Inspection on 01/08/06 for Downside

This inspection was carried out on 1st August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Downside 08/11/07

Downside 13/02/06

Downside 26/07/05

Downside 10/03/05

Downside 05/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

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 Downside The Avenue Kingston Lewes East Sussex BN7 3LW Lead Inspector Gwyneth Bryant Unannounced Inspection 1st August 2006 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 Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Downside Address The Avenue Kingston Lewes East Sussex BN7 3LW 01273 471604 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) Mrs Maria Bermingham Mrs Maria Bermingham Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is three (3). Service users must be older people aged sixty-five (65) years or over on admission. 13th February 2006 Date of last inspection Brief Description of the Service: Downside provides accommodation for 3 older people. The home is situated in the village of Kingston, near Lewes in East Sussex. Downside is a large detached bungalow with extensive gardens, to which the service users have access. The owner/manager and her family live on site and provide care to service users. The manager keeps chickens and grows a lot of the vegetables eaten in the home. The home adheres to the standards of The British Soil Association and the food provided in the home is totally organic. The manager also keeps two dogs and two cats and has three ponies. Anyone who wishes to live at Downside will need to like animals. One service users’ bedroom has full en-suite facilities with the other two having a hand wash basin. There is a communal bathroom to which service users have full access. There is level access to the extensive gardens and grounds and the registered is happy to arrange trips for service users to the wider community. Information about the home is usually made available by ‘word of mouth’. The Registered Manager visits prospective service users and carries out a preadmission assessment at which time a copy of the homes’ Statement of Purpose and Service Users Guide is provided. Copies of inspections reports are made available on request. Fees charged as from 1 April 2006 range from £360 to £415. Newspapers, toiletries, hairdressing and vitamin supplements are included in the fees. Additional charges are made for chiropody. Intermediate care is not provided. The email address is maria.bermingham@googlemail.com. The reader should note that due to the size of this home a number of standards relating to staff and staff training are not wholly applicable as the Manager provides most of the care to service users. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and took place over three hours. There were three service users in residence on the day. The purpose of the inspection was to check compliance with the regulations. The Manager and each of the three service users were spoken with. A tour of the premises was carried out and a range of documentation viewed including care plans, daily diary and policies and procedures. One survey from a service user, one completed by a relative on behalf of the service user and a pre-inspection questionnaire provided by the manager were all used to inform the inspection process. Comments in the surveys were positive about the care given. Other social and healthcare staff were not engaged with on this occasion. What the service does well: What has improved since the last inspection? 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. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 6 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 Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 7 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 and 4. Standard 6 is not applicable Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are carried out prior to service users moving into the home which ensure that their needs can be met. Prospective service users are provided with detailed information on services provided by the home to enable them to make an informed choice about where to live. EVIDENCE: The home has a Statement of Purpose and Service Users Guide that is regularly updated to accurately reflect services provided by the home. Each service user has a contract that outlines their terms and conditions of residence and ensure they are clear about services offered by the home. The pre-admission assessment for the last service user to be admitted was viewed and found to be satisfactory. The manager maintains a daily care diary during the one month trial period in order to provide a continuous assessment as to service users care needs and this information is used inform the care planning process. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 8 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning systems ensure that all aspects of service users’ personal, social and health care needs are identified and planned for and systems for handling medication are such that service users are not at risk. EVIDENCE: Care plans for the three service users were viewed and due to the size of the home the plans are brief but still include all relevant information in respect of service users care needs. Discussion with two service users found that they are happy with the care given and feels all need are fully met. The manager maintains detailed medication administration charts which includes a list of all medications prescribed for service users. She is able to discuss any concerns with the GP or community nurse to ensure she is able to fully meet service users healthcare needs. The ethos of the home is to promote service users independence and includes reference to privacy and dignity. Service users spoken with confirmed they are shown consideration and their privacy and personal preferences are respected. The service users spoken with spoke highly of the care given and confirmed that they feel their personal preferences are respected at all times. A copy of Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 9 care notes are provided for each service user which is held in their rooms. Relatives are kept informed of changes in care needs and invited to look at the latest inspection report. One survey completed by a relative on behalf of the service user said ‘I have found the care to be truly excellent’. This was confirmed by the positive comments made by three relatives on the front of the report. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 10 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are actively encouraged to exercise choice over their daily lives. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Routines of the home are flexible and service users are encouraged to continue with past and present activities. The manager maintains a photograph album of various birthday and Christmas celebrations that have taken place in the home, including afternoon tea taken in the garden during the summer. Weekly outings are arranged and participation in village activities is facilitated. Menus are changed regularly and service users encouraged to suggest changes based on their individual preferences. Wherever possible all food is organic and the manager provides vitamin supplements when required. The weekly menus are varied and the manager ensures they include fish and vegetarian dishes in addition to meat to ensure service users nutritional needs are fully met. The manager actively encourages service users to keep in touch with family and friends and visitors are welcome at all times. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 11 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and visitors feel able to express any concerns, confident that they will be listened to and acted upon and there are systems in place to protect service users from abuse. EVIDENCE: The complaints book was viewed and no complaints had been received since the last inspection. The home has brief policies and procedures on both complaints and adult protection. One service user spoken with was aware that she could talk to the manager should she have any concerns. The manager has had training in adult protection procedures provided by the local authority. No complaints or allegations have been received by the CSCI. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 12 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of decor within the home is good, with most areas homely, safe, clean and comfortable for service users but safety could be improved if work on the wiring system was completed. EVIDENCE: Service users bedrooms are spacious, well maintained and attractively furnished. Throughout the home decor is good and service users are encouraged to personalise their rooms with pictures and ornaments. Upgrading on the electrical wiring system remains outstanding. The manager confirmed that she will ensure it is completed within the extended timescale and notify the CSCI when it is completed. All parts of the home were clean, tidy and free from offensive odours. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 13 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, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a small, sufficiently trained and appropriately recruited care team. EVIDENCE: The manager provides most of the care to service users but has a carer to provide care in her absence. This carer is a trained nurse in her own country but the manager still carries out an induction period, including moving and handling and infection control procedures. When this carer is deputising for the manager she is provided with detailed instructions as to the care needs of service users including their likes and dislikes in respect of food and daily routines. The other member of staff in the home provides domestic assistance and does not have unsupervised access to service users. Both members of staff have been recruited in line with the regulations and appropriate checks have been carried out prior to appointment. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 14 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, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well managed home that is run in their best interests with all aspects of their health and safety adequately protected. EVIDENCE: The manager has been managing the home since it opened and she has extensive experience in caring for older people. She is a trained nurse and has undertaken training in food hygiene, infection control, dealing with challenging behaviour, supervision and adult protection. As part of quality monitoring the manager makes copies of inspection reports available to relatives and service users and invites them to write comments on the front page. Consultation with service users is on a daily basis due to the informal and friendly ethos of the home. A comments book is maintained and this was viewed showing that all comments have been positive in respect of care and attention given to service users. Service users are responsible for Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 15 their own finances if appropriate; relatives and solicitors support others, while the home does not handle the financial affairs of service users. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. There were records showing the regular testing of fire alarms and fire drills are carried out periodically. The certificate of liability insurance was made available and demonstrates service users and staff are fully protected. Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 16 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 3 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 17 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 OP19 Regulation 13 (4) (c) Requirement That the matters reported in the electrician’s report completed in September 2005 are rectified by the end of September 2006 and the CSCI notified when this has been done. Timescale for action 30/09/06 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 Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 18 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. Extracts may not be used or reproduced without the express permission of CSCI Downside DS0000021353.V295985.R01.S.doc Version 5.2 Page 19 - 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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