Inspection on 18/04/06 for Conifers

This inspection was carried out on 18th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Conifers 09/01/09

Conifers 18/01/08

Conifers 13/07/07

Conifers 05/10/05

Conifers 09/06/05

Conifers 14/10/04

Conifers 11/05/04

Similar services:

Deepdene Care Centre

Ferndale Residential Care Home

David Gresham House

Elizabeth House

Elvy Court Nursing Home

Fontenay Nursing Home

Clairmont Residential Home

Cornford House

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

CARE HOMES FOR OLDER PEOPLE Conifers Seal Square Selsey Chichester West Sussex PO20 0HP Lead Inspector Ms J Hartley Key Unannounced Inspection 19th April 2006 14:00 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 Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Conifers Address Seal Square Selsey Chichester West Sussex PO20 0HP 01243 606436 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) Family Care Private Company Limited Mr Martin Pelling Care Home 20 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (20) of places Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only service users over the age of 65 years of age may be admitted to the home. The home may accommodate one service user under the age of 65 years. 5th October 2005 Date of last inspection Brief Description of the Service: Conifers is a care home providing personal care and accommodation for up to twenty service users in the category of dementia, over sixty-five years. It is owned by Family Care Private Company Limited and managed by Mr Pelling. The home is located in Selsey and is close to shops and other amenities in this seaside town. The responsible person on behalf of the company is Mr Samarasekara. It is a detached property with accommodation on three floors. It consists of eighteen single rooms and one double room. There are sitting areas and a dining room. The exterior is well maintained with garden facilities accessible to service users. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over a period of five and a half hours. The inspector examined information held on the service file since the last inspection, and read previous reports, the Service User Guide and the Statement of Purpose. During the inspection the inspector spoke to some of the residents and staff and observed care practices. The inspector undertook a tour of the premises and looked at three care plans and three staff files. Various record books, policies and procedures were also examined. The current fee range at Conifers is £410 to £480, depending on the assessed needs of the individual resident. The overall rating for this home is good. What the service does well: What has improved since the last inspection? What they could do better: The registered Provider should provide the Commission with a report of the monthly monitoring visits he undertakes. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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 Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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, 3 The home has a Statement of Purpose and Service User Guide that includes the required information and is given to service users and their representatives. The manager undertakes a full assessment of need prior to admitting a resident. Social service and health assessments are on file for those residents who are referred through the Care Management system. The home does not provide intermediate care therefore Standard Six does not apply. The outcome for residents is good. EVIDENCE: The manager provided the inspector with the homes latest Welcome Pack, which contains the Service User Guide and Statement of Purpose. Both documents are up to date and include the required information. A copy is given to service users relatives or advocates. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 9 Service users files inspected included a full assessment of need and a plan of care for daily living. Service users referred through Care Management arrangements have a copy of the health or social services assessment on file. The manager confirmed that the home does not provide intermediate care. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9, 10 Service user’s health, personal and social care needs are set out in an individual plan of care. Their health needs are fully met by the home and community health services. Service users are treated with respect and their privacy is upheld. Medication policies, procedures and training are in place. There are no service users responsible for their own medication. The outcome for service users is good. EVIDENCE: Three service users’ care plans were seen during this inspection. They all clearly set out the action to be taken by care staff to ensure that all aspects of the health, personal and social care needs of service users are met. Due to the level of dementia experienced by service users, it is not always possible for the plan to be drawn up with the involvement of the service user. Care plans were seen to be reviewed regularly and when a change in needs arises. Reviews are signed by the manager. Care plans address the diversity of health/disability, religious, social and gender needs of the residents. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 11 Files were seen to include personal histories. Information from these is used by staff to aid conversation and memory. Each resident’s file was seen to have a section that records all health appointments and outcomes, enabling staff to monitor health needs and identify any patterns or changes that may be occurring. Records in service users’ file show that the home has regular contact with local community mental health services. Records show that nutritional and weight screening takes place prior to admission and is monitored continuously while residents are at the home. Cognitive function and behaviour is also monitored to enable the manager and staff to identify and patterns or changes in this area. It was noted that all residents are registered with a GP and dentist and a chiropodist visits the home regularly. Evidence was seen that the home uses the service of the Incontinence Advisory Service when needed. Conifers is taking part in a pilot scheme aimed at minimising the risk and impact of falls. Balance exercises have been set up to help minimise falls. Some residents, following risk assessments, wear padded hip protecting underwear to help to protect against hip fractures. Policies and procedures were seen for the receipt, recording, storage, handling, administration and disposal of medicines. Unused medication is returned to the pharmacy, a receipt book signed by the pharmacy was seen during the visit. Accurate records were seen of the administration of medication. The home has some service users who have diet-controlled diabetes. Blood sugar levels are monitored and recorded; the GP is contacted if there are any concerns. Evidence was seen that staff have received training in the administration of medication. Due to the needs of the service users at Conifers, no one is currently self-medicating. It was observed that personal care is undertaken in private. Residents said that they find the staff polite and friendly, and helpful. The manager and staff were observed treating the residents with respect and dignity. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 14, 15 The home provides residents with choice in their lives within a framework that minimises risk according to their individual levels of dementia. Contact with family and friends is encouraged. A programme of activities is available for those who wish to participate. Meals are wholesome and residents are offered alternatives if they do not like what are on the menu for the day. The outcome for service users is good. EVIDENCE: A member of staff has the role of activities co-ordinator within the home, evidence was seen that she has undertaken a course in providing activities for older people. Posters were seen in the home advertising an upcoming entertainer. The manager said that residents are also told of activities verbally. Activities recorded include walks, arts and crafts, quizzes and balance exercises, (to help reduce the risk of falls). Care plans record the social interests and hobbies of residents. Care plans were seen to record residents interests and hobbies. Residents said that they have family and friends visit them at the home. Residents said that they like the food prepared by the home. The menu is displayed on a board in the home. Planned meals consisted of plain and Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 13 wholesome food that is well balanced. Fresh vegetables were seen in the kitchen. Some residents have diet-controlled diabetes; evidence was seen that this is catered for by the home. A resident said that she is able to make choices about what time she goes to bed and gets up in the morning. It was evident from residents bedrooms that they are able to bring personal possessions with them when they move into the home. Care plans showed evidence of information being gathered from the residents and/or their relatives on personal likes and dislikes. Due to the level of dementia experienced by the service users at Conifers, they are unable to maintain control of their finances. The registered manager does not manage any finances on behalf of residents. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 14 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 complaints procedure is clear and complaints are recorded. Residents are protected from abuse by the home’s Adult Protection policy, whistle blowing policy, and staff training. The outcome for service users is good. EVIDENCE: The home has a clear complaints procedure, which includes how to contact The Commission and the Ombudsman. The procedure is included in the Welcome Pack that is given to new residents and their relatives. The home records any complaints that have been made; this was seen by the inspector. A relative said that a complaint she made was dealt with quickly and satisfactorily. The home’s policies and procedures for Adult Protection and whistle blowing were seen and found to be clear and adequate for the purpose. Staff training records seen during the visit show that staff have received training in Adult Abuse. A copy of the West Sussex Multi-Agency Policy and Procedure for Protecting Vulnerable Adults was seen in the home. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 15 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): 19, 26 Conifers is clean and tidy throughout with attractive enclosed grounds, and is suitable for its intended purpose. Some redecoration has taken place since the last inspection. There remains an issue with the siting of the laundry but a policy is in place to minimise risk. The outcome for residents is good. EVIDENCE: The location and layout of the home was seen to be suitable for its stated purpose. It was noted that the hall and stairs of the extension have been recently decorated. The grounds are tidy, attractive and accessible to service users. They are enclosed to minimise the risk of residents wandering out of the home. On the day of the visit the home was seen to be clean, tidy and free from offensive odours. Radiators and pipe work are covered and upper floor Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 16 windows have restrictors in place for safety. Residents’ bedrooms contain personal possessions. Some rooms have been recently redecorated. The rust that was noted on the bath chair plate at previous inspections has now been removed. Access to the laundry is through the kitchen, although there is a policy in place informing staff to use a route outside the building to the laundry, so that dirty washing does not need to be taken through area where food is stored or prepared. Mr Samarasekara is planning an extensive refurbishment of the property, which when complete, will address this issue. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 17 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, 28, 29, 30 Service users’ needs are met by the number and skills mix of staff on duty at Conifers. The home has exceeded the minimum ratio of fifty percent of care staff having an NVQ Level Two or equivalent qualification. There is a thorough recruitment process in place and new staff receive induction training. Staff at Conifers have undertaken a number of training courses to enable them to understand and meet the needs of residents as well as provide a safe environment for them to live in. The outcome for residents is good. EVIDENCE: The rota seen during the inspection showed that there are three care staff on duty during the day and two waking night staff at night. Conifers also employs a cook, a housekeeper and one domestic staff. Evidence was seen that Conifers exceeds the minimum ratio of fifty per cent of care staff with an NVQ Level Two or equivalent qualification. Case tracking showed that the home operates a thorough recruitment process that includes obtaining two written references and a Criminal Records Bureau check prior to staff commencing work. Staff training records show that there is an induction in place for new staff. Staff also receive training in Health and Safety, Adult Protection and the Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 18 Administration of Medication. Training records show that staff have undertaken a number of training courses to enable them to understand and meet the needs of residents as well as provide a safe environment for them to live in. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 19 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, 35, 38 Mr Pelling, the registered manager is experienced and has just completed his NVQ Level Four and Registered Managers Award. The registered provider needs to record his monthly visits to the care home as part of a quality monitoring system, to ensure that residents are benefiting from the management approach. The manager does not manage any finances on behalf of the residents. The home’s policies, procedures and staff training protect the health, safety and welfare of residents and staff. The outcome for residents is good. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 20 EVIDENCE: Mr Pelling has many years of experience of working within the care field. He informed the inspector that he has just completed the NVQ Level Four in Care and the Registered Managers Award. Evidence was seen that since the last inspection the manager has introduced a more thorough quality assurance and monitoring system that seeks the views of residents, relatives, GP’s nurses and social workers. Comments seen by the inspector from relatives and professionals were very positive about the services provided by Conifers. The registered provider carries out monitoring visits to the home, but has not been recording his findings. A report of his monitoring visits should be made and a copy sent to the Commission. Due to the needs of the residents at Conifers no resident is able to control their own finances. All current residents are either subject to Power of Attorney or Guardianship. The manager does not act as appointee for any of the service users. Staff records show that staff receive training in Health and Safety. Policies, procedures and risk assessments were seen to be in place regarding Health and Safety. Certificates and records were seen that show that fire, gas, and electrical equipment in the home are tested regularly. A new fire alarm panel has been installed, following the advice of the fire department. Evidence was seen that water temperatures are checked weekly. A Legionella test was carried out in June 2005. All the radiators and pipe work in the home are covered to minimise the risk of scalding. Windows have restrictors fitted. Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 21 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP33 Regulation 26 Requirement The registered Provider should make a report of his monthly monitoring visit to the home and provide the Commission with a copy. Timescale for action 18/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Conifers DS0000046710.V290561.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Conifers DS0000046710.V290561.R01.S.doc Version 5.1 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. 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