CARE HOMES FOR OLDER PEOPLE
Carisbrooke House Residential Home 10-11 Sandown Road Great Yarmouth Norfolk NR30 1EY Lead Inspector
Hilda Stephenson Announced 24 October 2005 9.30am
th 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. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Carisbrooke House Residential Home Address 10-11 Sandown Road Great Yarmouth Norfolk NR30 1EY 01493 855915 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) carisbrookehouse@aol.com Mr Selvaratnam Balaratnam Mr Shadzada Junaid Karim Care Home 22 Category(ies) of Dementia - over 65 (2) registration, with number Old age (22) of places Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Mr Junaid Karim to remain as Manager until at least 31st May 2006. 2. Mr Balaratnam to undertake appropriate training to ensure he can carry on the home with sufficient care, competence and skill. Date of last inspection 1.4.05 Brief Description of the Service: Carisbrooke House is a care home providing personal care and accommodation for up to 22 older people that includes 2 service users who have dementia. Mr Balaratnum owns it. Mr Karim is the manager and is in daily contact with the home.The home is located on a street close to the seafront of Great Yarmouth.The premises consists of two adjoining large three storey terraced houses, with a small patio area at the front of the building. The accommodation includes 12 single and 5 shared bedrooms, some having en-suite facilities. There are three lounges; two on the ground floor and one on the top floor, the ground floor dining room make up the communal rooms. Access to the upper floors is by a shaft lift. There is off street parking at the front of the building. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit to the home was undertaken as an announced inspection during the day of 24th October 2005. Evidence was obtained by speaking to residents, staff, relatives and the manager and proprietor. Written information and comment cards were received prior to the inspection. The home was found to be clean, tidy and residents appeared comfortable. What the service does well:
The home has a small loyal staff team, with the majority having worked at the home for some time. They have developed a rapport with their residents and continue to encourage them to make their own daily choices. The home employs a member of staff who organises activities with residents, although this subsided during the summer months, several group games such as a quiz, cards, draughts and bingo goes on during some afternoons. An outside entertainer visits once a month to sing old time music. Residents who do not wish to participate have their wishes respected. The home has access to the mobile library facilities and talking books for those with sight problems. The home employs a minimum of three care staff on duty during the day. Nutritious wholesome meals are served, with alternative meals for those who require a specialised diet. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 6 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 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 Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 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) 1,2,3,5 A good admission procedure is in place with residents and relatives receiving good clear information prior to admission. EVIDENCE: Written documents are given to all prospective residents to let them read about the facilities and services offered at the home. The manager visits all new residents beforehand to ask questions about their care needs, to enable the home to prepare any necessary equipment or adaptations. All prospective residents and their relatives are invited to visit the home prior to moving in. The assessment records of the last resident admitted were seen and were satisfactory. A copy of the homes terms and conditions are discussed and signed. All residents are advised that they are admitted for a trial period of a month when a review of the initial care is discussed with the resident and their relatives before they decide whether they wish to stay.
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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) 7,8,9.10 Residents have a written care plan which is reviewed on a regular basis. Residents are encouraged to make their own choices throughout the day. EVIDENCE: A sample of care plans was seen of some of the residents who spoke to the Inspector during the visit. The care plans for the majority of the residents are written with them by the senior carers to ensure that all the correct information on their care needs are put in place. Social and health needs are also included. The home has some specialist equipment to enable safe moving and handling of residents although, the lifting hoist is broken and the manager must ensure this is repaired as a matter of urgency, to ensure the safety of both the resident and staff. Evidence of visits from GP, District Nurses and Chiropodist, and any hospital appointments being kept. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 10 Medication is administered in a safe manner by staff that has undertaken the Boots training course. A separate medication inspection has been arranged. Residents continue to make there own choices throughout the day, time they wish to get up, where to go during the day and what they wish for their meals. One resident stated ‘I like to sit in this lounge because I watch television, and I can see people who come through the front door’. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 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) 12,13,14,15 Residents can choose whether they wish to take part in the group or individual social activities. A wholesome and varied menu is offered. EVIDENCE: The home has experienced problems in recruiting a social activity co-ordinator during the summer months and this area has been neglected. A member of staff is now in place and organised sociable activities such as music afternoons, bingo, games and music and movement has recommenced. Residents confirmed that they enjoy some of these organised events. The home has three lounges and can be used to entertain relatives, or residents can go to their own rooms. Staff offered tea to some visitors while the residents was having theirs. One resident stated ‘My son comes to visit and he takes me out, if I need any shopping the staff will pop out to buy it for me’. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 12 Residents confirmed that they have a choice of food with the cook offering alternatives to the main meals. One resident stated ‘that she had put on weight and enjoyed someone else doing the cooking’. The menu is altered over a four-week period combining seasonal changes and includes resident’s suggestions from time to time. The care staff prepare the teatime meal and the majority of the staff have not completed the food hygiene course and should be completed to ensure they are aware of the safety procedures within the kitchen area. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents’ views are listened to and acted upon. EVIDENCE: The manager advertises the complaints procedure and this is also included within the written admission documents. The home has received a number of comments regarding the lack of activities during the summer months, and these have now been resolved. The manager records complaints with the action taken. Residents and staff commented that they prefer to speak to the manager if they had any concerns. No complaints were received during this inspection. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 14 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) 19,20,21,26 In general the home is decorated when needed, with the bedrooms being redecorated when they become vacant. There is limited outside space. EVIDENCE: Carisbrooke House is situated near the seafront of Great Yarmouth. Accommodation is situated on three floors with access by a shaft lift. There are three lounges, although the lounge on the top floor is rarely used. A dining room is situated next to the kitchen. A tour of the premises confirmed that several areas require redecorating. Two bedroom carpets need replacing due to the unpleasant odour. The hoist needs repairing. A call bell in one of the bedrooms needs repairing, as well as the curtains, which need rehanging or replacing. The majority of the bedrooms are reasonably decorated and all were clean and tidy and contained residents’ personal possessions.
Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 15 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 Residents are cared for by sufficient numbers of well-trained staff. EVIDENCE: The home has a core staff team; three care staff is in attendance during the waking day, which reduces to two care staff overnight. The manager attends the home most days. A cook and domestic are on duty every day. Training is planned to assist staff to attend to residents’ complex needs. The majority of the staff team have undertaken the NVQ training to update their skills. When examining staff files they confirmed that staff had completed fire training, first aid, medication and adult protection awareness since the last inspection. A new member of staff had completed the induction training and has commenced the NVQ training at the local college. The home has consistently had a high number of staff that has completed the NVQ courses and should be commended for this. The manager has a good recruitment procedure that is followed to ensure the safety of residents. The care staff prepare the teatime meal and should enrol for a food hygiene course to ensure they are aware of the safety aspects of food preparation within the kitchen area.
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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) 31,33,35,36,38 The home is well managed with residents best interests safeguarded by the home’s procedures. EVIDENCE: The manager will be leaving the home after working and owning it for several years. A new manager has been appointed although she will be required to undergo the registration process with the Commission, and commences a week after this inspection. The manager audits the service by regular reviews of care records, supervision of staff and personal development, with regular regulation 26 visits undertaken by the new proprietor. Since the previous inspection the home has changed hands with Mr Balaratnum as the new proprietor, who visits on a weekly basis.
Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 17 Two Senior Care Staff provide support in health and safety issues and supervision of staff. Safe financial procedures are followed when residents lodge their personal spending money with the manager, the records were satisfactory. Lockable facilities are provided for those who prefer to tend to their own. The required regulation checks were carried out for fire, water, central heating and electrical maintenance were all in place. The insurance and registration certificate were also displayed. Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 18 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 3 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 2 3 3 x x x x 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x 3 3 x 3 Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 19 No 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. 2. 3. 4. 5. 6. Standard 8 19 19 19 19 30 23 23 23 23 18 Regulation Requirement The hoist must be repaired and in good working order. The carpet in bedroom 7 & 10 must be replaced. The call bell and curtains in room 4 needs replacing. The fridge freezer must be repaired. Hand drying facilities must be provided for staff. Staff who prepare food must complete the food hygeine course. Timescale for action 30/10/05 30/11/05 30/11/05 30/11/05 30/10/05 30/3/06 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 Good Practice Recommendations Carisbrooke House Residential Home I55 S64315 Carisbrooke House V242928 241005 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1 YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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