Inspection on 13/02/06 for Downside

This inspection was carried out on 13th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Downside 08/11/07

Downside 01/08/06

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 Paul Taylor Unannounced Inspection 13 February 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.V249664.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. Downside DS0000021353.V249664.R01.S.doc Version 5.0 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.V249664.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number must not exceed 3 The people accommodated will be elderly people over the age of 65 years 26th July 2005 Date of last inspection Brief Description of the Service: Down side 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. 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 and in fact some people who have moved into the home have done so because of the presence of animals. Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection of Downside took place on 13/02/06. The inspection started at 10 a.m. and took three and a half hours. The Inspector met with two service users and the manager and examined various written records. The home continues to provide good care to the service users. The size and intimate nature of the home means that the needs and idiosyncrasies of the service users are very well monitored and met. The ethos operated at Downside means that both animals and humans are valued and have their place in the home. This means that service users need to like animals if they wish to live there. One of the service users reported that the presence of animals was a significant factor in making her want to live at Downside. What the service does well: What has improved since the last inspection? The recording of maintenance and environmental issues has improved and the system in the home is now efficient. Downside DS0000021353.V249664.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. Downside DS0000021353.V249664.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 Downside DS0000021353.V249664.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 and 5. Service users are carefully assessed before moving into the home. Relatives and potential service users are welcome to visit the home before making a decision as to whether they want to move in. EVIDENCE: The home will admit potential service users for a trial period of assessment lasting for one month. At the time of the inspection there was one resident who had been in the home for nearly a month. The Inspector saw evidence of liaison with the resident’s last home, G.P., relatives and the resident herself as part of the assessment. The manager told the Inspector that the needs of service users are assessed on an ongoing basis throughout their stay to ensure that the home remains an appropriate place for them to live. The Inspector also saw records and comments from relatives written prior to service users moving in to the home. One of the service users knew the manager prior to moving into the home and that was one of the reasons she wanted to move into Downside. The presence of animals in the home was a key factor in attracting one of the other service users to Downside. Downside DS0000021353.V249664.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 and 10. The size of the home is a strength. The manager is very aware of service users health and social needs. Medication is monitored and there was evidence of good communication with health professionals. Privacy and respect are valued highly in the home. EVIDENCE: The health needs of each service user are known to the manager. The Inspector examined a number of different written records and found evidence of liaison with health professionals such as physiotherapists, district nurses, and G.P. There was written correspondence to service users G.P.s with regards to medication changes and observations made by the manager with regards to health issues. The manager is married to a Consultant Psychiatrist and so has access to specialist advice with regards to mental health issues should she need it. The social needs of each service user are recorded and updated in a separate part of their care plans. The Inspector examined records of medication administered in the home. These were up to date and signed by the manager. There was a record of medication received into the home. Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 10 The Inspector met with two of the service users who were very complimentary about the approach of the manager and how they have their dignity and privacy respected. Downside DS0000021353.V249664.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): 13 and 15. Service users are able to receive visitors and to go out if they wish. The food in the home is of an excellent standard and enjoyed by all. The food is organic and the menu was varied and healthy. EVIDENCE: There was written evidence available to confirm that service users have regular visitors. There was also photographic evidence of outings that service users had been on as well as a record of parties and social events that had occurred in the home. Service users confirmed that they do go out on occasion and that the manager encourages them to do so. When the Inspector arrived for the inspection the manager was baking home made cakes and buns for the home’s residents. The Inspector saw a menu record. The manager informed the Inspector that the food in the home is organic and the home is a member of The British Soil Association. The Inspector saw written evidence from a District Nurse praising the quality of the food in the home. The two service users who met with the Inspector were very complimentary about the food they receive. Downside DS0000021353.V249664.R01.S.doc Version 5.0 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 the following standard(s): 16 Service users are aware of the complaints procedure. There was evidence that past complaint had been dealt with effectively and quickly. EVIDENCE: The home has a complaints procedure in place and this includes details of how service users can contact the Commission for Social Care Inspection if they wish. The two service users who met with the Inspector were aware of how to complain if they wished. There were no ongoing complaints at the time of the inspection. The Inspector examined the complaints record and saw evidence of how a complaint in the past had been resolved very quickly. Downside DS0000021353.V249664.R01.S.doc Version 5.0 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 the following standard(s): 19,25 and 26. The home was clean and pleasantly furnished. Service users rooms were clean and spacious. The home is a safe environment. Work on the wiring system needs to be completed by the end of June 2006. EVIDENCE: The Inspector toured the premises with the manager and met with the three service users in their rooms. The home was tidy and clean and the service users rooms were spacious, personalised and had views of the Downs and surrounding countryside. There was a record of maintenance and repairs that had been carried out in the home. There was a record of fire drills and the inspection of fire equipment. The Inspector also saw the public indemnity insurance certificate. There was a report written by an electrical contractor who had examined the wiring in the home in September 2005. This had pointed out some shortfalls in the system The manager told the Inspector that these are due to be rectified by the end of June 2006. Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 14 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 and 29. The manager is the main source of support to the service users. There are two other members of staff who work on a part time basis and records indicate that they are appropriately experienced and qualified. Any visitors who will be living on the premises should have appropriate checks in place to confirm their integrity. EVIDENCE: The manager works full time in the home. There are two other members of staff who also work in another nearby rest home. They come into the home when they are required. Members of the manager’s family will also assist in the running of the home on occasion. As already mentioned, the manager’s husband is a Consultant Psychiatrist and so is able to offer input and advice in the event of mental health issues. The Inspector examined the recruitment records of the two members of staff who work in the home. These contained the information required in the National Minimum Standards and there was evidence of their training and qualifications. The manager reported that there may be a visitor from abroad in the future who will live on the premises but will not be involved in the care of the service users. It is recommended that the manager ensure that they have a record of good conduct from the relevant authorities to confirm their integrity. Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 15 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 and 38. The manager is very committed to ensuring that service users needs are met. She has extensive nursing experience as well as experience in a management role. Service users are very happy with how the home is run. The home is managed effectively and efficiently with very good outcomes for the service users. EVIDENCE: There was very positive verbal feedback received from the service users with regards to the approach of the manager and the care they receive from her. One service users told the Inspector ‘ You’re treated like you belong, part of the family, it’s not an institution at all.’ There was a comments book, which is made available to visitors, and this contained very positive feedback about the home, it’s ethos and approach of the manager. The Inspector saw written feedback from a Senior Community Nurse which included the comments ‘High quality care with special attention to dietary requirements.’ Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 16 The service users who met with the Inspector were very happy with how the home is run. The small size of the home means that the needs and idiosyncrasies of the service users are easily monitored and changes in their condition are noticed quickly. The health, safety and welfare of the service users are promoted and protected both as part of their individual care plans and as part of the monitoring of environmental safety checks as well. Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 17 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 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X X X X 3 Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 18 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 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 June 2006. Timescale for action 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP29 Good Practice Recommendations That anyone living on site has the relevant checks completed on them to confirm their integrity. Downside DS0000021353.V249664.R01.S.doc Version 5.0 Page 19 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.V249664.R01.S.doc Version 5.0 Page 20 - 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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