Inspection on 04/05/05 for Coniston House Residential Home

This inspection was carried out on 4th May 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 16/11/05

Coniston House Residential Home 05/01/05

Coniston House Residential Home 24/08/04

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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 75-77 Orwell Road Felixtowe Suffolk IP11 7PY Lead Inspector John Goodship Unannounced 4 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Coniston House Address 75-77 Orwell Road Felixtowe Suffolk IP11 7PY 01394 276201 01394 276201 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Enviromedical Ltd Lisa Jane Hawkins Care Home 26 Category(ies) of DE(E) Dementia Over 65 (1) registration, with number OP Old Age (26) of places Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 05/01/05 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 I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place 5 months after the previous one. It was unannounced. The previous manager had just left and the replacement had not yet taken up post. The acting manager, who was also the deputy manager, was present throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The new manager with the owners must immediately improve the training arrangements for staff. They must ensure that no one is employed without Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 6 proper documentation. There must be monthly visits and reports by the owners to ensure that improvements are being made and that the Commission’s requirements are being met. More consultation with residents will help the Home to show that it is meeting their needs, and give residents a greater say in their lives at the Home. 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 I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4 Prospective residents are only admitted if they and the Home assess that their needs can be met. EVIDENCE: The Home was currently providing respite care for one person. This only happened as there were some vacant rooms at the time. The proper preadmission assessment had been undertaken by the acting manager. The resident expressed her satisfaction with the Home and was socialising well with other residents in the main sitting room. The Home had been temporarily registered for the care of a person with diagnosed dementia. A suitable home had now been offered through Social Care Services, and this person had now left the Home. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10 The care planning system sets out the needs of residents in a clear and comprehensive way. Health care needs, including medication needs, are met with appropriately trained staff. EVIDENCE: Care plans and daily records of care had been changed on to a new filing system. This brought all information together for ease of access, and for updating and reviews. Some of the entries were acknowledged by the acting manager to be uninformative and lacking in detail. A descriptive entry is essential to record that the elements of the care plan are being fulfilled, and to record the absence, as well as the occurrence, of care incidents which may trigger a review of care. One resident had suffered a fall in the dining room 2 days before the inspection. They had been treated at A&E, and returned to the home the same day. There were full descriptions of the circumstances in the care record, as well as continuing observations of progress. No notice of this incident had been reported to the Commission as required under Regulation 37 of the Care Home Regulations. A format for doing this was discussed, and the notification was made an Immediate Requirement. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 10 The administration of medication followed good practice, and those staff involved were appropriately trained. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Residents are able to control their surroundings, and their contact with relatives and community organisations to suit their tastes and abilities. EVIDENCE: The list of weekly activities was displayed, and a church service was in progress in the main sitting room. There were 2 other sitting rooms for residents if they did not wish to attend the service. A weekly exercise class had been stopped as no-one attended. The acting manager would like to increase the range of stimulating activities, in consultation with the residents. Some residents were taken out on trips by relatives and voluntary organisations. 6 residents looked after their own money and had secure facilities for doing so. Rooms were personalised with some items of residents’ own furniture and with pictures and ornaments. Meals were varied and were liked by the residents. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The ethos of the management of the Home means that residents and relatives are able to raise matters with senior staff, and have confidence that action will be taken if required. The Home needs a more systematic approach to staff training to demonstrate that residents are protected from abuse. EVIDENCE: The Home had received one complaint in the last 12 months. This had been fully discussed at the previous inspection. The acting manager stated that relatives sometimes raise matters of concern with her, but none had led to a complaint. Staff had received training in the protection of vulnerable adults. This was confirmed by staff, but there was no record of who attended the training. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 Residents enjoy on the whole safe and comfortable facilities. For the protection of all residents, it is essential that all hot water taps have their temperature regulated. EVIDENCE: There were still no mixer valves in the “old” part of the Home. This had been a requirement of the previous inspection. The acting manager stated that work had been scheduled to start the previous week. This had not happened. Hot water temperatures were sampled at 50C and above. Although risk assessments had been done on those rooms, the installation of valves was left as an immediate requirement with the Home. All residents’ rooms met the standards for size and facilities. 16 of the 22 rooms had en-suite facilities. There were 2 lifts, one in each part of the Home. There were 3 communal rooms, although most residents used the larger one next to the dining room. All radiators were now guarded for safety of residents. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 14 Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The Home has sufficient staff on duty for the needs of residents. The home cannot assure the residents that they are in safe hands until it complies with the Care Home Regulations regarding staff records, and staff training. EVIDENCE: The Home was fully staffed at the time of the inspection. The information held on file for 3 new members of staff did not meet the Regulation 19 concerning identification documents. One file also had no references and no application form completed by the applicant. All 3 had POVAfirst notifications, but only one had a full CRB certificate. These serious gaps in records were made immediate requirements at the last 2 inspections and are repeated. There was no training plan or schedule for the current year. A record of training sessions over the previous 12 months was available, but only showed Fire Safety sessions. No other mandatory courses were recorded. The development of a training plan was a recommendation from the previous inspection and is repeated. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35,37,38 Residents expressed their appreciation of their care by the staff. However, the shortfalls in the matters listed below mean that residents cannot be assured that their safety and welfare is protected until the national minimum standards have been met. EVIDENCE: A new manager had been appointed but had not taken up post at the time of the inspection. Appropriate arrangements were in place to cover the vacancy, and the Commission had been correctly notified. There was no evidence of any systematic quality assurance programme. No monthly visit reports by senior staff of the provider had been made, as required by Regulation. There was no evidence of a process for consulting residents and staff, and for auditing standards. Apart from 6 residents who looked after their own money, the Home held a cash float for everyone else which was topped up as required by relatives. A Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 17 transactions book was kept for each resident which was open to inspection by relatives. As detailed above, there was an absence of proper records for staff recruitment and training, and little evidence of a full staff training programme. The regulation of hot water temperatures had still not been completed. The registered person had not informed the Commission of a serious injury to a service user. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 3 3 3 3 1 3 STAFFING Standard No Score 27 3 28 x 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 1 x 3 x 1 1 Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 19 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 18 25 Regulation 13(6) 13(4) Requirement A record must be kept of all staff who receive training in the protection of vulnerable adults. Valves for the control of hot water temperatures must be fitted to all outlets. This requirement is repeated from the last 2 inspection reports. 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 training on an ongoing basis in the mandatory topics. Timescale for action Immediate and ongoing 31/05/05 3. 29 19 Schedule 2 Immediate and ongoing 4. 30 18 (1)(c) 5. 33 26 6. 38 37 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 previous report. The registered person shall give Immediate notice to the Commission of all and deaths, illness and other events ongoing. as described in this Regulation I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 20 Training schedule to be produced by 01/07/05 Immediate and ongoing. Coniston House without delay. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations The registered person should advise staff on the proper way to record each residents care in the daily record. Coniston House I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich 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 I54 - I04 S60116 Coniston House V226472 050711 Stage 4.doc Version 1.30 Page 22 - 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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