Inspection on 07/06/05 for Britannia House

This inspection was carried out on 7th June 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 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

Britannia House 13/09/07

Britannia House 14/06/06

Britannia House 08/11/05

Britannia House 08/12/04

Britannia House 28/06/04

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

CARE HOMES FOR OLDER PEOPLE Britannia House 7-11 Jameson Road Bexhill on Sea East Sussex TN40 1EG Lead Inspector Andy Denness Announced 7 June 2005 14:00 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. Britannia House Version 1.10 Page 3 SERVICE INFORMATION Name of service Britannia House Address 7-11 Jameson Road Bexhill on Sea East Sussex TN40 1EG 01424 217419 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) Britannia Care Homes Ltd Vacant Care Home 21 Category(ies) of Demenita (DE) 21 registration, with number of places Britannia House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is twenty one (21) 2. The residents accommodated will be aged sixty five (65) or over on admission Date of last inspection 8 December 2004 Brief Description of the Service: Britannia House is an adapted property situated a short level walk from Bexhill town centre with its shops access to bus and rail routes and local amenities. Accommodation is provided on three floors with a shaft lift and a stair lift fitted to assist those who may have problems managing stairs. Bedroom accommodation consists of 3 double and 15 single rooms. The home is registered to accommodate up to 21 older people who have a dementia type illness. The registered owners are Britannia Care Homes Ltd, who own two other care homes in the area. Britannia House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced Inspection took place over an afternoon and evening in June and lasted 5 ½ hours. To help gather evidence on how the home is performing the Inspector met with staff, the manager and the owners of the home, and examined a range of records and written information. An inspection of the premises took place. Discussions took place with eight service users and three relatives and information was also obtained from comment cards returned by relatives and a pre-inspection questionnaire completed by the manager. What the service does well: What has improved since the last inspection? What they could do better: 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. Britannia House Version 1.10 Page 6 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 Britannia House Version 1.10 Page 7 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) 1,2,3,4 & 5. Current pre-admission procedures are satisfactory and help ensure that service users are appropriately placed in a service that is suitable to meet their assessed needs. EVIDENCE: A service user guide and a statement of purpose have been produced for the home, these documents provide guidance for prospective service users and their relatives about the home, the service provided and how it is performing. Both documents were examined; the statement of purpose has recently been reviewed and now clearly contains all of the required information. Assessments of prospective new service users are carried out by a senior manager of Britannia Care Homes Ltd using a standard assessment process, a selection of completed assessments were examined, they were of a satisfactory standard. Relatives and some residents confirmed that they had the opportunity to look around the home prior to moving in. A contract is issued to all service users or their relatives, this was examined, it covered all required areas. Britannia House Version 1.10 Page 8 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. The quality of the arrangements in place regarding the meeting of service users’ health, personal care and social care needs varied from individual to individual and work is required to ensure that needs are not overlooked. Procedures and practice regarding medication were good. EVIDENCE: An examination of individual plans of care indicated that their quality varied considerably. One plan examined clearly described the individual’s needs and gave guidance to staff of the level of help and support required. Other plans were scant and contained little information or guidance. Also the current daily recording system was not being used properly and it was not always possible for example to ascertain the last time a service user had bathed or had their haircut. Because of service users mental health needs and in most cases poor memory, it is imperative that these matters are addressed. Records examined confirmed service users health needs are met with the support of a range of health care professionals including local GP’s surgery and a local Consultant Psychiatrist who provides support and assistance regarding service users’ mental health needs. Because of potential risks of service users looking after their own medication, staff do this for them. A pre-packed medication system, which is easy to monitor, is used, storage and records were examined and found to be in order. Britannia House Version 1.10 Page 9 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) 12,13,14 & 15. Satisfactory arrangements are in place regarding social activities, meals and visitors. Service users are given choices in all areas of their daily living. EVIDENCE: During the inspection an activities organiser was visiting to provide mental and physical stimulation for service users via various activities. Observations indicated that this was much appreciated by service users and was described by a visitor as “superb”. Records confirmed that other activities are provided on occasions by staff and that opportunities are available for service users to participate in religious activities. Service users said that they have choices in their daily lives such as what time to get up and go to bed. It was highlighted at the last inspection that apart from their rooms, service users did not have a room to receive visitors in private, one has now been provided. Records examined confirmed that a varied and wholesome menu with choices is provided. The Inspector sat and ate a meal with service users; it was well prepared and enjoyed by them. Britannia House Version 1.10 Page 10 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 & 17. Procedures and practices regarding complaints and adult protection were satisfactory. EVIDENCE: Written procedures were seen regarding complaints and relatives said that they would feel happy speaking to the manager or her staff should they be unhappy with any aspect of the service provided at Britannia House. It was not possible to examine the home’s complaints record. A written procedure is also in place adult protection matters, since the last inspection the manager has obtained a copy of the local guidance regarding adult protection matters. Britannia House Version 1.10 Page 11 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) 19,20,21,22,23,24,25 & 26. Physical standards throughout the home were good, ensuring that service users live in a spacious, comfortable, safe, well-maintained environment which is suitably equipped to meet their needs. EVIDENCE: An inspection of all areas of the environment confirmed that physical standards throughout the home are good. All bedrooms comply with the size requirements of national minimum standards; service users said that they are able to bring their own furniture with them; some have done this, which has resulted in pleasant personalised rooms. Service users have a choice of two lounges and a dining room to use; these rooms are furnished and decorated in a comfortable homely style. Heating is provided by a gas central heating system with radiators in all rooms, which are all guarded. Tests confirmed that hot water is delivered to wash hand basins and baths at a safe temperature. The home is fitted with a shaft lift and a stair lift to assist service users access first and second floor accommodation. Some bathrooms are fitted with hoists to assist access to baths and handrails and other adaptations are sited throughout the home. Britannia House Version 1.10 Page 12 A satisfactory standard of cleanliness was found in all areas of the home. Written policies are in place regarding infection control but records examined indicated that not all staff are trained in the subject. The laundry was suitably equipped. The home has a pleasant rear garden, with patio furniture, which was being used by service users on the day of the inspection to have their afternoon tea, some said that they much appreciated this facility. Britannia House Version 1.10 Page 13 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) 27,28,29 & 30. Staffing arrangements were satisfactory although some further training is required to ensure that they have the skills necessary to meet service users needs. EVIDENCE: Staffing levels on the day of the inspection were satisfactory; records examined indicated that this is usually the case. However it was noted that apart from the week of the Inspection, the manager spends considerable time on shift as a carer; although no evidence was found that this was having a detrimental effect on the service, this should be carefully monitored to ensure that she does have the time to carry out her managerial responsibilities. Staff were observed to work in caring and respectful way with service users; comments from service users and relatives regarding staff included “they work hard”, “cheerful” and “are good”. Records examined confirmed that most staff are trained in food hygiene, moving and handling, fire prevention and first aid. Currently only two staff are trained to NVQ level as is required, records indicated that five further staff are due to start their training in September. Recently because of poor practice regarding recruitment procedures a formal legal notice was served against the home requiring them to take immediate action to address problems in this area. A separate inspection of records just before this inspection confirms that standards in this area are now good. Britannia House Version 1.10 Page 14 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) 31,33,34,35,37 & 38. Management and administrative systems in the home are good and work well in supporting staff in their day to day work. EVIDENCE: The manager is experienced in caring for older people with dementia and throughout the inspection demonstrated a clear understanding of the needs associated with their condition. She has applied to the Commission for Social Care Inspection to be registered as the manager. Both staff, service users and relatives spoke positively of her, comments regarding her included, “superb”. The home do not manage any money on behalf of service users, any expenditure on such things as hair or chiropody is billed to relatives. The insurance certificate for the home indicated that insurance levels are set at the required levels. From discussions with staff and an examination of records it was evident that staff receive the one to one support from the manager that is required. A selection of records and policies and procedures required by regulation were examined, these were in order and stored securely. Britannia House Version 1.10 Page 15 Although the home has recently produced some new questionnaires to use as part of their quality control process, few have been completed, it has been required that work is done to improve this process. The manager showed an understanding of health and safety matters including the risk assessment process. A selection of health and safety records including fire records and the testing of hot water temperatures were examined, these were in order. Britannia House Version 1.10 Page 16 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 2 3 2 3 3 3 2 x Britannia House Version 1.10 Page 17 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(1) Requirement That care plans are expanded to ensure a full description of needs and support required from staff and that clear accurate daily records are kept of support provided to service users. That infection control training is provided for untrained staff. That 50 of staff are trained to NVQ level 2 by the end of 2005. That the manager is trained to NVQ level 4 in care and mangement by the end of 2005. That quality assurance questionairres are distributed and the resuts collated and acted on. Timescale for action 7/7/05 2. 3. 4. 5. 26 28 31 33 18(1)(a) 18(1)(a) 18(1)(a) 24(1) 7/9/05 31/12/05 31/12/05 7/9/05 Britannia House Version 1.10 Page 18 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 37 Good Practice Recommendations That changes are made to the current computer recording system to ensure that information cannot be altered after entering and that the identity of the staff entering the information is recorded and cannot be changed, Britannia House Version 1.10 Page 19 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. 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