed. A pre inspection questionnaire had been completed by the home prior to this visit, and 10 surveys sent to residents, of which 6 were returned, 10 to relatives, of which 7 were returned, and 3 to general practitioners, of which 2 were returned. The registered manager was available throughout the day to assist with the inspection process. A tour of the premises took place and a random selection of records and policies were examined. Time was spent with the residents, observing care practices, and conversation took place with most of them and any visitors to the home. A district nurse and two librarians were also visiting the home and gave their views. Staff were also given the opportunity to speak with the inspector. Feedback was given to the registered manager at the end of the site visit. What the service does well: What has improved since the last inspection? Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 6 Many areas of the home have been redecorated and new carpets fitted. This includes the lounge diner and the hallways. The recording of medication means that it can be checked to ensure the safety of the residents. Care plans have generally improved to include most of the information needed to make sure a resident receives the right care. What they could do better: 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 DS0000044339.V304457.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 Biffins DS0000044339.V304457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The personalised life history means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: The Statement of Purpose and Service User Guide have been updated in April 2006 to reflect the service that the home can offer to future residents. These are displayed in the hall, along with the last inspection report. Two residents and a visitor explained a detailed pre admission procedure whereby they or their family had visited the home. The manager had also visited them to make sure the home was suitable to meet their needs and a review was held approximately one month after admission to make sure everybody was happy with the arrangement. Two care plans looked at had Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 9 detailed pre admission forms. One staff member explained how a detailed life history is collated either from the resident, relatives or social services to give them as much information as possible to make sure they can meet each individual’s diverse needs. Five of the six surveys returned commented that they had received enough information before moving into the home. Intermediate care is not provided by the home. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 10 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 the following standard(s): 7,8,9,10,11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Medication practices ensure that residents receive their medication. Residents can be sure that their health and personal care needs will be fully met EVIDENCE: Care plans were viewed for two residents who had recently moved into the home. These plans were detailed and provided the information needed for staff to provide the appropriate individual care. There was evidence of regular reviews and the manager confirmed that he invites residents/relatives to review the care plan twice a year, unless there are significant changes beforehand. Contact with other health professionals is sought and recorded in the plan. Two GPs responded to the survey sent to them confirming that they have a good relationship with the home and have no concerns about the care provided. A district nurse was visiting the home during the site visit and confirmed that she and her colleagues visit the home on a regular basis and are happy with the standard of care. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 11 Residents and relatives were very happy with the care that is given in the home and the way they are treated by staff. This was reflected in the results of the surveys that they had completed as all six said that they received the support they needed from the staff and that they listen to them. One resident said, “the staff are absolutely marvellous, I couldn’t be happier – I couldn’t wish for better care” and another resident said, “I couldn’t ask for better – they’ve been my friends”. They felt that their privacy was respected and confirmed that they can make choices in their every day living. One resident confirmed that he receives his post unopened and has his own telephone to maintain contact with family and friends, and also enjoys a glass of wine with his lunch each day. Two residents said that staff do not always knock before entering their rooms, although one said, “I don’t mind this as it feels like family”. Staff were very knowledgeable about the residents and their individual preferences and were able to provide detailed information about each individual resident. Medication procedures were checked and were generally seen to be correct. Specimen signatures were available for staff who administer medication and training had been undertaken in April 2005 and was due for renewal. An advocate had been obtained for a resident that did not have any relatives to assist her in making a will and find out her wishes in respect of funeral arrangements. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. A limited range of activities within the home and community means the residents do not have a range of opportunity to keep them occupied. Staff chores mean that they do not have the time to spend with residents, including mealtimes to make it a relaxed social event. EVIDENCE: There is no member of staff responsible for activities in the home. Staff and residents spoke of playing Bingo once a week and doing an exercise class once a week. At the site visit, residents were seen to spend long periods either in the lounge or in their bedroom unoccupied and with no member of staff present. Care staff duties involve preparing and cooking the meals, cleaning the home and doing the laundry and a large amount of their day was spent doing these chores. Some residents were happy with the amount that they have to do while others are clearly not, and stated that they are bored. One resident said, “I don’t do much – I am getting bored with Bingo” and another resident said, “I would like something else to do”. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 13 A resident explained that she would like to go out but had been told it was not possible as they can’t spare the staff, and another resident said she would like to go in the garden but she doesn’t want to be out there alone. Staff were seen to interact well with residents and chatted with them whilst performing tasks but did not seem to have the time to sit with them. Two residents confirmed that they receive communion in the home, and the library service provides books for two residents. A barbecue is planned during the summer and the manager said he hopes to hire a minibus in October to take some residents out. Visitors confirmed that they are able to visit the home at any time and are always made to feel welcome. The residents were generally happy with the food in the home. Although a choice is offered at breakfast and tea, there is not a choice at lunchtime. Residents confirmed that the staff know their individual likes and dislikes and offer an alternative when necessary. One resident said that she had asked for lasagne at a residents’ meeting and the home had bought some for her. At the inspection she didn’t like the shepherds pie that was being offered for lunch, and was given ham. Nine residents came to the dining area for their lunch at the site visit. The food looked nutritious and of good quality. A bowl of fruit was available in the kitchen and the manager confirmed that fresh food and vegetables are bought weekly for the home. Staff assisted residents sensitively by drawing up a chair to sit beside them and chatting to them whilst offering help, but did not stay with the residents throughout the meal as they were assisting in the kitchen. This meant that for the most part the residents were left alone, with little interaction and it did not appear to be a relaxed social event. Good nutritional charts are kept for individual residents and a record of their weight is kept monthly. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 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 the following standard(s): 16,,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaint procedure and staff knowledge of POVA. EVIDENCE: The home has a complaints procedure and surveys from residents and relatives confirmed that they would know who to speak to if they had any concerns. There have been no complaints since the last inspection. The manager confirmed that in house training has recently taken place for staff relating to adult abuse and a further training aid had been received from the local authority, which he intends to use. All staff spoken with had a good understanding of various forms of abuse, and how to report it. There have been no POVA issues in the home since the last inspection. Biffins DS0000044339.V304457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,24,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of mixer valves on the hot water system could potentially put the residents at risk of scalding, although other areas of the home have improved and are clean and hygienic. EVIDENCE: The lounge, dining area and the hall have been painted with new carpet fitted. Two bedrooms have also been redecorated and new lino fitted in the bathrooms. One resident was very proud of her new bedroom and had personalised it with her own belongings and photos. The home was clean and had no unpleasant odours, and the surveys confirmed that all residents are happy with the cleanliness of the home. Some areas of the home still need attention to provide a safe environment for the residents. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 16 The COSHH cupboard needs to be fitted with a lock. Some hot water taps are still delivering water in excess of 43 degrees, which could potentially put the residents at risk of scalding. The manager explained that he has sought professional advice from an engineer and intends to rectify this situation in the near future. Wedges in two doors could pose as a fire risk. Biffins DS0000044339.V304457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The home needs to show improvement in recruiting, deployment of staff and staff training in order to improve the outcomes for people using this service. EVIDENCE: The rota was seen for the week of inspection. This must be more explicit as to the role of the care staff during their shifts and hours spent cooking, cleaning and doing laundry. Basic needs are met, but there are areas that could be improved to meet individual needs and the manager must evidence that there are enough staff, either by deployment of present staff or engaging more staff. The recruitment files were viewed for two members of staff who had joined the home since the last inspection. Both had shortfalls in information and a recruitment process which is not thorough does not offer protection for the residents of the home. A training matrix has been introduced to identify any training needs of staff. The manager is nearing completion of NVQ 4 in management. Two staff have achieved NVQ level 2 and two staff are in the process of doing NVQ level 2. Funding has been requested for four staff to do NVQ level two or above. However generally there were shortfalls in the training programme, including fire training, first aid, medication, and more specialist subjects such as diabetes awareness. New staff members had not completed their induction Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 18 programme and there was no evidence to say that they had received any formal guidance in the first three months of their employment. Lack of staff training does not provide them with the skills to fulfil their role. Biffins DS0000044339.V304457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The manager provides stability to the home but must develop a quality assurance programme and adhere to health and safety regulations to protect the residents. EVIDENCE: The manager is a qualified nurse and is nearing completion of NVQ level 4 in management. He is supported by an assistant manager, who is on permanent night duty and a supervisor during the day. Residents were positive about his role in the home and felt they could approach him with any problems that arose. He had a very good knowledge of all the residents. The home has monthly meetings for the staff. These have limited value as they are generally attended by the same staff and the minutes have not been Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 20 circulated to the staff who choose not to attend. Residents’ meetings are also held, and one resident told how a request at one of these meetings enabled her to get the food of her choice. This information, along with any other views from stakeholders of the service should be collated and an annual development plan produced as part of the quality assurance programme, to ensure that the home is run in the best interests of the residents. The policies and procedures of the home should be reviewed and updated as appropriate. Money for six residents is held securely by the home and any financial transactions recorded individually. Two were checked at random and there was a discrepancy with one of them. Staff supervision is in place and evidence was seen of this in staff files. However two members of staff who started work in the home in April 2006, have yet to receive any formal supervision and their induction has not been documented until three months after their commencement date. Fire drills were noted to be always done at the same time of the day, which means that some members of staff are not involved in this procedure. Fire safety and first aid training needs to be updated for staff. Wedges were seen to be used on two doors. A lock must be fitted to the COSHH cupboard and weekly temperatures at which water is delivered, and the running of any unused taps must be recorded to protect the health and welfare of the residents. Biffins DS0000044339.V304457.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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X 3 X 3 2 3 STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 2 x 2 Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP12 Regulation 16(2)(n) Requirement The registered person shall consult the residents about a programme to provide stimulation and occupation of their time. The registered person shall continue to develop a plan for residents to engage in local, social and community activities. This is a repeat requirement The registered person should keep the home in a good state of repair. This refers to the water temperatures. This is a repeat requirement The registered person must ensure that at all times there are enough care staff in the home to meet all the needs of the residents. The registered person must operate a thorough recruitment procedure to ensure the protection of residents. The registered person must provide an induction programme and staff training to provide DS0000044339.V304457.R01.S.doc Timescale for action 01/10/06 2. OP13 16(2)(m) 01/10/06 3. OP25 23(2) 01/10/06 4. OP27 18(1)(a) 01/10/06 5. OP29 Schedule 2 18©(1) 01/09/06 6. OP30 01/10/06 Biffins Version 5.2 Page 23 7. OP33 24, 26 8. OP35 16(2)(l) 9. OP36 18(2) 10. OP38 12 them with the skills to perform their role. The registered person must maintain a quality assurance system for reviewing and improving the quality of care provided. This relates to providing evidence that the home is run in the best interests of the residents. Reg 26 reports must be available at inspection. This is a repeat requirement The registered person must maintain accurate accounts of any money held on the residents’ behalf The registered person must ensure that all persons working in the home are appropriately supervised This is a repeat requirement The registered person must ensure the home is conducted to promote the health and welfare of the service user. This refers to the storage of COSHH substances, fire safety – including the removal of wedges, first aid training and the temperatures at which hot water is delivered. This is a repeat requirement 01/10/06 01/10/06 01/10/06 01/10/06 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 OP7 Good Practice Recommendations Care plans should include personal preferences of residents, with a risk assessment and management. This relates to the absence of footplates on wheelchairs, sitting in wheelchairs, bare legs, and the necessity of staff DS0000044339.V304457.R01.S.doc Version 5.2 Page 24 Biffins 2 OP28 knocking on doors before entering. A picture of the resident should be available. A minimum ratio of 50 of care staff to achieve NVQ level 2 or above. Biffins DS0000044339.V304457.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Essex Local Office 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 DS0000044339.V304457.R01.S.doc Version 5.2 Page 26 - 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!