CARE HOMES FOR OLDER PEOPLE
Charlesworth 37 Beaconsfield Villas Brighton East Sussex BN1 6HB Lead Inspector
Merle Blakeley Unannounced 1 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Charlesworth Address 37 Beaconsfield Villas Brighton East Sussex BN1 6HB 01273 565561 None None Mrs Eileen Margaret Horne (Person) 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) Mrs Eileen Margaret Horne Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (OP), 18. of places Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The number of people accommodated must not exceed 18 2. The people accommodated will be aged 65 years or over on admission Date of last inspection 21 December 2004 Brief Description of the Service: Charlesworth is registered to care for up to eighteen older people who do not require a high level of care. The home is situated near to the Preston Park area of Brighton and consists of a large double fronted semi detached Victorian house. Accommodation comprises of fourteen single bedrooms and two double bedrooms, which are located over three floors. None of the rooms provide en suite facilities. The home has a pleasant rear garden that residents enjoy during the warmer months. A lift is available to the first floor only. The home would not be particularly suitable for wheelchair users and those with extreme mobility conditions. The home is located in a residential area of Brighton and is close to local transport, parks and other local amenities. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Unannounced Inspection took place over a period of seven hours on 1st June 2005. The inspection process included talking and having lunch with most of the residents, discussions with the proprietor/manager and staff on duty, document reading and feedback from a visiting professional. What the service does well: What has improved since the last inspection? What they could do better:
The home needs to ensure that staff are provided with a minimum of three paid days training each year, current training needs include Adult Protection and Health & Safety Training. Although the home has a Quality Assurance Programme, Residents Satisfaction Questionnaires are not being carried out frequently enough. Feedback from residents needs to occur at least twice a year, so the home can gauge how well the service is performing. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 6 Two health & safety matters need to be addressed; the wedging open of internal fire doors needs to be discontinued and the home needs to find an alternative method that is in line with current fire regulations. Hot water temperature outlets on the lower ground floor need to be regulated, as they are too high at present. The rear garden also needs some attention, as it is looking a little overgrown. An action plan was received from the home on 26th July 2005 and addresses all the requirements that were made during this inspection. 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. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 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 Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 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) 2,3 & 5 The home has updated its terms and conditions for residents. The proprietor/manager carries out assessments on all new residents. Trial visits for prospective residents are offered. EVIDENCE: The proprietor/manager has produced a resident’s terms and conditions booklet, which outlines the services the home will offer. The booklet also describes the facilities in the home, fees; lay out of home, medication and personal effects. Before a resident moves into the home they are assessed to ensure that their needs can be met. The proprietor/manager will visit the person either in their home or in hospital and carry out the assessment there. As the proprietor/manager has had many years experience of caring for older people, she feels she is able to ascertain residents needs fairly swiftly. Social Workers also refer prospective residents and they also provide detailed background histories for the home. New residents are encouraged to make several trial visits to the home prior to moving in and this would normally involve coming in for coffee or staying for lunch. The home has a very relaxed policy regarding trial periods and if they are not happy they are free to go at any time without having to give any notice period.
Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 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 standard(s) 7, 8 & 9 Residents care plans are comprehensive and reviewed on a regular basis. Healthcare needs appear to be well met. Medication records are maintained correctly. EVIDENCE: Care plans were viewed and contain all the relevant information on residents assessed needs. The home now has a good system for recording daily information, which can include medication changes, appointments, visits to or by specialist healthcare professionals and the general daily well being of residents. Any significant changes are recorded in the residents care plans. The care plan update file was also viewed and it appeared to be very informative. Residents have access to a wide range of local healthcare services. All residents are registered with their doctor and if necessary other visiting services can be offered. Residents are weighed fortnightly. One current service user is due to be reassessed as her needs have changed. Medication records were also viewed and these were found to be in order. The home has a good working relationship with their local pharmacist who stated that she is due to give the staff team a talk on medication updates soon. She also stated that the home was very organised in the way that they handled their medication administration.
Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 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 standard(s) 12 & 15 Residents are offered recreational activities. The home provides a nutritious and well balanced diet. EVIDENCE: The home organises an activities timetable for residents, which includes two regular entertainers who come in on a fortnightly basis, massage therapy sessions, ‘music for health’ sessions and in-house activities. A hairdresser also comes into the home on a regular basis. Residents tend to be very social in the home and they stated that they enjoy these activity sessions. Up until recently gentle exercise classes were also being held but unfortunately the person who was taking the classes is no longer able to provide this service. Residents said that they missed these classes, as they were enjoyable. The home provides a traditional English menu and the Inspector enjoyed lunch with the residents. The atmosphere during lunch was very convivial and all of the residents said that they loved the food and really enjoyed their meal times. Most of the residents take lunch together in the dining room on the lower ground floor. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 11 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) 18 The home has a policy and procedure regarding Adult Protection. The remainder of the staff team need to attend Adult Protection training. EVIDENCE: The home has a written Adult Protection policy and procedure. Some of the staff have attended training on this subject and it will be required that the proprietor/manager and remaining staff members also attend a course on Adult Protection. There are currently no concerns within the home. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 12 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) 22, 24, 25 & 26 The home has been assessed by a qualified occupational therapist. Resident’s rooms are comfortable and they are able to bring in their own personal belongings. The home is maintained to a good standard. EVIDENCE: The home was assessed by an occupational therapist in the past few months and the report indicated that no additional adaptations were necessary. Resident’s rooms appear comfortable, well decorated and homely and many have brought in their own possessions such as small pieces of furniture and other personal items. The resident’s who were spoken to stated that they were very happy with their rooms and felt quite comfortable and happy living in the home. No one had any complaints or concerns. The home is maintained to a good standard and rooms are redecorated as they become vacant. The home has recently had a new boiler installed and hot water temperatures were checked in the lower ground floor area. The hot water was found to be rather too hot at 51C, so the home will need to have the temperature adjusted down to close to 43C. The home was found to be very clean and hygienic. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28 & 30 To date, two staff have obtained NVQ training qualifications. More regular training opportunities need to be provided for staff. EVIDENCE: Currently two of the staff members have completed their NVQ Level 2 training, which is approximately 25 of the staff team. Another staff member will commence the training later this year. Three staff have been booked to attend a food hygiene course. The home needs to be providing more regular training opportunities, as they should have access to a minimum of three paid days training per year. Fire Safety Training is being held in November 2005. Adult Protection and Health & Safety Training also need to be attended by all staff members. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 37 & 38 The management approach of the home is open and friendly. The home needs to ensure that Resident Feedback Questionnaires are carried out at least twice a year. The home maintains the required records. To comply with current Fire Safety legislation the home must refrain from wedging open doors in the hallways. EVIDENCE: The atmosphere within the home is very friendly and open and both staff and residents felt that they could approach the proprietor/manager if they had any concerns. The home has a Quality Assurance Policy, which includes Residents Satisfaction Questionnaires, Code of Values and Aims and Objectives, however only one residents survey appears to have been carried out and the home must ensure that this procedure is carried out at least twice a year. These surveys are for residents to highlight any areas that may be in need of improvement within the home. A number of records were viewed during the inspection and these were all found to be adequately maintained. Overall the home appears to be safe and well maintained.
Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 15 As mentioned previously the home must discontinue the practice of wedging open corridor doors and hot water temperatures need to be readjusted down to around 43C. The rear garden is looking a little overgrown and is in need of some attention. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x 3 x 3 3 3 STAFFING Standard No Score 27 x 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x 3 2 x x x 3 2 Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 17 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. Standard OP25 OP30 OP33 OP38 Regulation 13(4) 18© 24 23(4)(a) Requirement That hot water temperatures are readjusted to the correct level. That all staff receive a minimum of three paid days training per year in the required core skills. That Resident Satisfaction Questionnaires are carried out at least twice a year. That the home discontinues the practice of wedging open corridor doors. Timescale for action Immediate 30/11/05 Immediate Immediate 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 OP19 Good Practice Recommendations That the rear garden is attended to. Charlesworth H59-H10 S14190 Charlesworth V229143 010605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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