Inspection on 16/11/05 for Coniston House Residential Home

This inspection was carried out on 16th November 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

Coniston House Residential Home 22/10/07

Coniston House Residential Home 27/04/07

Coniston House Residential Home 03/05/06

Coniston House Residential Home 04/05/05

Coniston House Residential Home 05/01/05

Coniston House Residential Home 24/08/04

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 Coniston House Residential Home 75-79 Orwell Road Felixstowe Suffolk IP11 7PY Lead Inspector John Goodship Announced Inspection 16th November 2005 10:00 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 Coniston House Residential Home DS0000060116.V267736.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. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Coniston House Residential Home Address 75-79 Orwell Road Felixstowe Suffolk IP11 7PY 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) 01394 276201 01394 276201 Enviro Medical Limited Ms SallyAnn Royal Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Approval to care for one person under the age of 65 whose name was made known to the Commission on 28 September 2005 4th May 2005 Date of last inspection Brief Description of the Service: Coniston House is a registered care home for older people situated in a residential area of the coastal town of Felixstowe, close to town centre amenities and the seafront. The home was first registered in 1984 and was bought by Enviromedical Ltd in June 2004. This organisation also runs a similar home in Southend-on-Sea. The home was originally registered to provide accommodation and care for up to nineteen older people but in 1999 was extended into the property next door and is now able to accommodate up to twenty-six service users.There is private parking to the rear of the property. The rear gardens of the property have been landscaped to provide a particularly pleasant area for service users to spent time in the more clement weather.Service user accommodation is sited on three floors all of which are serviced by 2 shaft lifts. There are twenty two single rooms and two shared rooms. 75 of rooms have the advantage of ensuite toilet facilities. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection of the year and was an announced inspection undertaken by two inspectors. The inspection focused on progress regarding requirements and recommendations since the last inspection. This was the first inspection since the new manger was appointed and registered. The home was fully occupied. Methods used during the inspection included discussion with residents, staff and visitors, observation, examination of records, other documents and use of information provided by the home prior to inspection. Eight resident comment cards were also received. The inspectors were assisted throughout by the manager, Ms. Royal and the owners were present for part of the inspection. What the service does well: What has improved since the last inspection? There is a new manager now in post. There have been a number of improvements to the environment including valves for control of hot water temperatures have been fitted to all outlets, a new hoist has been purchased for use on the top floor of the home. Ramps and grab rails have been fitted to both front and back doors for ease of access. Staff have undertaken some mandatory training which has been documented, for example Manual Handling, Fire Safety and Protection of Vulnerable Adult (POVA) training. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 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. Coniston House Residential Home DS0000060116.V267736.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 Coniston House Residential Home DS0000060116.V267736.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): 1,5 People are able to make an informed decision about the home from the written information they receive and from what they see when they visit the home. EVIDENCE: A new statement of purpose has been produced since the last inspection, however, the arrangements for making a complaint must be included. Information on how to access the complaints procedure, inspection reports and an explanation as to how the service users’ views of the home are obtained need to be added to the service user’s guide. The manager confirmed that prospective residents and their representatives are encouraged to visit the home and assess its suitability to meet their needs. This was confirmed by a recently admitted resident. Coniston House Residential Home DS0000060116.V267736.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): 7,8,10 The lack of comprehensive, up-to-date care planning means that residents’ health and social care needs may not be identified or fully met EVIDENCE: The manager acknowledged that the new Standex system for care plans was poorly completed. Many of the records seen lacked personal details, assessment or planning to meet identified needs. Shift records were completed but most lacked sufficient detail of daily activities. Evidence of service-user involvement in this process was not apparent although 3 out of 4 responses on the relative/visitors comments cards stated that they were consulted about care. The home has one resident receiving respite care who has started to exhibit challenging anti-social behaviour. Appropriate referral to the psychogeriatrician had resulted in a new medication being trialled. The guidance for staff to help and assist this service-user was not made clear in the care plan. It was however, recorded in the daily records. The inspectors saw Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 10 that unobtrusive observation and distraction techniques were being used by staff. The 8 residents who completed comment cards all stated that their privacy was respected. This view was confirmed by residents spoken to during the inspection. The manager confirmed that there were no service-users who wished to selfmedicate at this time. The only service-user who did self-medicate recently requested that staff take over this role. Coniston House Residential Home DS0000060116.V267736.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): 12,13,14,15 Daily life in the home satisfies the expectations and preferences of most service-users. EVIDENCE: A list of weekly activities was displayed on the notice board which included, manicure, hoopla, chiropodist, skittles, video, bingo, dominoes and that days inspection. A Church service was in progress in the lounge and seen to be attended by several residents. Those not wishing to attend were able to socialise in the other two sitting rooms or spend time in their own rooms. One lady was seen to be reading happily in her room. She had her own ‘library’ bought from the book stall at the summer fair with the intention of returning them for next years stall.. The community librarian also visits the home on a regular basis. The staff mostly facilitate the activitie, which are not always well attended according to the manager. Four out of 8 replies received from the residents’ comments cards completed before the inspection stated that ‘there were not enough suitable activities.’ One comment was ‘It would be nice to get together for a talk, quiz or games of some sort’. There were several visitors in the home during the inspection. Service-users spoken with confirmed that they are encouraged to maintain friendships and contact with the local community. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 12 Several residents said that the meals were good and 7 out of the 8 comment cards received agreed with this There was a varied menu for day displayed and roast chicken dinner was being enjoyed in the dining room during the inspection. Coniston House Residential Home DS0000060116.V267736.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 Service users can expect that any concerns or complaints will be treated seriously. EVIDENCE: An anonymous complaint was received by the Commission in October 2005. It made allegations about a member of staff, and questioned some of the Home’s care practices relating to the lifting of residents and the time they were assisted to get up in the mornings. After investigation by the Commission, two elements of the complaint were not upheld, two were upheld and action was required by the manager, and one element was unresolved pending further investigation by the manager. The comment cards indicated that one relative had made a previous complaint but was satisfied with the overall care provided. Staff had received POVA training in March 05 and this was documented in a training file. Two staff members confirmed their attendance and had a knowledge of their responsibilities for reporting suspected abuse and protecting service users’ from abuse. Coniston House Residential Home DS0000060116.V267736.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): 19,20,22,23,24,25,26 The environment was pleasant, comfortable and well furnished, however, the inability to access a hoist on the first floor may potentially impact on serviceusers’ independence and create a health and safety issue for staff and serviceusers. EVIDENCE: Five residents were pleased to show off their rooms, all of which were personalised and some contained items of their own furniture. The rooms were comfortably furnished and well decorated. The home was clean and odour free. New ramps and rails at front (No 79) and back doors had been recently installed for ease of access. A new hoist had been purchased since the last inspection for use on the top floor. The small dimensions of the lift do not allow transfer of hoists between floors in this part of the home. Lack of Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 15 satisfactory access to a hoist on the first floor was a concern which was discussed with the home owners during the inspection. A large new crack was seen in the wall of the ‘red’ sitting room. The owners promised urgent action. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 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 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 are not fully protected by the recruitment procedures of the home. Service-users do not benefit from a well-organised training programme to ensure that staff achieve and maintain competence. EVIDENCE: Two out of the 8 relative/visitors comments received stated that they did not always think that there were sufficient staff on duty. Residents spoken with at the time of inspection did not confirm this view and were satisfied that their needs were met. The staff rota for the month was examined and the number of staff working in the home were sufficient to meet the needs of the service-users. The manager is in the process of changing the shift pattern to allow an extra member of staff in the afternoon. There were currently two night vacancies of 30 hours in total. New staff were being recruited. Records of the two latest employees recruited were viewed. POVA clearances had been obtained in both cases before employment had started. One of the references for one person was a testimonial which is not acceptable. There was no identification or photo on file. The other person’s records showed that references were still awaited two months after commencement. In both Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 17 cases manual handling training had not been given until nearly three months after employment started. Only one staff member had achieved an NVQ level 2. Two staff spoken with stated that they were wanting to undertake level 3 when they had completed their induction and foundation course. The manager plans to commence the Registered Managers Award in the near future. The manager provided evidence of a record of training, however, this did not include all staff and was not clear if all had completed mandatory training. Staff spoken to confirmed their attendance at Fire, Manual handling, POVA and Dementia training. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 36, 37 The home is managed in a way that meets the needs of service users to their satisfaction. However continued shortfalls in matters listed below means that service users cannot be assured that their safety and welfare is fully protected. EVIDENCE: The new manager registered on 14.9.05, had previous experience in elderly care. Service users spoken with all said that they liked living in Coniston House. They felt well cared for and that staff treated them well. This was confirmed by the 8 service users who completed comment cards. One relative responded “It is a home I should be happy to reside in myself if it ever became necessary”. Individual cash floats for several service users were kept in a safe in the manager’s office. One was checked at random and reconciled with the record book. Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 19 A log book was seen which recorded bath temperatures. There was no evidence of fire risk assessments. The manager confirmed that formal Supervision is not taking place as required under regulation 18(2) Record keeping in relation to staff recruitment, care planning and training Were inadequate. The home does not have policies and procedures on Continence, Pressure area care, Moving and Handling, Sexuality and relationships to better ensure the health, safety and welfare of staff and service users. The Commission had not been informed off a recent serious injury which required hospital attention seen documented in the care plan. No monthly visit reports have been received by the Commission since June. This is a repeat requirement. Fire risk assessments are to be completed as required by regulation 23.4 Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 2 X X X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 1 1 2 Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 21 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 OP1 Regulation 5(1) Requirement The service-users’ guide must comply with the regulation and include the complaints procedure and recent inspection report. Care plans must be fully completed to show assessment, planning and review Provision of adequate equipment for moving/handling of people on the first floor. All documents listed in this Regulation and Schedule must be kept in the file for each staff member. This requirement is repeated from the previous report. Staff must receive manual handling training prior to caring for service-users who require such assistance. There must be training on an ongoing basis in the mandatory topics. The registered provider must make monthly unannounced visits to the Home and provide the Commission with copies of each months report. This requirement is repeated from the DS0000060116.V267736.R01.S.doc Timescale for action 30/12/05 2 3 4. OP7 OP22 OP29 14(2) 15(1)(2) (b)(c) 13(5) 23(2)(n) 19 Sch 2 16/11/05 30/12/05 16/11/05 5 OP30 18 (1)(c) 16/11/05 6 OP33 26 16/11/05 Coniston House Residential Home Version 5.0 Page 22 7 8 9 OP36 OP37 OP38 18(2) 17 (1)(a) Schedule 3 37 previous report. Care staff must receive formal supervision Care plans must be kept according to requirements The registered person shall give notice to the Commission of all deaths, illness and other events as described in this Regulation without delay. 30/12/05 16/11/05 16/11/05 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. 2. Refer to Standard OP7 OP12 Good Practice Recommendations The registered person should advise staff on the proper way to record each residents care in the daily record. The registered manager should enable service-users to be involved in compiling a more varied activities programme Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Coniston House Residential Home DS0000060116.V267736.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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