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Inspection on 28/11/05 for Carleen Nursing & Residential Care Home

Also see our care home review for Carleen Nursing & Residential Care Home for more information

This inspection was carried out on 28th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This home is one of a group of three and a training co-ordinator is employed for the group to ensure that training needs are addressed. The staff work hard to provide a good standard of care, which is appreciated by the residents and their visitors; the home is welcoming and has a happy atmosphere.

What has improved since the last inspection?

The fabric of the home is being well maintained, so that all areas are clean, odour-free and pleasant to use. Several bedrooms have been redecorated, with minor inconvenience to the residents. A new passenger lift has been installed; the old one is now used as a service lift. A new menu has been introduced and following further discussions the residents are happy with the meal choices that are now available.

What the care home could do better:

There is little that can be done better, the home is well run and the majority of the residents are happy with their care. Most of the residents are happier now that the proposed menu changes have been implemented. The management and staff should continue to maintain the high standard of care that the home provides.

CARE HOMES FOR OLDER PEOPLE Carleen Nursing & Residential Care Home 38 Portchester Road Fareham Hampshire PO16 8PT Lead Inspector Pat Griffiths Unannounced Inspection 28th November 2005 10:00 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 Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carleen Nursing & Residential Care Home Address 38 Portchester Road Fareham Hampshire PO16 8PT 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) (01329) 232418 (01329) 828794 Serincourt Limited Miss Stella Warne Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33), Physical disability (33), Physical disability of places over 65 years of age (33), Terminally ill (33), Terminally ill over 65 years of age (33) Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No service user under the age of 50 years is to be admitted No more that 9 beds may be used at any one time for service users who are only in need of personal care. 19th April 2005 Date of last inspection Brief Description of the Service: Carleen Nursing and Residential Care Home is registered to provide nursing and personal care for 33 people. Service users must be over the age of 50 years. The Home is also registered to admit service users who are terminally ill or who have physical disabilities. Carleen is a large house that is in a residential area of Fareham and is close to local amenities. The home has a ground floor extension and provides accommodation over two floors, which are connected by a passenger lift. There are two sitting rooms and a dining room on the ground floor. There are eleven single and eleven shared bedrooms, eight of which have ensuite facilities. The home has large, welltended, front and rear gardens, which are accessible to the residents and there is ample parking space for staff and visitors at the front of the building. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection for the inspection year 2005/06 and took place over one day. Pre-inspection comment cards had been completed by residents and their relatives or visitors and returned to the commission. The matron/manager and other staff members assisted the inspector. The inspector was able to look around the home, talk to staff, residents and visitors and examine records, policies and procedures. What the service does well: What has improved since the last inspection? What they could do better: There is little that can be done better, the home is well run and the majority of the residents are happy with their care. Most of the residents are happier now that the proposed menu changes have been implemented. The management and staff should continue to maintain the high standard of care that the home provides. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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): EVIDENCE: These standards were examined at the last inspection Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 the following standard(s): 10 Arrangements are in place to ensure the privacy of the residents, but are not always followed. EVIDENCE: Several residents who share bedrooms had returned comment cards to the commission saying that their privacy was not always maintained. This was discussed with the manager, who advised that staff would be reminded of the need to use curtains and screens properly in shared bedrooms to maintain the privacy and dignity of all residents. Whilst walking round the home the inspector observed that staff did knock and wait for an answer before entering rooms. Staff were also seen to address residents in a respectful way, only raising their voices for the deaf or hard of hearing residents. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 10 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): 13, 14 and 15 Residents are encouraged to exercise choice and control in their lives, they receive good meals and their visitors are encouraged. EVIDENCE: Residents are encouraged by the staff to maintain contact with friends and family and the home has an open visiting policy. They can entertain their visitors in the communal rooms or in the privacy of their bedrooms. Several residents manage their own financial affairs with help from their relatives and leaflets providing information about external advocate services are available on the hall table. During the tour of the home the inspector noted that several bedrooms had been made homely and personalised with the residents own possessions, such as pictures, ornaments and small pieces of furniture. Residents are encouraged by the staff to choose what clothes they will wear, what time they get up and what time they will go to bed, this information is contained in the personal care plans. During the last inspection some residents expressed dissatisfaction with their meals, the menu choices and presentation of meals. The manager and the chef have addressed this matter and a new menu is now in place. A new Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 11 heated food trolley has been obtained, which ensures that meals stay hot when taken to the residents who are not eating in the dining room. Three cooked meals are available daily, as are snacks and fresh fruit when required. Residents said that they enjoyed most of their meals and knew that they could ask for something different if they did not like the menu choices that were available. There are set meal times but residents can ask to have their meals earlier or later if they are going to be out or wish to have a lie-in. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: These standards were examined during the last inspection Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26 The home is clean, pleasant, safe and well maintained. EVIDENCE: On the day of the visit the inspector was able to tour the home; seeing several bedrooms, the sitting rooms, the kitchen and the dining room. All were clean, pleasant and free from odour. The routine maintenance is undertaken by the home’s own maintenance staff and there is an on-going plan of repair and decoration. There is a large rear garden, which is easily accessible for the residents and has paved areas for sitting out; it is maintained by the gardener. Staff are undertaking training in Infection Control and there is an infection control procedure in place in the home and gloves and aprons are available. The home has its own laundry on site, in a building at the rear of the home. The home has cleaning and laundry staff. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 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 and 30 Residents are protected and their needs met by an appropriately recruited and trained staff group. EVIDENCE: The staff skill mix includes qualified nurses, carers and ancillary staff for cleaning, catering and laundry services. The home also employs gardening and maintenance staff. All staff have undertaken statutory training, which includes manual handling, fire safety and adult protection. Sixty percent of the care staff have completed an NVQ (National Vocational Qualification) at level 2 or 3 and two more staff have recently started the course. The home has robust recruitment policies and procedures in place. All care and nursing staff applicants are interviewed by the matron or director of care. Four staff files were examined by the inspector and found to contain suitable application forms, which had been completed. Proof of the applicant’s identity and documentary evidence of relevant qualifications was seen. Written references and CRB (Criminal Records Bureau) disclosures had been obtained before staff started work in the home. The home is one of a group of three, which has its own training department. The training co-ordinators organise the training for all staff. New care staff undertake the ‘Skills for care’ training as well as mandatory training such as Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 15 fire safety and manual handling. The registered nurses have recently undertaken training to update their skills and competencies in medication administration, which was provided by a pharmacist from a national chain of chemists. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 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 and 38 An experienced manager with good staff management, which is backed by sound procedures and runs the home in the best interests of the residents, ensuring that their health safety and welfare are promoted and protected. EVIDENCE: The registered manager is a registered nurse, who has been in post for several years. The home has a comprehensive set of policies and procedures, which are currently being reviewed and updated. The home has a development plan, which includes the addition of a small extension to provide more single rooms on the ground floor. There is an ongoing programme of redecoration and refurbishment, carried out by in-house maintenance staff. The home has recently completed a service-user survey and the results will shortly be made available to the commission and any other interested parties. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 17 Some residents, usually with help from their relatives, manage their own money. Others keep small amounts of pocket money in the homes safe. This money is kept in separate, labelled, plastic wallets in the safe in the office. The balance was checked on three accounts and found to balance. Staff supervision has been implemented and is now undertaken on a regular basis and documented records kept of each session. The manager advised that training in supervisory skills was being offered for staff who had not undertaken this role before. The inspector was able to able to see the service contracts for services such as the boilers, the fire safety equipment and the lift. The record of the weekly fire alarm tests was also examined and found to be up-to-date. It was noted that there are some problems with parts of the kitchen floor. The cook pointed out that the dishwasher has been leaking and causing the lino underneath to ‘lift’. The owner, who was in the home, said that he was aware of some problems with the dishwasher and that the matter would be investigated. The owner told the inspector that the dishwasher would be repaired and the floor covering repaired or replaced. Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Carleen Nursing & Residential Care Home DS0000011511.V259425.R01.S.doc Version 5.0 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!