Inspection on 09/11/06 for Collins House

This inspection was carried out on 9th November 2006.

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 28/09/05

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 9th November 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Collins House DS0000036411.V316424.R01.S.doc Version 5.2 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.V316424.R01.S.doc Version 5.2 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 Manager post vacant Care Home 45 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (45) of places Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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 24 service users with dementia over the age of 65. 28th September 2005 Date of last inspection Brief Description of the Service: Collins House cares for 45 older people, 24 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. The home has a Statement of Purpose and Service User Guide, which have been updated in 2006. These documents, together with the last inspection report are available to residents/visitors in the main hallway of the home. The current weekly fees are £584.92. There are additional charges for chiropody, hairdresser, newspapers/magazines, personal toiletries and taxi fares. The future of the home is currently under review. Consultation regarding the various options is taking place between November 2006 – January 2007. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key site visit was unannounced and took place on 9th November 2006 and lasted over a seven hour period. At this inspection all the key standards and the progress made since the last inspection were assessed. A pre inspection questionnaire had been completed by the home. Surveys had been sent to a random selection of residents and visitors. Five responses were received from residents, and six from visitors. Their comments are included in this report. A general practitioner, a district nurse and a social worker who visited the home also returned surveys and had no concerns regarding care in the home. A random inspection had been carried out on 1st June 2006 and information from that inspection will be included in this report. At the site visit a tour of the premises took place. Time was spent with the residents in the lounges and dining room, and some residents and a visitor were spoken with individually. Care practices were observed throughout the day. The manager assisted during the inspection and staff were given the opportunity to speak to the inspector. Feedback was given to the manager throughout the inspection. What the service does well: The staff team have a good knowledge of the individual residents and their needs. Feedback from residents and visitors was very positive about the staff in the home. The home has a thorough admission procedure. People are given the opportunity to visit the home and a senior member of staff assesses the person in their own home to make sure their needs can be met. The home is clean and has a friendly atmosphere. There are no unpleasant smells. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 6 The local GP and district nurse are in regular contact with the home and confirmed that they have a good relationship with the home and no concerns about the care given. What has improved since the last inspection? What they could do better: Staff morale is low due to the many changes they have experienced over the last two years and the continuing uncertainty of the future of the home. Thurrock Council must make sure that there are enough staff at all times of the day and night to meet the needs of the residents. Some areas of the home are in need of decorating and some furniture needs to be replaced. The training programme for the staff must be more structured to ensure all staff take advantage of training opportunities that give them the skills to do their job. Record keeping in care plans and medication records must be clearer to make sure that residents get the best care and are not put at risk. Clinical waste must be disposed of safely to prevent the risk of infection. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. EVIDENCE: The home has an up to date Statement of Purpose and Service User Guide which reflects the service that the home can offer to future residents. They are available in large, bold print and are displayed in the hall, along with the last inspection report. The manager was able to describe a thorough pre admission assessment. Residents or their families are given the opportunity to visit the home before they move in. The manager or her deputy also visit the resident to make sure that the home is suitable to meet their needs. A review is held approximately Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 10 one month after admission to make sure that everybody is happy with the arrangement. Two care plans viewed at the site visit had detailed pre admission assessments recorded. The surveys received from both the residents and the relatives confirmed that they felt they had received enough information before moving into the home. Intermediate care is not offered by the home. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care planning does not always provide all the information to ensure a resident’s health and personal care needs are met. EVIDENCE: Care plans were viewed for two residents. One had good information relating to health needs and risk assessments. The management of these risks had been recorded well. The other care plan related to a resident with a medical condition. It was unclear what this condition was and no risk assessment had been done relating to this condition. Both plans had failed to record any weights of the residents. Nutritional charts relating to these residents were inadequate. Daily records varied, but did not always identify how a resident had spent their day. There was no evidence of resident/relative involvement. The care plans were discussed with the manager at the site visit, who acknowledged that there were omissions in the recording and did not evidence Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 12 the quality of the care being given, and substantiated by both residents and relatives. Records showed that residents’ health care needs are catered for with regular input from the GP and District Nurse. Other professional services such as the chiropodist, optician and hospital based services are accessed as necessary. The accident book was viewed and it was noted that falls relating to serious injury mainly occurred at night. Discussion took place with the manager regarding staffing levels at night and this is being reviewed. One resident’s first language is not English and a keyworker has been allocated to her who can speak with her in her native tongue. Medication administration and storage had improved since the last inspection. Staff who administer medication have had refresher training at the local hospital. Three medication records were selected at random and there were discrepancies on two of them in relation to the amount of medication held by the home. Homely medication was not recorded accurately and some handwritten drugs were still being transcribed by one person, which has the potential for errors to occur. Staff were seen to speak to residents sensitively and respectfully. Residents were dressed appropriately in their own clothes which were clean and ironed. Any personal care is delivered in the privacy of their own room and shared rooms have screening available. The residents have the opportunity to see visitors or make a telephone call in private. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Food and activities offered provide the residents with choice and occupation to enhance their lives. EVIDENCE: Residents were complimentary about the activities that take place in the home although people generally felt that they would like the programme to be extended. Some felt that there were not enough staff available to arrange activities for the number of residents. A relative who was visiting the home was complimentary about the activities organiser and the singers who visit the home. A member of staff said that the activities person allowed her more time to do her job and she could see the difference it had made to some residents. Another member of staff confirmed that entertainers come into the home at least once a month and residents have a buffet and an alcoholic drink on these occasions if they choose. The home has a vehicle but it is not used on a regular basis due to lack of drivers and staffing levels. The home relies on the goodwill of the staff on the occasions that it is used. A small number of residents attend outside clubs or Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 14 day care. Some residents spoken with at the site visit confirmed that they would like to go out more and that they would like some evening entertainment. Residents’ religious beliefs are respected and a service is held in the home on a regular basis. Arrangements have been made for a resident to attend her local church. The survey results all indicated that the residents enjoyed the food in the home. One comment was, “I love the food and usually devour everything – there is always sufficient to eat”. The home operates a four weekly menu and residents have a choice at mealtimes. Time was spent with the residents in the dining area at breakfast and lunch. The food looked attractive and staff assisted the residents sensitively. Some residents were seen to spend long periods in the dining area prior to the meal being served or waiting for the care staff to be able to attend to their needs after a meal. Meetings are held for residents every three months when they can discuss their life in the home and any changes they would like. A member of staff gave details of a request from residents to have an entertainer in the evening, and the arrangements that were underway to make this possible. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are partially protected by the home’s complaint procedure but all staff must have POVA training to fully protect the residents. EVIDENCE: The home has a complaints policy and procedure which is detailed in the Service User Guide. Residents confirmed that they knew who to speak to if they were unhappy with anything in the home. One resident said that they had complained once and it had been dealt with immediately. Another resident said at the site visit, “If you have any problems they listen and help you if they can”. One complaint had been recorded since the last random inspection. The manager explained that an advocacy service is being asked to support the residents through the current period of change. There have been two allegations of abuse involving three members of staff since the last key inspection which Thurrock Council have investigated. One was not founded, one resulted in a member of staff being dismissed, and the third has been deferred. Two members of night staff have not had training in the Protection of Vulnerable Adults. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 16 Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Areas of the home are in need of redecoration and refurbishment. EVIDENCE: Consultation is taking place between October 2006 and January 2007 regarding the future of Collins House. Essential maintenance work only is being carried out until a decision has been made. This means that there are areas in the home in need of redecoration and refurbishment. One survey returned by a resident said, “I would like new windows without drafts” and another said their bedroom “needs decorating”. A relative who visits two to three times a week said, “It’s nice and clean – spotless”. Some new equipment has been made available. This includes weighing scales, hoists, some beds, a dishwasher and a tumble drier. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 18 Generally the home was free from unpleasant odours. Clinical waste bins outside the home were overfull and the lid was not closed which could be a health hazard. The home has an attractive courtyard garden that is fully enclosed to allow the residents to use it safely. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. . Staff morale is low and staffing deployment and training must be resolved to prevent an adverse effect on residents. EVIDENCE: Staffing at Collins House is currently under review. The needs level of the residents is being identified and the numbers, deployment and tasks that staff perform are being addressed. One resident said, “Sometimes staff are stretched and not able to comply immediately – they do their best”, another said “sometimes it’s a bit short, a bit late getting up sometimes” and a relative responded in a survey that they felt there were not always enough staff on duty. The manager confirmed that agency staff are still used to cover shortages. One resident said in a survey, “when they are short there is agency who do not know our needs”. At the site visit it was noted that there were still eleven residents in the dining area at 10.30 am, having just finished their breakfast and waiting for staff to assist them. It was also noted that on two occasions call bells were not answered for a long time. At the previous random inspection in June 2006, many residents were waiting in the dining room for long periods of time at lunchtime prior to lunch being served. The accident book evidenced that most of the falls resulting in serious injury occurred at night. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 20 Staff spoken with at the site visit spoke of being “unsettled” and were worried that changes meant they “will not have time” to do their job. They felt that time spent with individual residents would suffer and one said, “it feels like a conveyor belt”. There has been no new recruitment since the last inspection, although some staff have transferred from a sister home. Thurrock Council have a policy to renew CRB checks every three years. Files that had shortfalls at the random inspection in June 2006, had been updated and were in order. Training records evidenced that some staff had received adequate training to give them the skills to perform their job, but others had received very little training and were in need of updating. Some staff files showed no evidence of any training in 2006. Two members of night staff had been booked on POVA training three times but had failed to attend. The manager confirmed that she will be identifying individual training needs and arranging for these needs to be met. She confirmed that some staff are nearing completion of NVQ level 2 and the home will then have 50 of the care staff with an NVQ qualification. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager provides stability to the home and must develop strategies to evidence that the home is run in the best interests of the residents. EVIDENCE: The home has recently appointed a permanent manager. She has previously been the manager of a sister home and has many years experience. She has an NVQ level 4 qualification in care and management. She has a good understanding of the unrest that the home has experienced and areas that need to be improved. Residents spoke positively about the manager and felt she was approachable. One resident commented, “she’s lovely, she’s a nice person”. The home has regular meetings for staff and residents and a survey was sent to relatives in June 2006 to ask them their views. This information, along with Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 22 any other views from stakeholders of the service should be collated and an annual development plan produced as part of the quality assurance programme to evidence that the home is run in the best interests of the residents. Monthly visits to monitor the home are undertaken by a senior manager of Thurrock Council as required by regulation. Money held by the home for individual residents was checked at the random inspection in June 2006. It was found to be stored securely and any financial transactions recorded accurately. The manager feels the home is fully compliant with fire regulations. The pre inspection questionnaire identified that systems and services are monitored and maintained. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 23 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 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 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 3 X 3 X 3 X X 3 Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 24 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. Standard OP7 Regulation 15(1) Requirement The registered person must prepare a written plan to meet the residents’ needs. This refers to risk assessments and management, and the involvement of the residents/relatives. This is a repeat requirement Timescale for action 01/02/07 2. OP8 12 (1) (a)(b) 3. OP9 13(2) The registered person must promote the health of the residents. This refers to the recording of weights and the development of nutritional charts This is a repeat requirement The registered person must make arrangements for the safe administration of medication. This refers to the accurate recording. This is a repeat requirement The registered person must ensure residents are not placed at risk of harm or abuse. DS0000036411.V316424.R01.S.doc 01/02/07 01/02/07 4. OP18 13(6) 01/02/07 Collins House Version 5.2 Page 25 5. OP19 23 (2)(b)(d) 6. OP26 16(2)(k) 7. OP27 18(1)(a) This refers to the training of all staff in this area This is a repeat requirement The registered person must ensure the premises are kept in a good state of repair and reasonably decorated and furnished. The registered person must make suitable arrangements for the disposal of clinical waste. This refers to the overflowing container in the courtyard. 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 particularly refers to the night shift. This is a repeat requirement 01/04/07 01/01/07 01/01/07 8. OP30 18(1)(c ) 9. OP33 24(2) The registered person must 01/03/07 ensure that staff receive training appropriate to the work that they perform. This refers to some staff receiving training to update their skills The registered person must 01/01/07 compile a report in respect of any quality review and supply it to CSCI and the residents This is a repeat requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 26 No. 1. Refer to Standard OP13 Good Practice Recommendations The use of the minibus is developed to enable the residents to go out more. The manager is registered with CSCI. 2. OP31 Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Collins House DS0000036411.V316424.R01.S.doc Version 5.2 Page 28 - 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. 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