Inspection on 28/09/05 for Collins House

This inspection was carried out on 28th 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

Collins House 19/01/09

Collins House 17/09/08

Collins House 09/10/07

Collins House 09/11/06

Collins House 19/04/05

Collins House 04/10/04

Collins House 23/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Collins House Springhouse Road Corringham Essex SS17 7LE Lead Inspector Christine Bennett Unannounced Inspection 13:00 28 /29th September 2005 th 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 Collins House DS0000036411.V255034.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. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Collins House Address Springhouse Road Corringham Essex SS17 7LE 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) 01375 671162 01375 361065 Thurrock Council Care Home 45 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (45) of places Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Number of service users to whom personal care is to be provided must not exceed 45. Personal care to be provided to no more than 45 older people over the age of 65. Personal care to be provided to no more than 22 service users with dementia over the age of 65. Radiators within the establishment to be made safe by September 2003 and confirmation submitted when work has been completed. 19th April 2005 Date of last inspection Brief Description of the Service: Collins House cares for 45 older people, 22 of whom might additionally have been diagnosed with dementia. The home is situated in a residential area close to local amenities and Corringham shopping centre. The home is on two floors and there is a passenger lift to enable access to both levels. There are 41 single and 2 double bedrooms, a large dining room and a number of lounges. There is a secure courtyard garden and the home has access to a minibus owned by Thurrock Council. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days lasting 9 hours 45 minutes. A tour of the premises took place and a number of records were examined. Discussion took place with the acting manager and five other members of staff. Twelve residents and four visitors to the home were also asked to give their opinions of the home. What the service does well: What has improved since the last inspection? What they could do better: Although an activity programme is established in the home, the acting manager is aware that it needs to be developed further to keep people occupied and stimulated. The care plan system must be written in a way to make sure that the care staff can easily understand the care needs of individual residents. Some of the records did not show the quality of the care that is being given. Medication procedures must be more thorough to make sure that no mistakes are made. There must be sufficient numbers of staff at certain times of day to make sure that the residents are cared for properly and vacancies filled to minimise the use of agency staff, and make sure there are always the right amount of staff on duty. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 6 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. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Collins House DS0000036411.V255034.R01.S.doc Version 5.0 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 the following standard(s): 1&6 The home’s Statement of Purpose and Service User Guide provides prospective residents with the details of the services offered, enabling people to make an informed decision prior to moving into the home. EVIDENCE: The Statement of Purpose and the Service User Guide are detailed and give information about the services provided by the home and prospective residents can make an informed decision as to whether the home can meet their needs. Minor amendments are necessary to both documents to bring them up to date. The home does not offer intermediate care. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 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 the following standard(s): 7, 8, 9 & 10 The care planning system needs to be clearer to ensure that staff can meet the residents’ needs. The health needs of the residents are met with evidence of good multi disciplinary working taking place on a regular basis. The medication system must be improved to prevent residents being put at risk. EVIDENCE: The acting manager is in the process of reviewing care plans and says they have improved since she has been in post. A care plan was examined of a resident who was prone to falls. Major shortfalls were seen in this plan. The resident had been seen by a physiotherapist following a fall and a plan of action had been made including daily exercises, blood pressure recordings and referral to a chiropodist. There was no indication as to how this plan would be implemented and no evidence that any of the requests had been done. The same plan evidenced that the incontinence advisor had requested information to be completed in the plan but this was poorly recorded. There was no risk assessment for falls and no evidence of regular reviews. No weights had been recorded and the acting manager advised that as the resident was unable to stand unaided, the home did not have any suitable scales. Daily records varied in the information they gave, and some entries were inappropriate. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 10 These issues were discussed with the acting manager at the inspection, and it was agreed that the records did not evidence the quality of care being given, and substantiated by both residents and their relatives. The manager confirmed good relations with the multi disciplinary team and both the GP and the district nurse come into the home on a weekly basis to see residents and review medication. There was also evidence of the involvement of a physiotherapist, incontinence advisor and one relative told of an incident when her father had fallen and how prompt the home was in getting him to hospital for treatment. Records for the administration of medication were viewed. Three MAR sheets were selected at random. One did not have any picture identification and a medication had not been signed in therefore could not be checked to see if it was accurate. Medication had frequently been handwritten in by one member of staff onto individual records. It is strongly recommended that these be checked by a second person and referenced back to the original prescription, as there is the potential for error when charts are regularly re-written by care staff. One record appeared to have a discrepancy about the amount of medication held by the home but due to poor recording, it was not possible to check this accurately. A cream that had been prescribed for one resident was found in the room of another resident. The acting manager confirmed that a meeting had taken place the previous week with the pharmacist as there had been problems with the dispensing of medication. A copy of “The Administration and Control of Medicines in Care Homes” was left with the home. Collins House DS0000036411.V255034.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): 12, 13 & 14 Some social activities take place but these are dependant on the care staff, and residents do not always feel stimulated. EVIDENCE: The activities programme has recently been amended and it is now the responsibility of individual carers, who have been allocated the task on a rota system, to organise the daily activity. Some carers welcomed this but others did not feel comfortable in this role. On the day of inspection the Pearly Queen was supposed to come to entertain the residents and twenty-three were waiting in the dining area. When she did not arrive, it was left to the carer to provide alternative entertainment. The residents were asked their views on the activities provided by the home and comments made were, “not a lot to do, we could do with people coming in more”, “we only sit about” and a visitor said, “there is not enough for him to do”. Staff comments were, “there is no organisation, activity comes low on the list of priorities”, “there are not enough staff to give them the time”. The home has access to a minibus and recent outings took place to a Butterfly Farm and a “Chas and Dave” evening but this was limited to 3-4 residents. Residents confirmed that they could receive visitors at any time. Meetings are held for the residents every 3 months when they can discuss their life in the home and any changes they would like implemented. They were generally happy, one man said “we get a good life” and a lady said, “I Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 12 don’t think you could better it”. One visitor confirmed that her mother can go to bed when she wants and a resident said that she can lock any personal possessions away in her room and she has been able to bring belongings from home to make her bedroom the way she wants it. Collins House DS0000036411.V255034.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): 16 & 18 The home has a satisfactory complaints procedure, which must be followed when investigating concerns. Appropriate arrangements are in place to protect residents from abuse. EVIDENCE: The home has received two complaints since the last inspection. The home has a satisfactory complaints procedure but did not follow it when investigating both these complaints and therefore there was no indication that the complainants were happy with the outcome of the investigations. Residents and relatives said that the management of the home is very approachable and that they feel confident that any concerns would be sorted out. There have been no POVA issues since the last inspection. Some members of staff are presently undertaking training and generally staff had a good understanding of POVA issues and the reporting of abuse. Collins House DS0000036411.V255034.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): 22 & 26 The home is clean and comfortably furnished, with sufficient aids to enhance the quality of the residents’ lives. EVIDENCE: The home is clean with no unpleasant odours. One visitor said she was, “delighted with the cleanliness”. The dependency of the residents has risen and further aids have been supplied to the home to aid both staff and residents. These include hoists and wheelchairs. Some parts of the home do need redecorating and the acting manager was able to confirm that there is a 2-year redecoration plan in place. The home has worked hard to improve infection control within the home. This included seeking advice from the Health Protection Agency. As a result new measures are in place with regard to the laundry, the accessibility of long gloves and the disposal of pads. Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 15 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 Shortfalls in staff and the deployment of staff mean that there are not always enough staff to meet residents’ needs. Recruitment practices have improved and offer protection for residents. EVIDENCE: The home has vacancies for day and night care staff and housekeeping staff. These vacancies are at present being covered by existing staff or agency staff. The acting manager said that since the last inspection one more carer has been allocated to the morning shift. However care staff are now required to provide the activity programme for the home. Staff said that they are always busy and do not have the time to spend talking to residents or giving one to one activities. They felt that the busy periods between 12-1pm and 4-5pm had not been addressed satisfactorily and there were often shortfalls in the work force, when a staff member goes sick at short notice. One staff member said that the residents need more care than ever and the acting manager confirmed that 30 residents had high dependency needs. The rota was examined for the week of inspection. 4 permanent members of staff and 5 agency staff staffed the early shift for one day. Although the acting manager confirmed that two of the agency staff are used on a regular basis and have a good knowledge of the residents, it is not an acceptable ratio. In the afternoon of the same day, there were 4 permanent staff and 3 agency staff on the rota. However one of the staff was not coming on duty until 5pm, which meant there were 6 staff on duty instead of the 8 proposed for the afternoon. During the early evening, two carers were seen to be assisting residents with feeding in one lounge. In another lounge nearby a female resident was shouting at one Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 16 of the male residents. There were no staff in attendance and she only ceased to shout when he had left the lounge. This was discussed with the acting manager at the end of the inspection. The registered provider must ensure that the level of staffing meets residents’ needs. There has been no new recruitment since December 2004. The staff files were seen for three members of staff and they contained evidence that the required checks, including references and CRB were carried out prior to commencement of employment. The application forms did not evidence that gaps in their employment record had been explored. Collins House DS0000036411.V255034.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): 31, 33 & 36 The appointment of the acting manager has bought a period of stability to the home. EVIDENCE: The acting manager has been in post on a six-month contract since May 2005. Thurrock Council has not yet made an application for registration of a manager to the Commission. Staff and residents were complimentary about the management of the home. One staff member said, “She is very approachable, quite firm which is good”. Regulation 26 reports have been submitted to the Commission on a regular basis. Staff meetings are held but individual supervision has lapsed since the last inspection. Residents meetings are held every three months and the acting manager must now collate this information and develop a plan to reflect that it is monitoring the quality of the service that it offers. Collins House DS0000036411.V255034.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 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 x X X 3 X X X 3 STAFFING Standard No Score 27 2 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 2 X X Collins House DS0000036411.V255034.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 Standard OP7 OP9 Regulation 15(1) 13(2) Requirement The registered person must prepare a written plan to meet the residents needs The registered person must make arrangements for the safe administration of medication This is a repeat requirement The registered person must provide activities in relation to recreation, fitness and training for residents’ various needs This is a repeat requirement The registered person must ensure that the complaints procedure is followed when investigating complaints The registered person must ensure that at all times suitable staff are working in the home in numbers appropriate for the health and welfare of the residents This is a repeat requirement The registered person must compile a report in respect of any review and supply it to CSCI Timescale for action 31/12/05 31/12/05 3 OP12 16(2)(n) 01/02/06 4 OP16 22 31/12/05 5 OP27 18(1)(a) 31/12/05 6 OP33 24(2) 31/03/06 Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP1 OP22 OP29 OP36 Good Practice Recommendations The Statement of Purpose and the Service User Guide should be updated to include current information. The registered provider should provide sit-on weighing scales for the use of frail residents Gaps in employment history should be explored and recorded Formal supervision of staff should be done 6 times per year Collins House DS0000036411.V255034.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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