Inspection on 22/08/05 for Chine Breeze Court

This inspection was carried out on 22nd August 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

Chine Breeze Court 04/07/06

Chine Breeze Court 09/03/06

Chine Breeze Court 25/11/04

Chine Breeze Court 09/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Chine Breeze Court 73 Alumhurst Road Westbourne Bournemouth Dorset BH4 8HP Lead Inspector Gloria Ashwell Unannounced 22 August 2005 14.00 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. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Chine Breeze Court Address 73 Alumhurst Road Westbourne Bournemout Dorset BH4 8HP 01202 761307 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) Mr & Mrs Jenkins Mrs J Morris CRH P - Care home with nursing 19 Category(ies) of OP Old age (19) registration, with number of places Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25th November 2004 Brief Description of the Service: The registered providers are Mr and Mrs Jenkins. The registered manager is Mrs Morris who is a suitably experienced nurse. Chine Breeze Court is registered to provide nursing and personal care for a maximum of 19 older people in 15 rooms, 4 of which may be used as shared rooms by residents who have made a positive choice to share with each other. 4 of the 11 single use bedrooms have en-suite hygiene facilities. The accommodation is on two floors with a passenger lift serving both floors. The home is located in a residential area of Westbourne, Bournemouth within walking distance of local amenities and the sea at Alum Chine. The home is on the local bus route and has off road car parking at the front of the home. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. Since the last inspection no formal complaints against the home have been received or investigated. The inspector arrived (unannounced) at 14.10 on 22 August 2005. During the inspection she spoke to 8 residents, 2 visiting relatives and 4 care workers. The inspector observed staff interaction with residents, the carrying out of routine tasks, toured the premises and together with the registered manager considered evidence relating to the National Minimum Standards, as described in this report, before departing at 16.45. The inspector left a selection of ‘Comment Cards’ and prepaid envelopes (for return to the Commission) with the manager. At conclusion of the visit the inspector issued an Immediate Requirement regarding the process of staff employment. What the service does well: What has improved since the last inspection? Chine Breeze Court is a large traditionally built house requiring continuous maintenance. There is an ongoing programme of redecoration and refurbishment including recent provision of 15 new armchairs and some new bedroom carpets. To meet requirements of the last inspection report a system for the formal supervision of staff has been introduced and some improvements to medicine recording have been implemented. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 6 What they could do better: 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. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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 Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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) 3 & 6 Standard 6 is not applicable because the home does not provide intermediate care. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them but the home does not then always write to prospective residents confirming the ability to properly care for them. Prospective residents (or their representatives) are encouraged to visit Chine Breeze Court in advance of admission to establish their impressions of life at the home and the available accommodation. EVIDENCE: The records of a recently admitted resident included those of a pre-admission assessment carried out by the manager when she visited the person in hospital. The inspector spoke with a visiting relative who confirmed that in advance of a close relative’s admission Chine Breeze Court was visited on a number of occasions and the available rooms viewed. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 9 Following pre-admission assessment, if the home decides to offer a place to a new resident, they do not always write to the person stating that Chine Breeze Court will be able to meet their assessed needs; a related requirement has been made to address this shortfall in practice. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 & 11 Staff have written information necessary to provide correct care to residents with the exception of a terminally ill resident whose rapidly changing needs were not recorded in a care plan. However, the needs of residents, including the dying person, were being properly met despite some difficulties associated with the use of shared bedrooms compromising the promotion of dignity and privacy. Medicines prescribed by doctors are safely stored and carefully administered to residents by trained nurses, unless the residents have chosen to store and administer their own medicines, in accordance with risk assessment. The written procedure for the management of death does not provide staff with appropriate guidance on the management of death with particular regard to use of shared rooms, and in circumstances of sudden/unexpected/ accidental death. EVIDENCE: Care plans based on relevant assessments are recorded for each resident but the care plan for a dying resident with rapidly changing needs had not been reviewed to include these changes. From direct observation, discussion with Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 11 residents, visitors and staff, and examination of daily records there was evidence of the routine provision of good care to all residents. Residents feel they receive good care; a resident confined to bed and considered by staff to be at risk of dehydration smilingly said “They keep on at me to drink…”. Records indicated that medicines had been accurately administered and residents said that they receive the correct medicines at correct times. Trained nurses undertake all medicine handling, storage and recording. A number of residents are accommodated in shared bedrooms; the manager said that each person or their representative had agreed to these arrangements but there was no written evidence of this. The dying resident was confined to bed and accommodated in a shared bedroom. The manager said that to minimise disruption and distress to the other resident she spends all day in the communal lounge or conservatory, but at night it is not possible to provide separate accommodation because the home has no vacant rooms in which she could be temporarily accommodated. In consequence, this resident must at night endure the use of a room shared with a dying person who requires frequent attentions from staff, and by day is discouraged from returning to her bedroom. The written procedure for the management of dying residents and actions to be taken by staff after the death of a resident fails to give appropriate guidance on use of shared bedrooms and actions to be taken when a sudden/unexpected/accidental death may have occurred in the home. It is recommended that the policy be reviewed and amended to ensure the provision of accurate guidance to staff and to describe arrangements for the promotion of dignity and privacy with particular regard to the use of shared rooms. This information should be reflected in the service user guide to ensure that residents and their representatives have sufficient information upon which to make their choice of home. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 12 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) These standards were not assessed during this inspection. EVIDENCE: Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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 The complaints policy and procedure provide residents with information and guidance about making complaints including to whom they can be made. EVIDENCE: No complaints against the home have been received or investigated since the last inspection. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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, 22, 25 & 26 Much of the décor, furnishings and fittings in Chine Breeze Court is old and worn but there is an ongoing programme of improvement through maintenance and replacement. Despite a somewhat dated and tired appearance the home presents an essentially homely and comfortable environment for residents. The home has not been assessed by an Occupational Therapist or similarly qualified person to ensure it is suitable to meet the various needs of residents. The home has identified risks of scalding associated with unguarded radiators and pipes but has not completed installation of the guards necessary to protect residents from injury. The standard of premises cleanliness is at present poor due to the short-term absence of a cleaner so risks of infection are increased. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 15 EVIDENCE: Many parts of the premises are of an unacceptably low standard e.g. the cork floor tiles of an en suite toilet were stained beneath the toilet pedestal, wooden window frames had bare wood exposed by peeled paint, some rooms had stained ceilings indicating water damage, there were areas of peeling wallpaper, the lounge carpet had worn threadbare parts. A bathroom casement window was held open by a tin of talcum powder because the sash cord was broken. Many items of household linen, including towels and sheets, were faded, holed, thin and fraying. There is an ongoing programme to improve the premises; on the morning of the day of inspection 2 bedrooms had received new carpets and the manager has recently ordered new towels and face cloths and 15 new armchairs have been installed in bedrooms. There are plans to extend the premises to provide new and improved facilities including a new kitchen, staff room, sluice room, laundry and an additional bedroom. However, to keep pace with the continuous deterioration of much used facilities the programme of refurbishment must be increased at the earliest opportunity. Despite repeated requirements made by the Commission the home has not been assessed by an Occupational Therapist or similarly qualified person to ensure it is suitable to meet the needs of residents and has not completed installation of the guards necessary to protect residents from risks of accidental scalding from hot radiators and pipes. At the time of inspection a number of carpets bore loose debris and 2 opened bags of clinical waste were lying on bathroom floors; the manager arranged immediate removal of the waste bags and explained that the home is at present without a cleaner because one is on holiday and the other post is awaiting commencement of a new employee. Interim arrangements must be made to ensure that at all times the standard of general cleanliness remains satisfactory. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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) 28 &29 The home is at all times in the charge of a registered nurse but insufficient care staff are trained to the required levels and by lack of knowledge may inadvertently place residents at risk of harm or neglect Recruitment and employment practices do not reliably protect against the employment of unsuitable staff who may place residents at risk of harm. A related Immediate Requirement was issued during the inspection. EVIDENCE: In addition to registered nurses the home currently employs 13 care staff, including 5 holding a National Vocational Qualification (NVQ) in care. To meet the National Minimum Standards at least 50 of care staff should hold this qualification so the home should make arrangements to increase the number of staff to meet this target. Employment records of a recently employed care worker were examined. Despite the applicant having worked in 2 other registered care homes neither of the 2 references had been obtained from the registered manager of either home. No POVA check had been recorded and the home held only a CRB disclosure obtained during May 2004 for a different type of work to that being applied for. The home must improve recruitment practises to ensure residents are not placed at risk by the employment of potentially unsuitable staff. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 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 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) 36 &37 All nursing and care staff are subject to continuous supervision and participate in periodic sessions of formal supervision to ensure they are able to properly carry out their work. The Commission has not received regular reports about the conduct of the home from the registered providers; in the event of complex or unsatisfactory circumstances arising the Commission might not be informed and so cannot offer advice/guidance on management of the situation. The home is not properly displaying the registration certificate and may thereby be withholding from service users essential details about the home and the service it is registered to provide. EVIDENCE: In accordance with a requirement of the previous inspection the home has commenced use of a formal system of supervision for all nursing and care staff, to ensure they are able to properly conduct their duties. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 18 Since November 2004 the Registered Providers have not submitted reports to the Commission at the monthly frequency required by the Care Standards Act 2000. The registration certificate provided by the Commission constitutes 2 pages; only the first page is displayed in the home. This report contains requirements for the provision of regular reports to the Commission and for the proper display of the registration certificate. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 19 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 x 3 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x 2 x x 2 2 STAFFING Standard No Score 27 x 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 3 2 x Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 20 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. Standard 4 Regulation 14(1)(d) Requirement Following pre-admission assessment, when the home decides to offer a place to a new resident, they should firstly write to the person stating that they will be able to meet their assessed needs. A comprehensive care plan must be recorded for each resident. At all times service user accommodation must be maintained to a satisfactory standard. The registered person shall ensure that an assessment is carried out by an Occupational Therapist to demonstrate that it meets the needs of the service users. Previous timescales of 30/11/03, 30/04/04, 30/09/04 and 31/03/05 not met. The registered person must ensure that appropriate action is taken in response to risk of scalding assessments on pipework and radiators. Previous timescales of 31/03/03, 30/11/03, 30/09/04 and 31/03/05 not met. All parts of the home must be Timescale for action 23/09/05 2. 3. 7 19 15 23(2)(e) 23/09/05 01/11/05 4. 22 23(2) 01/11/05 5. 25 13(4) 01/10/05 6. 26 16(2)(j) 23/09/05 Page 21 Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 kept clean and in good order. 7. 28 18(1)(a) (c)(i) The registered person shall ensure that a minimum ratio of 50 trained members of staff (NVQ Level 2 or equivalent) is achieved by 2005, excluding the registered manager and in care homes providing nursing, excluding those members of care staff who are registered nurses. Previous timescale of 01/01/05 not met. There must be evidence that the home operates a robust recruitment procedure. New staff must not commence work in the home without evidence of suitable CRB and POVA disclosure. The Registered Providers must arrange for the home to be visited at least once each month to inspect the premises, interview, with their consent, residents and staff and must provide to the Commission a written report on the conduct of the home. The certificate of registration must be properly displayed in the home. 01/01/06 8. 29 19 & Schedule 2 22/08/05 9. 37 26 23/09/05 10. 37 23/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 10 & 11 Good Practice Recommendations The home should develop and implement a written policy/procedure for the use of shared rooms, to include written consent from both involved residents (or their representatives) and reference to arrangements in the event of either person becoming seriously ill. This should also be referred to in the service user guide. D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 22 Chine Breeze Court 2. 11 The written procedure regarding management of death/sudden (unexpected/accidental) death should be improved to ensure accuracy and clarity. Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset, BH17 0NF 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 Chine Breeze Court D55 S20438 Chine Breeze Court V243287 220805 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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