Inspection on 19/09/05 for Cavell House

This inspection was carried out on 19th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cavell House 09/06/10

Cavell House 16/06/08

Cavell House 18/07/07

Cavell House 27/04/06

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Cavell House Middle Road Shoreham-by-sea West Sussex BN43 6GS Lead Inspector Mrs S Rodgers Unannounced Inspection 19th September 2005 11:30 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 Cavell House DS0000065235.V251906.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. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cavell House Address Middle Road Shoreham-by-sea West Sussex BN43 6GS 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) 01273 440708 Ashbourne (Eton) Limited Mr Derek Farquhar Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52) of places Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to fifty-two (52) male and or female service users in the category of Old Age, not falling within any other category may be admitted/accommodated. Only service users over 65 years of age may be admitted. Date of last inspection Brief Description of the Service: Cavell House is a care home with nursing situated in the town of Shoreham by Sea. The establishment has been extended and adapted to provide accommodation for up to fifty-two service users in the category of older persons, over the age of 65years (OP). The establishment consists of the original building, which was a local authority care home and a new annex. The majority of the home is on one level, however one section of the older building has two floors, accessed by stairs and a passenger lift. The service provider Ashbourne (Eton) Ltd. The responsible person on behalf of the company is Mrs Marilyn Mac Dougall. The registered manager in charge of the day to day running of the home is Mr Derek Farquhar. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours on the 19 September 2005. The inspection was carried out as part of the routine programme of inspections. Preparation for this inspection focused on a review of previous inspection reports, general correspondence. During the course of the inspection the inspector toured the home, spoke with residents either privately in their own bedrooms or within the communal areas of the home in order to gain a sense of how the home is being run. Two visitors were also present and spoken at the time of inspection. Three staff were also spoken with. Six requirements have been identified at this inspection. The registered manager is requested to inform the Commission of action to be taken with regards these issues by the 10 September 2005 What the service does well: Residents told the inspector that the care they receive from trained nurses and care staff is of a good standard. Residents told the inspector that “anything you want they get”, one resident said the inspector, “I’ll put your name on the waiting list it is good here”. Visitors spoken with also confirmed that the care and service their relatives and friend receive is satisfactory. Staff spoken with confirmed that they receive regular training updates, which are run by the deputy manager. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Although residents said they are satisfied with the care they receive and appear well care for, there is a significant number of residents who are either high or medium dependency the management must undertake a review of staffing levels in order care standards do not drop. Some residents who require nursing care are being nursed on divan beds this is not acceptable as the health and safety of both residents and staff is at risk. Bathing facilities need to be assessed and bathrooms being used for storage need to be reinstated as functioning bathrooms. The shower that is out of use must be repaired, as it is not acceptable for residents to be transported from one end of the building to the other in order to have a shower, their privacy and dignity may be affected. Some resident and staff continue to raise concerns regarding the provision of meals. The menu is said to be repetitive i.e. sausages 3 times a week, poorly cooked, stodgy and not presented very well. The standard of cleanliness thought out the home has deteriorated since the last inspection. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 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. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 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 Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 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): 6 Intermediate care is not provided at Cavell House. EVIDENCE: Mr Farquhar advised the inspector that intermediate care is not provided by the service. This is reflected in the Statement of Purpose. From touring the building and speaking with residents and observing working practices the inspector was able to determine that intermediate care services were not being provided at the time of this inspection. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 Service users health needs are being met. EVIDENCE: Review of care plans indicate that all residents are registered with a local GP. Visits of all health professionals or visits to hospital are clearly recorded in individual care plans. Care plans also clearly identify what assistance is required with regards personal hygiene, nutritional needs, manual handling. All nursing interventions i.e. pressure area care are recorded in care plans as required. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 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 the following standard(s): 13, 14,15 Residents are enabled to maintain contact with family and friends, and are able to develop individual lifestyles within their own capabilities. Meals being provided look unappetizing and are repetitive. EVIDENCE: From speaking with residents and visitors the inspector was able to ascertain that contact with family and friends is encouraged by management. The Service User Guide gives clear information regarding the arrangements for maintaining contact with family and friends. It also advises them that they are required to ‘sign in’ in the visitor’s book in order to comply with health and safety requirements. Visitors spoken with at the inspection confirmed that they are made to feel welcome. Resident who were asked confirmed that they do retain some control and choice over their every day activities such as when they get up or go to bed and what activities they wish to undertake if any, however they did say that they are aware of the need to take into consideration that staff have other people to take care of too. Ashbourne (Eton) Ltd use a franchise catering company. Although the survey carried out following the last inspection indicated that overall residents were Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 12 satisfied with meal provided, during this inspection some resident continued to raise concerns about the quality of food provided and the repetitiveness of the menu, i.e. sausages 3 times a week, and sometimes 3 times a day and macaroni cheese also being offered 2-3 times a week. Staff also raised concerns regarding the standard of food provided, they told the inspector that they “wouldn’t eat the meals provided”, they said, “meals continue to go downhill”, “meals not balanced, i.e. sausages 3 times a day sometimes, and macaroni cheese two days running”, “ for pudding it’s mainly ice cream”, “rice pudding stodgy”. One resident told the inspector that her meals have improved since the last inspection as they are not liquidised to a sup consistency however now she chooses from the main menu she can see that meals provided are repetitive. They also expressed concern over the lack of fresh vegetables and fruit provided. The inspector was not present at lunchtime, however there were some meals dished up for night staff, the plated food looked overcooked and unappetizing. There was also some liquidised meals cooling down, the inspector was advised by a member of the kitchen staff that these would be going out reheated that evening to the residents who require a liquidized diet, it was confirmed that these residents have the same meal at suppertime as they do at lunchtime. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 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 the following standard(s): 18 Systems to respond to allegations of abuse are in place. EVIDENCE: The home has policies and procedures to follow should there be an allegation of abuse. The home has a copy of the local authorities adult protection procedure. The deputy manager is responsible for the training programme. Training records clearly demonstrate that all but one member of staff, the new administrator, have received instruction in adult protection issues including signs of abuse. The staff members spoken with gave a clear account of action they would take should they suspect abuse of a resident. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 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 the following standard(s): 21, 24, 26, Bathing facilities are insufficient to meet the needs of current service uses. The lack of specialist equipment is putting the health and safety of residents and staff at risk. The standard of cleanliness throughout the home is poor. EVIDENCE: Staff advised the inspector that the majority of residents require shower, only one of the two showers is currently in use. This means that some residents are transported from one end of the home to another. Two of the four bathrooms are also out of commission as they are being used as storerooms; all bathing facilities must be re-commissioned. The National Minimum Standards require that there are bathing/showering facilities in the ratio of 1 bathroom to every 8 residents to be provided. During the tour of the premises the inspector noted an increase in residents require nursing in bed. Some residents who require nursing care are being nursed on divan beds, this is not acceptable as the health and safety of both residents and staff are at risk. Staff also raised their concerns regarding Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 15 nursing residents on beds as they feel that resident and staff are being put at risk of causing harm to residents or having an accident themselves whilst carrying out their duties. Since the last inspection the cleanliness of the home has deteriorated. Carpets in bedrooms and communal areas were strewn with litter and food debris, a number of rooms also smelled of urine. The inspector was advised that the deterioration of cleanliness was not because the domestics were not doing their job but that since the last inspection 3 domestics have left and not been replaced. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 16 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, 29 The standard of care being provided is at risk of deteriorating due to the increase in residents who require full care. The recruitment procedure needs to be implemented in full each time a new member of staff is employed. EVIDENCE: Staff spoken with at the inspection raised concerns regarding staffing the home to meet the needs of residents currently being admitted to the home. The inspector was told by staff and observed from her tour of the building that there has been an increase in the number of residents admitted who need full care. Staff told the inspector that they feel “they are unable to give residents the care they require/deserve”. The management must review depencey levels to determine if the current staffing levels remain appropriate. Staff told the inspector that they have raised these issues at staff meeting but nothing is being done about them, they said that they do not feel that they are listened to. A recruitment procedure is followed. Records of five members of staff were reviewed. It was noted that one staff member has been employed prior to all references being obtained. Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 17 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): 35 Systems are in place to safeguard the financial interests of residents. EVIDENCE: Mr Farquhar advised the inspector that resident or the family or representatives control personal finances. However there is a facility for residents to deposit money for safekeeping. Records of transaction are kept and appeared in good order. Cavell House DS0000065235.V251906.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 3 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x 1 x x 1 x 1 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 19 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 2 3 4 5 Standard 15 21 24 27 29 Regulation 16 23 (j) 23 (n) 16 19 Requirement A wholesome and nutritious diet must be provided. There must be sufficient number of baths/showering facilities. Suitable equipment must be provided. There must be sufficient staff on duty to meet the needs of residents. All recruitment checks must be carried out prior to a new member of staff commencing employment. The home must be kept clean and free from offensive odours. Timescale for action 10/10/05 10/10/05 10/10/05 10/10/05 10/10/05 6 26 16 (k) 10/10/05 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 Cavell House DS0000065235.V251906.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Cavell House DS0000065235.V251906.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!