Inspection on 09/12/05 for Derwent Residential Care Home

This inspection was carried out on 9th December 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 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

Derwent Residential Care Home 17/10/08

Derwent Residential Care Home 06/11/07

Derwent Residential Care Home 22/11/06

Derwent Residential Care Home 01/04/05

Derwent Residential Care Home 31/01/05

Derwent Residential Care Home 17/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Derwent Residential Care Home 38 Sedlescombe Road South St Leonards-on-sea East Sussex TN38 0TB Lead Inspector Caroline Johnson Unannounced Inspection 9th December 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 Derwent Residential Care Home DS0000041049.V264096.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. Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Derwent Residential Care Home Address 38 Sedlescombe Road South St Leonards-on-sea East Sussex TN38 0TB 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) 01424 436044 derwent.admintconnect.com The Derwent Residential Care Ltd Denise King Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-five (25) Service users must be aged sixty-five (65) years or over on admission Date of last inspection 01 April 2005 Brief Description of the Service: The Derwent Residential Care Home is a large detached house situated on the outskirts of St Leonards On Sea. It is registered for twenty-five older people. There is good access to St Leonards where there are a range of shops and services. There are fifteen single and five sharing bedrooms, all with en-suite facilities. In the main, the service caters for residents who are very able and fairly independent. Communal space includes a dining room, lounge and conservatory. There are very pleasant grounds to the rear of the house. Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second inspection in the year running from April 1 2005 to March 31 2006. The inspection lasted from 10.00am until 4.30pm. During the inspection there was an opportunity to meet with one resident in their bedroom and with four residents in the lounge. One member of care staff was interviewed. In addition time was spent with the deputy manager. The manager although not on duty, came to the home and was involved in the majority of the inspection. A number of records were examined including the plans for the care to be provided for two residents and the pre admission documentation held in respect of two recently admitted residents. A full tour of the building was not undertaken. However, communal areas and the laundry facilities were seen. Since the last inspection of the home the manager changed her role within the home. She now works as deputy manager and a new manager was recruited to manage the home. The timescale for the commencement of the extension of property to the rear of the building (referred to in the previous report) has been changed. What the service does well: What has improved since the last inspection? The range of activities on offer to residents has increased and residents spoken with stated that they were happy with the activities provided. Four of the bedrooms have been redecorated. The home has completed the process of fitting thermostats to all hot water outlets. Previously staffing arrangements at night included one waking and one sleep-in carer. This has been revised and there are now two waking night carers on duty. The manager is currently working towards achieving the Registered Manager’s Award and the deputy manager is studying for NVQ level three. Derwent Residential Care Home DS0000041049.V264096.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. Derwent Residential Care Home DS0000041049.V264096.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 Derwent Residential Care Home DS0000041049.V264096.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): 3,4 The home’s admission procedures are good and records indicate that they only admit residents when they are confident that they are able to meet the needs assessed. EVIDENCE: Pre-admission documentation was seen in respect of two recently admitted residents. The home obtained social care assessments for both and in addition they were thorough in their own assessment of the needs and abilities of both residents. Following the assessment process they confirmed in writing to the resident/relatives that they could meet the assessed needs. Information provided for staff was clear and detailed ensuring that everyone was clear about the level of support that each resident requires. Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 Care planning is detailed and staff are provided with the information required to meet the needs of the resident’s accommodated. Attention needs to be given to ensuring that residents are weighed at regular intervals. In addition in relation to one care plan the system in place to show that the care plan had been reviewed was a bit misleading and should be revised. Staff should be provided with regular formal training in the administration of medication. EVIDENCE: Two care plans were seen. Both included detailed information for staff to follow to ensure the residents’ needs could be met. In one of the care plans it was noted that the resident’s weight had not been monitored for some time. In addition the system for recording that the care plan had been reviewed was misleading as it looked as if it had been signed for the coming months. The standards relating to medications were not fully inspected. However, the manager advised that both she and her deputy supervise staff until they are sure that they are competent to administer medications. Only senior staff would have this responsibility. The local pharmacist provided training for staff Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 10 on the medications in use in the home last year. No training has been provided this year. Derwent Residential Care Home DS0000041049.V264096.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): 12,14 Since the last inspection, the home has increased the range of activities provided for the residents. The residents spoken with were happy with the activities on offer. The use of the local theatre group has added to the activities and provided an opportunity for residents and their relatives to get together socially in the evenings. EVIDENCE: As part of the admission process the manager carries out an assessment of the individual needs/wishes of residents in relation to activities. Every day there is an activity provided in the home. These include bingo, beetle drive, scrabble and cards. A volunteer also runs a group activity one afternoon a week. An external company is employed to run a motivation and music session once a fortnight. In addition the mobile library visits every two weeks. Video afternoons are arranged and staff occasionally take residents for a walk. A local vicar visits once a month. A local theatre company recently performed `Winter Wonderland’ in the home. The manager advised that this was very well attended by the residents and the company have also been invited to return to perform `Cinderella’. A number of activities had been planned for the Christmas period including a party and a Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 12 local children’s school choir and another church choir were due to visit to sing Carols. The home has a newsletter caller the `Derwent Telegraph’, which is produced periodically. At the time of inspection the latest edition was being published and would be made available to residents and their relatives. Residents spoken with during the inspection praised the staff team for their `excellent support and care’. They stated that the food was `very good’ and they were happy with the activities provided. They are advised of each activity and choose if they would like to attend. Derwent Residential Care Home DS0000041049.V264096.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, Residents spoken with were happy with the care provided and stated that if they had a complaint they would be able to speak with the manager or her deputy. EVIDENCE: There have been no complaints since the last inspection of the home. The residents spoken with stated that they had no cause to make any complaints to the manager, as they were more that satisfied with the care provided. Following the last inspection of the home all staff completed a handbook on the subject of abuse. Staff studying for a NVQ have also studied the subject in more detail. Derwent Residential Care Home DS0000041049.V264096.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): 19,20,25,26 All areas of the home seen were well decorated. The fitting of the thermostats to all hot water outlets is a good safeguard against the risk of accidents occurring. It is essential that there is a washing machine in working order at all times. The use of the tumble drier in the conservatory was meant to be a short-term practice and it is not satisfactory that this continues. In spite of the heating provided in the conservatory the temperature remains low and it is not comfortable to use this room for any length of time. EVIDENCE: A full tour of the building was not undertaken. However, all areas seen were clean and there were no unpleasant odours. The lounge had been decorated for Christmas and was very festive. There is a large dining room and this is well decorated. The home has completed the programme of fitting individual thermostats to all hot water outlets through the house. The manager advised that there are thermometers in each of the bathrooms and staff test water temperatures prior to each bath. There are no hoist facilities in the home. In addition there Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 15 is no assisted bath. Baths have raised seats to assist those with limited mobility. There are plans to provide an assisted bath when an extension to property is built. At the time of inspection the washing machine was not working. A new part had been ordered two weeks previously but had still to be delivered. Staff were taking laundry to the local laundrette. A new industrial tumble drier was purchased in April 2005 but still cannot be used, as the electrics need to be upgraded. A second tumble drier was then purchased and as there was no room left in the laundry it was placed in the conservatory and has been there ever since. On the day of inspection although there were two storage heaters in the conservatory the temperature was very cool. Derwent Residential Care Home DS0000041049.V264096.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): 27,28,30 At the time of inspection staffing levels were assessed as satisfactory but borderline. If the needs of the residents were to change a review of the staffing levels provided would need to be carried out. Taking into consideration the increase in the manager’s workload due to administrative tasks and the induction of new staff to the home it is considered that the amount of time designated to management tasks needs to be increased. Documentation held in relation to staff induction must be kept on the premises and available for inspection. EVIDENCE: There has been a big turnover in the staff team in the past few months. However the majority of posts have now been filled. At the time of inspection there was one member of staff on sick leave and one vacancy. These hours were being covered by part-time staff and where necessary the use of agency staff. There are two care staff on each shift plus the manager or deputy. The manager works at least eighteen hours a week on shift. Since the last inspection the administrator has left her position. This means that the manager now has to carry out more of the administration tasks. Previously at nighttime there would have been one waking carer and one sleep-in member of staff. This has been reviewed and there are now two waking carers. Ancillary staffing includes a cook, kitchen assistant, housekeeper and laundry assistant. Two care staff have completed NVQ level three and one staff member has a nursing qualification. Three staff are currently working through their induction. Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 17 Documentation relating to induction was not on the premises. However the manager talked about the level of support that each staff member was being given and in one case the three-month probationary period had been extended to allow the carer more time to achieve the training tasks set for her. During the year staff received training in food hygiene and first aid. Two of the new staff need training in first aid and one of the kitchen assistants needs training in food hygiene. Training in moving and handling is to be provided in the New Year. Staff last received training in fire safety in 2004. They have completed handbooks of fire safety this year. Further training will be arranged for staff next year. Derwent Residential Care Home DS0000041049.V264096.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): 31,32,33,36,38 The home is well run and the manager and her deputy work well together to support the staff and residents. The owner or a representative on his behalf must visit the home monthly to assess the running of the home and provide a report of the visit to the manager and the Commission. The owner needs to draw up an annual development plan clarifying the dates for work not achieved as part of the previous development plan and detailing the plan for the coming year. Record keeping in relation to fire drills needs to be more detailed. Fire doors must not be propped open and if it is assessed that a door needs to be kept open then a door guard must be fitted. EVIDENCE: Since the last inspection of the home the manager changed her role within the home. She now works as deputy manager and a new manager was recruited to manage the home. The manager is currently studying for the Registered Manager’s Award. The deputy manager is studying for NVQ level three. A staff member spoken with described the manager and her deputy as very supportive. They stated that they receive regular supervisions and appraisals. Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 19 They were concerned with issues like the laundry arrangements and the delays to the building of the extension. However, they stated that the management team were keeping staff informed whenever they were advised of any changes. In May 2005 the manager and her deputy carried out a quality assurance survey of the building. The survey highlighted all the areas of the home that required upgrading or redecoration. Since then four bedrooms have been redecorated. In a number of rooms, areas highlighted as requiring attention included replacing carpets and furniture, and in bathrooms, lino and heaters. The amount of work required in bedrooms varies and many rooms are well furnished. The annual development plan for 2004-2005 referred to replacing the heating system and replacing carpets in communal areas. This work has yet to be completed. The manager advised that the work required has been delayed in part to tie in with the plans to extend the property. However, the extension was originally due to be started over a year and a half ago and the timescales have changed on a number of occasions since then. Quality assurance questionnaires are distributed to residents periodically and in most cases relatives assist the residents to complete them. The most recent questionnaire showed an improvement in the results of the previous questionnaire. In relation to fire safety, records showed that alarms and lights are tested regularly. Fire drills are also held regularly but records need to show that drills are being evaluated and the length of each drill held. Communal doors are propped open at times to assist residents to move about more freely and one resident chooses to have her door propped open. A visual check is carried out in respect of all portable appliances. This work needs to be carried out by someone qualified to check all portable appliances. The owner visits the home at least once a month and is also in touch regularly by telephone. In order to meet Regulations the proprietor needs to ensure that he visits the home once a month on an unannounced basis and that he provides a report on the conduct of the home to the Commission and to the manager of the home. Derwent Residential Care Home DS0000041049.V264096.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 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 X X X X 2 2 STAFFING Standard No Score 27 2 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 2 X X 3 X 2 Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 21 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. 2. 3. Standard OP8 OP9 OP25 Regulation 17(1a) Sch3 pr. 3(m) 13(2) 23(2p) Requirement Records must show that residents are weighed regularly Staff must receive regular formal training in the administration of medication. The heating in the conservatory must be monitored closely to ensure that the temperature is suitable to meet the needs of the residents. The home must confirm that the washing machine is working. The amount of time designated to management tasks must be increased. Documentation relating to staff inductions must be available for inspection. The proprietor or a representative on his behalf must visit the home once a month unannounced and prepare a report on the conduct of the home. The report must be copied to the manager of the home and to the Commission. An annual development plan must be drawn up. The plan DS0000041049.V264096.R01.S.doc Timescale for action 31/01/06 31/03/06 31/01/06 4. 5. 6. 7. OP26 OP27 OP30 OP31 23(2e) 8(1) 17(2)Sch 4 para(6f) 26 15/01/06 31/01/06 15/01/06 31/01/06 8. OP33 24(1,2,3) 28/02/06 Derwent Residential Care Home Version 5.0 Page 22 9. OP38 23(4a,e) 10. OP38 13(4a,c) must include the areas not achieved from the previous plan and the areas highlighted in the home’s quality assurance assessment of the building. Records of fire drills must show that each drill has been evaluated. The length of each drill must be recorded. Fire doors must not be propped open. If having carried out an assessment it is considered necessary to keep a door open then a door guard must be fitted. The testing of portable appliances must be carried out annually by someone qualified to do so. 15/02/06 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations In relation to one of the care plans seen the system for recording that the plan had been reviewed was confusing and should be revised. Derwent Residential Care Home DS0000041049.V264096.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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