Inspection on 24/05/05 for Cheneys

This inspection was carried out on 24th May 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

Cheneys 19/08/08

Cheneys 03/10/07

Cheneys 26/10/06

Cheneys 19/12/05

Cheneys 26/10/04

Cheneys 24/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

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 Cheneys Links Road Seaford East Sussex BN25 4HY Lead Inspector Andy Denness Announced 24 May 2005 13:00 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. Cheneys Version 1.10 Page 3 SERVICE INFORMATION Name of service Cheneys Address Links Road Seaford East Sussex BN25 4HY 01273 471166 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) Sussex Housing & Care Vacant Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (OP) of places Cheneys Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. That only older people may be accommodated 2. That service users accommodated will be aged sixty five (65) years or older on admission 3. That the maximum number of service users to be accommodated will not exceed fifty four (54) 4. That up to a maximum number of twenty five (25) service users may be in receipt of nursing care Date of last inspection 26 October 2004 Brief Description of the Service: Cheneys is situated in a quiet residential area of Seaford a short walk from the sea front and approximately half a mile away from the town centre with its shops and access to bus and rail routes. The home is part purpose built and part adapted with accommodation on two floors; two shaft lifts are fitted to assist service users access first floor accommodation. Large pleasant gardens are situated to the rear of the property. The home is registered to accommodate up to 54 older people, 25 of whom may be in receipt of nursing care. The registered owners are Sussex Housing and Care, a local housing association. Cheneys Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced Inspection took place over an afternoon and evening in May, lasted 6 hours and was undertaken by two Inspectors. To help gather evidence on how the home is performing the Inspectors met with staff and the home’s manager, examined a range of records and written information and undertook a tour of the premises. In depth discussions took place with ten individual service users and one Inspector sat and ate an evening meal with service users also met with the home’s ‘resident’s committee. Information was also obtained from comment cards that were returned, by 14 service users and 8 relatives. The Inspection took place during a difficult period for the home; because of a reorganisation of staff conditions of employment and changes in working practices, a considerable number of staff have left, meaning that that the majority of staff are now agency. The manager and senior nurse have also just left. This has meant considerable disruption and unhappiness for service users. This report should be read against this background and the efforts of Sussex Housing and Care to rectify matters. What the service does well: What has improved since the last inspection? What they could do better: Requirements made as result of this inspection included improvements to medication recording and dispensing, consultation with service users over the current use of lounge and dining space, improvements to staff training and management support, the recording of action taken to prevent and treat pressure sores and the repairing of a first floor window. Efforts should continue to recruit a manager and a permanent staff team. Cheneys Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cheneys Version 1.10 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 Cheneys Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 & 5. Pre admission procedures are good and help ensure that service users are admitted to a service that is suitable to meet their assessed needs. EVIDENCE: A statement of purpose and a service user’s guide have been produced for the home, these documents provide guidance for prospective service users about Cheneys and the service provided; both documents were examined, they were of a good quality, however the statement of purpose does require some amendments to reflect current staffing arrangements. Assessments of service users’ needs are undertaken by the management prior to admission to the home; a selection were examined, they were of a satisfactory quality and covered all required areas of daily living. Most service users spoken to said that that they or their relatives had the opportunity to visit the home prior to moving in. All service users are issued with a contract detailing the terms and conditions of their stay at Cheneys, this document contained all required information. Cheneys Version 1.10 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 The policies, procedures and practices in the home regarding personal and social care needs are good and help ensure that identified service user needs in these areas are appropriately met. Those service users requiring nursing care receive all necessary support from trained nurses. However concerns were identified regarding medication and pressure sore management that could lead to health risks for service users. EVIDENCE: Using the initial assessment of need as a starting point individual plans of care are compiled for each service user; these identify amongst other things what support service users require from staff to meet their day to day needs in relation to health, personal and social care needs. Since the last inspection improvements to the care planning system have continued and all plans examined were of a good standard. From records examined and discussions with service users it was evident that needs identified in the plans were being appropriately met. It was however noted that records are not maintained of action taken to prevent or treat pressure sores, this matter was raised at the last inspection and urgent action has been required to rectify it. Medication is in the main managed for service users by staff. A monitored dosage system is used, records and storage were examined. It was of serious concern that Cheneys Version 1.10 Page 10 several medications had not been dispensed although they had been signed for and several medication records were incomplete; service users also said that medication was sometimes dispensed later than it should have been; immediate action has been required to address these matters. Observations made during the inspection indicated that wheelchairs are not always used correctly, action has been required to rectify this. Cheneys Version 1.10 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Arrangements in the home regarding social needs, visitors and community participation are good and ensure service users choice and variety in all areas of daily living. Work is required to ensure an appropriate level of on and off site activities. EVIDENCE: At the last inspection it was required that service users were surveyed to ascertain their views on activities provided for them, this has been done and the management of the home recognise that there is a need to expand leisure activities both on and off site; they said that they now have funding to employ an activities organiser for 30 hours per week and plan to appoint to the post in the near future. A visitor to the home was met during the inspection, they confirmed that they are always made welcome, can stay as long as they like and are kept informed of important occurrences in their relative’s life. Service users spoken to confirmed that they have choice in all areas of their daily living, ranging from what time to get or go to bed to whether to stay in their room or not. A new catering manager has been employed since the last inspection; this has had a positive effect on the quality of meals with several service users reporting improvements. Menus examined confirmed that a varied and wholesome menu is provided and service users said that choices and alternatives are available for them. The Inspector ate a meal with service users, it well prepared and presented and was obviously enjoyed by service users. Service users did express some concern over current dining room Cheneys Version 1.10 Page 12 arrangements which have recently been changed; because of this it has been recommended that these arrangements be reviewed. Cheneys Version 1.10 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Current arrangements regarding complaints and adult protection are good and help ensure that matters are managed appropriately EVIDENCE: The home has detailed complaints and adult protection procedures in place, both procedures were examined; they were of a satisfactory quality. Records examined confirmed that complaints are managed in line with written procedures. Service users said that they feel able to complain to should they be unhappy with any aspect of the service that they receive. Since the last inspection two complaints have been forwarded to the Commission for Social Care Inspection regarding the home. Matters were referred back to manager and registered owners who then investigated and handled the matters appropriately. Cheneys Version 1.10 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 & 26. Physical standards throughout the home were generally good ensuring that service users live in a spacious, comfortable, safe, well maintained environment which is suitable to meet their needs. EVIDENCE: An inspection of all areas of the environment confirmed that physical standards throughout are good. All bedrooms comply with the size requirements of national minimum standards and are furnished and decorated to a satisfactory standard. Service users said that they are able to bring their own furniture with them and most have done so, this results in pleasant personalised rooms. Communal areas consist of several sitting and dining areas, which are furnished and decorated to a good standard. A group of service users spoken to expressed their unhappiness over recent changes to the dining room arrangements which were initiated without consultation with them; it has been recommended that this situation is reviewed. Many bedrooms have ensuite facilities and other WCs and bathrooms are available for those service users who do not have these. These rooms were equipped and maintained to a Cheneys Version 1.10 Page 15 satisfactory standard. Two shaft lifts are fitted to assist access to first floor accommodation and various hoists and special baths are available to assist those service users who may have mobility problems. Heating is provided by a gas central heating system with radiators in all rooms, all radiators are guarded and service users can control the temperature of their rooms themselves. Tests confirmed that hot water is delivered to wash hand basins and baths at a safe temperature. A high standard of cleanliness was found in all areas of the home. Written policies are in place regarding infection control and records examined confirmed that all staff are trained in the subject. The laundry was suitably equipped with commercial washing machines and dryers, which comply with the requirements of national minimum standards; service users were very complimentary of the laundry service provided for them. Records examined confirmed that all equipment is serviced regularly. It was noted that in one first floor bedroom the window restraint and hinge were broken and presented a risk to service users, immediate action was required to address this. Cheneys Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. The current numbers and skill mix of staff ensure that service users’ needs are appropriately met, however the heavy use of agency staff does not install confidence in service users. EVIDENCE: Numbers of staff on duty were sufficient to meet the needs of service users, records examined confirmed that this is the case at all other times; service users confirmed that the numbers of staff were satisfactory. However because of a reorganisation of staff conditions of employment and changes in working practices, a considerable number of staff have left, this has meant that the majority of staff are now agency. The manager and senior nurse have also just left. This has meant considerable disruption for service users who spoke of their unhappiness over the situation. Whilst the reasons for the reorganisation are understandable, discussions indicated that the result is an unhappy service user group who sometimes do not know the person who is providing their care. The registered provider has attempted to overcome this situation by a recruitment drive and transferring a manager from another home in their group on a temporary basis to support the staff team. Prior to the inspection and at inspection the Inspector met with the service user’s committee to discuss these concerns, it appears that there have been some small improvements to the situation but there is still much to do. It has been required that the home continue in their efforts to recruit a permanent staff and management team. Records examined confirmed that 50 of staff are not yet trained to NVQ level as is required. Records examined confirmed that Cheneys Version 1.10 Page 17 permanent staff undertake a range of basic training courses including moving and handling, first aid, fire prevention etc. and that that robust recruitment procedures are followed, when new staff are employed, this includes the use of application forms, the following up of two references, ID checks, criminal record checks, Protection of Vulnerable Adult checks and the issuing of contracts of employment. Cheneys Version 1.10 Page 18 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) 35, 36 37 and 38. The lack of a registered manager at this troublesome time for the home could have a detrimental effect on the service provided. The appointment of a new manager and senior nurse is seen as imperative if the service is to improve EVIDENCE: The registered manager has recently resigned, to counteract this the registered provider has transferred a manager from another home and their senior manager to support the home during this period. It has been required that effort continue to appoint a new manager and senior nurse. The home’s involvement in service users finances is limited to holding some personal spending monies for them. Balances and records regarding this were examined and found to be in order. Discussions with staff confirmed that the home’s management team does not currently provide formal supervision for them. A selection of records required by regulation was examined, there were in order and stored securely. Secure storage arrangements are available for service Cheneys Version 1.10 Page 19 users to place valuables if they so wish. Regular risk assessments of the environment are undertaken and the environment appeared generally well maintained and safe. Any substances that may be hazardous to health are stored securely and written guidance is available in case of accidents with them. The home is fitted with a full fire protection system; records examined confirmed that it is tested regularly as is required and that fire drills take place at the prescribed intervals. Cheneys Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 1 x x x 3 1 3 3 Cheneys Version 1.10 Page 21 Yes 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. Standard 1 8 Regulation 1 15(1) Requirement That the homes statement of purpose is reviewed to reflect current staffing arrangements. That when a pressure sore risk assessment indicates a high score then records are kept of preventative action taken and treatment provided (outstanding from last inspection) and that wheelchairs are used safely and correctly. That with immediate efect action is taken to ensure that medication is dispensed at the right time and accurate records maintained. That an apporopriate level of leisure activities is provided for service users. That the current dining room arrangements are reviewed. That the broken window restrictor and hinge in the first floor bedroom are repaired. That efforts continue to recruit a permanant staff team. That efforts continue to recruit a permanant manager and senior nurse. That formal supervision is provided for staff. Version 1.10 Timescale for action 24/6/05 24/5/05 3. 9 13(2) 24/5/05 4. 5. 6. 7. 8. 9. 12 15 25 27 31 36 12(1)(a) 18(1)(a) 18(1)(a) 18(2) 24/8/05 24/6/05 24/5/05 24/5/05 24/5/05 24/6/05 Cheneys Page 22 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 30 Good Practice Recommendations That 50 of staff are trained to NVQ level 2 by the end of 2005. Cheneys Version 1.10 Page 23 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 © 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 Cheneys Version 1.10 Page 24 - 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!