Inspection on 10/10/06 for Catherine Miller House

This inspection was carried out on 10th October 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Catherine Miller House 07/10/08

Catherine Miller House 17/09/07

Catherine Miller House 21/02/06

Catherine Miller House 31/10/05

Catherine Miller House 28/02/05

Catherine Miller House 14/09/04

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 Catherine Miller House 13-17 Old Leigh Road Leigh On Sea Essex SS9 1LB Lead Inspector Pauline Marshall Key Inspection 10th October 2006 11:50 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 Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 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. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Catherine Miller House Address 13-17 Old Leigh Road Leigh On Sea Essex SS9 1LB 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 713113 01702 713113 Mr Andrew Howard Stern Mrs Virginia Margaret Prodger Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30) of places Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2006 Brief Description of the Service: BRIEF DESCRIPTION OF THE SERVICES PROVIDED. Catherine Miller House provides personal care and accommodation for up to thirty older people. The registration category also permits the home to provide care to those service users who have dementia. The home was originally three properties that have been converted into one. This has created a home, which has several different levels with two quite separate living areas. Catherine Miller House has twenty-six single bedrooms and two shared bedrooms, all with en-suite facilities. The home is well maintained and decorated. Catherine Miller House is situated in a residential area of Leigh on sea, close to local shops. There are good bus and train links into the area. The home has a large well-maintained garden to the rear of the property. There are limited parking facilities to the front of the property. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with up to date information on the home. Fees range from £455.00 to £485.10 and there are additional charges for hairdressing, chiropodist, newspapers, toiletries and transport. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that lasted for five hours and fortyfive minutes. The process included a tour of the premises, a random selection of resident and staff files and discussions with residents, staff, the manager and the owners. As part of this inspection surveys were sent to ten residents, six relatives’ two General Practitioners, three health professionals to obtain their views on the service the home provide. Five residents surveys were returned and all were positive about the service they received. One residents survey said that the food is always very good and the home is clean and well run. All six of the relatives’ surveys were positive and one stated that immediate action was taken when concerns were raised with the home; another commented on how welcoming and helpful the home was. Both of the General Practitioners surveys that were returned were positive. All three health care professionals surveys were returned and were positive and one said the homes atmosphere has always been friendly and accommodative. Twenty-eight of the thirty-eight standards were inspected. What the service does well: What has improved since the last inspection? The home has employed an activities lady for an additional day each week. The radiator that was in a poor position in the hallway has been removed. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 6 The medication is no longer stored in temperatures that are too hot and is now stored in a locked trolley that is fixed to the wall in the hallway and the lighting in this area has been improved. There are more signs on communal rooms around the home that assist those with dementia. New staff has been recruited and there is less use of agency staff. What they could do better: The homes’ polices and procedures should be reviewed regularly and updated to reflect any changes. All residents must have a contract of their terms and conditions with the home. Care plans should include all the relevant information including the residents wishes on death and dying. When staff assists residents at meal times, it should be one staff assisting one resident. All complaints should be logged in the homes complaints book. Any radiators that are uncovered should have a risk assessment in place. 50 of care staff should receive a minimum of NVQ 2 training. Written evidence of any reference requests made over the telephone must be kept at the home. The homes quality assurance system must ensure that survey materials are analysed and a report of the findings published and sent to all interested parties and the CSCI. Staff supervision should be carried at least six times a year. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 7 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. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 8 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 Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 9 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, 2, 3, 5, 6 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home carries out a thorough pre-admission assessment of needs and provides prospective residents with sufficient information to enable them to make an informed choice. Trial visits are encouraged to give prospective residents the opportunity to assess the quality of the service. Contracts have not been drawn up for all residents. Catherine Miller House does not provide intermediate care. EVIDENCE: The manager provided a copy of the homes Statement of Purpose dated 2003 and Service User Guide dated 2004. The proprietors visited the home whilst the inspection was in progress and said that the Statement of Purpose and Service User Guide have been updated several times since that date and that a check would be made and the most recent copy would be sent to the CSCI and displayed in the hallway of the home. Mr Stern provided copies of both Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 10 documents by email the next day and both documents contained all the relevant information. Two of the four care files examined did not contain a statement of terms and conditions. The manager said that a contract was prepared for every resident and she would ask the proprietor if he had removed these two for some reason. The home carries out a thorough pre-admission assessment and offers prospective residents the opportunity to have trial visits prior to admission. Catherine Miller House does not provide intermediate care. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 11 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 judgment has been made using available evidence including a visit to the service. The homes care plans are clear and give good instructions to staff and the daily notes were informative. Health care needs are fully met and recorded. Medication practice is good and medication is now appropriately stored. Residents’ wishes on death and dying are not always recorded. Residents are treated with respect and their privacy is upheld. EVIDENCE: All four care files examined contained good clear care plans that are reviewed on a monthly basis. Daily notes were thorough and informative. All health care appointments were recorded in the care plan with the outcome of any visits. Residents spoken with confirmed that they were consulted on all aspects of care at the home and that they were treated with dignity and respect by the staff. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 12 Medication is now stored in a locked trolley that is secured to the wall in the hallway and is now within the required temperature range. The manager has improved the lighting in the area to assist staff when administering medication. The manager said that she is in the process of reviewing her medication policy and that she will acquire the Royal Pharmaceutical Society of Great Britain’s Administration of Medication in care homes guidelines to ensure that her policy works within them. Three of the four care files examined did not include information on residents’ wishes in the event of their death. This information should be recorded to enable staff to deal with a resident’s death in a way that the resident and their family wish. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 13 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 good. This judgment has been made using available evidence including a visit to the service. Residents experience a lifestyle that matches their needs, they are encouraged to maintain contact with family and friends and have as much choice and control over their lives as possible. Residents receive a wholesome appealing balanced diet in spacious pleasing surroundings. EVIDENCE: The home offers its residents a good range of activities and has engaged an activities lady for a further day each week. Residents spoken with confirmed that they enjoyed the music and movement sessions and that they had plenty to do. The home offers open house visiting and always ensures that residents are appropriately dressed and ready for when their relatives arrive at the home to escort them on any outings. The home consults with residents on a daily basis but the last recorded residents meeting was held on 25th May 2005, residents spoken with confirmed that they are regularly asked what they want. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 14 Residents had recently completed a document entitled “my ideal meals” each resident stated their ideal menu and had discussions with the staff and the manager. As a result of this a new four-week menu was formulated that ensured that all meals requested by all residents were included. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 15 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 adequate. This judgment has been made using available evidence including a visit to the service. The home has a good complaints procedure but has not logged the recent complaint in the complaints book. The Adult Protection procedure does not include the need to refer to the Adult Protection Co-ordinator. EVIDENCE: The home has received one complaint in the past year. This complaint was in the form of a letter and the manager had responded within the timescales of the homes complaints procedure but had not logged the complaint in the homes complaints book. All complaints must be logged in the complaints book. The homes policy on abuse does not state the necessity to refer all suspected abuse to the Adult Protection Co-ordinator at the Local Authority; the homes policy must include this information. Staff spoken with had a good knowledge of Adult Protection and had received training at Southend Borough Council. The manager said that any staff that had not yet had this training would be booked in on the next available course. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 16 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, 25, 26 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Residents live in a safe well-maintained environment; rooms meet their individual needs. The home needs to address the issue of hot radiators that was identified at the last inspection. The home is clean, pleasant and hygienic. EVIDENCE: The home consists of three properties converted into one. There are two separate living areas and the home has several different levels. One resident who uses a wheelchair requires a ramp to cross over the two steps outside their bedroom; staff said that there had been problems with this ramp for some time. The manager said that a replacement ramp has been ordered and is due for delivery this week. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 17 The home has two passenger lifts that ensure access to both separate living areas. Twenty-six of the bedrooms are for single occupancy and two bedrooms are shared; all rooms are en-suite. The home has signs on communal areas to aid residents with dementia. The home is well furnished, decorated and maintained. The last inspection identified that two of the homes radiators were unsafe and too hot to the touch. One of these has been removed and has left an area that needs to be repaired and painted. There are several uncovered radiators on the upper floor of the home. The proprietor asked if covers would be necessary as they have thermostatic controls and are only hand hot. These radiators may be safe in milder weather, however should the weather get colder and the radiators need to be turned up to provide residents with sufficient heat they would then present a risk to residents safety. A risk assessment should be in place to assess the risks of the heating being increased during colder weather and if irradiators were identified as being unsafe, covers would need to be provided. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 18 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 adequate. This judgment has been made using available evidence including a visit to the service. Staff are well trained, competent and supplied in sufficient quantities to meet residents needs, however the home does not have an adequate level of NVQ trained staff. The homes recruitment practice is generally robust but the outcome of a telephone reference was not recorded and there was no evidence of induction for two staff members. EVIDENCE: The homes duty roster evidenced that adequate staff with the appropriate skill mix were on duty. Staff spoken with felt that the training offered by the home is good and they said that they had recently had Non-Abusive Psychological & Physical Intervention (NAPPI) training. The manager said that this training had become necessary due to the increasing levels of dementia within the home. Two of the sixteen staff employed at the home has received NVQ training. This does not meet the National Minimum Standards, which state that 50 of care staff should be NVQ 2 trained. The manager and proprietor said that they are unable to secure funding for staff over twenty-five years old. It was suggested that the home contacts the local college for advice. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 19 The manager said that the homes recruitment policy is in the process of being updated and was last reviewed in August 2004. Two of the four staff files examined contained all the relevant documentation. One file contained one written reference only; the manager said that a telephone reference had been acquired but that no record was kept of the conversation. When obtaining a reference over the telephone, a thorough record of the conversation must be kept to evidence that appropriate references have been sought. Two of the staff files did not contain any evidence of induction taking place. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 20 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 area is adequate. This judgment has been made using available evidence including a visit to the service. The home is well managed and run in the best interests of the residents and their financial interests are safeguarded. The homes quality assurance system needs further development. Staff are supervised but need to receive the level of support and supervision as laid down in the National Minimum Standards. The health, safety and welfare of residents and staff is promoted and protected but paper towels need to be provided in all communal areas. . EVIDENCE: The manager has managed the home for the past seven years and has achieved the City and Guilds 325/3 Advanced Management for Care qualification. An application has been made for the manager to undertake the NVQ level 4 in Care and NVQ Assessors Award and she is due to commence Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 21 shortly. Residents and staff spoken with said that the manager is really nice, easy to talk to and is very supportive. The proprietor visits the home twice a week and ensures that all maintenance tasks are carried out. On these visits a check of any food or provisions needed is carried out and the proprietor supplies them. The proprietor has not completed any regulation 26 reports; after discussions the proprietor said that they would do so in future and send a copy to the CSCI. The home has undertaken a residents survey and published the results in percentages; there was a small minority of negative responses and there is no action plan to address these issues. The quality assurance system used by the home must provide a report of the findings and an action plan of how issues are to be addressed; a copy of this report must be supplied to all interested parties and the CSCI. Residents’ finances are not dealt with by the home. Four staff files were examined and two contained one supervision document, another had two supervision documents and the other did not contain any supervision documents. Supervision should be carried out at least six times each year as stated in the National Minimum Standards. Several of the communal toilets and bathrooms contained cotton towels which may increase the risk of the spread of infection occurring within the home as these towels are used by many different people. Paper towels should replace cotton towels to minimise the risk of the spread of infection. All safety certificates are in place and regular fire drills are carried out by the home. The home is currently in the process of reviewing all of its policies and procedures. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 22 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 2 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 23 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 OP25 Regulation 13(4) Requirement The registered provider shall ensure that all parts of the home are so far as is possible free from avoidable hazards. This refers to hot radiators and is a repeat requirement. 2. OP2 5 (c ) The registered person shall provide the resident with a contract stating the terms and conditions of their residency. The registered person shall prepare a written plan that includes all aspects of their health and welfare. 31/12/06 Timescale for action 31/12/06 3. OP7 15 (1) 31/12/06 4. OP18 13 (6) This refers to the need to establish each resident’s wishes on death and dying and to record them in the care plan. The registered person shall make 31/12/06 arrangements to prevent residents being harmed, abused or placed at risk of harm or abuse. This refers to the homes Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 Page 24 5. OP29 19 (b) (i) policy that must state that any suspected abuse is to be referred to the Local Authority Adult Protection Co-ordinator. The registered person shall not employ a person to work at the care home unless all the documents required in Schedule 2 are obtained. This refers to the telephone reference that was not recorded. The registered person shall supply to the Commission a report of any review of the quality of care. This refers to the need to compile results of consultations and prepare a report of the findings and any action plan that is necessary. 31/12/06 6. OP33 24 (2) 31/12/06 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. 2. 3. Refer to Standard OP28 OP36 OP38 Good Practice Recommendations A minimum of 50 of care staff should attain NVQ Level 2. Supervision should be carried out for all staff at least six times each year as stated in the National Minimum Standards. Paper towels should replace cotton hand towels in all communal areas to prevent the risk of the spread of infection. Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 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 Catherine Miller House DS0000015490.V293495.R01.S.doc Version 5.1 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!