Inspection on 05/07/05 for Drumconner

This inspection was carried out on 5th July 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

Drumconner 04/02/08

Drumconner 07/03/07

Drumconner 14/01/06

Drumconner 12/01/05

Drumconner 14/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Drumconner 13-21 Brighton Road Lancing West Sussex BN15 8RJ Lead Inspector Helen Tomlinson Announced Tuesday, 5 July 2005, 09.30am, V227873 th 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. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Drumconner Address 13-21 Brighton Road, Lancing, West Sussex, BN15 8RJ 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) 01903 753516 Mr Roger John Kinsman (Jnr) CRH 48 Category(ies) of OP-48, PD(E)-48, PD-48 registration, with number of places Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Only service users over the age of 50 years in the PD category may be admitted. Date of last inspection 12/01/05 Brief Description of the Service: Drumconnor is a care home registered to provide personal and nursing care for up to 48 people who are over 65 years or people with a physical disability who are over 50 years. The home is a large detached building which has been extended. It stands in its own, well maintained gardens with a car park to the side. It is situated in a residential area on the main coast road from Worthing to Brighton in the village of Lancing. Local shops and other community facilities are close by. It is on a bus route. The accommodation is provided on two floors with a passenger lift allowing access to the top floor. Communal areas include three lounges, a dining room and a lounge/bar area for entertaining. There are 35 single and 6 double bedrooms. A number of rooms have en-suite facilities. Some have a sea view. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. The inspector arrived at 10am and left the home at 7pm. The inspection continued on Thursday 7th July at 11am until 2pm. The registered manager, Mr Kinsman (Jnr) was present throughout both days of the inspection. Over the course of the inspection fourteen residents, two visitors and eight members of staff were spoken with. Staff were observed giving support and assistance. Four residents files were examined in detail and other records were seen as was necessary. A tour of the premises took place. Staff files were examined. 7 comment cards were received from visitors/relatives prior to the inspection. Comments made included praise for the staff and management at the manner in which the care home operates. Four of the seven said there were insufficient staff on duty with two commenting on the weekends being worse than during the week. This is discussed further in the body of the report. What the service does well: What has improved since the last inspection? Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 6 The registered manager said a recommendation made at the last inspection regarding a radiator which posed a potential risk to residents had been remedied. A guard has now been placed on that radiator. All windows seen had restrictors fitted. The registered manager stated the window identified as opening too far at the last inspection now had a restrictor fitted. Some bedroom doors had locks fitted. The registered manager stated this was being done as the bedrooms became vacant. Should any resident wish to have a lock fitted in the meantime then this would be done. What they could do better: Residents do not have a full assessment of their needs carried out, recorded and agreed by them prior to entering the home. Residents should not be admitted into the home if they are not within the categories of registration on the certificate displayed in the home. Residents do not have as required a written care plan and updated health assessment that are reviewed when their condition changes. Therefore not all resident’s needs are identified and met fully. Residents do not have a comprehensive complete assessment of risks that identify all risks and actions to be taken to protect their safety. Residents are not currently having their medication stored and administered in accordance with the Royal Pharmaceutical Society and Nursing and Midwifery Council guidelines. Residents should have allegations of abuse reported appropriately by using policies and procedures which have been based on the West Sussex Social and Caring Services Adult Protection Guidelines. Storage of residents wheelchairs must be provided that is not in residents bathrooms. Staff recruitment and employment checks are not complete and do not demonstrate that all staff are fit to work with vulnerable adults. Please contact the provider for advice of actions taken in response to this Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 8 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 Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 9 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 Resident’s needs were not adequately assessed prior to becoming accommodated in the home. EVIDENCE: The registered manager said that he visited any prospective resident prior to them becoming accommodated in the home to make sure their needs could be met. This assessment was usually recorded on paper which was not kept after the person had a file set up at the home. A discussion took place regarding the assessment process being robust to make sure the person’s needs were fully understood, could be met in the home and they were within the categories the home was registered for. Drumconnor is not registered to accommodate people with dementia unless their physical needs outweigh their mental health needs. The inspector examined the file of one person who had a diagnosis of dementia and whose physical needs were not greater than her mental health needs. It was discussed with the registered manager that any such placement must be reviewed and accommodation must not be offered to people with needs which the home is not registered to manage. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 10 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 and 10 Residents had a plan of care documented. This was not always up to date. Health care needs were not fully assessed. Some practices around the storage and recording of medication did not meet with current guidance. Residents were treated with respect and dignity. EVIDENCE: Four resident’s care plans were examined. These contained a large amount of information about the resident’s needs. The same problems were assessed for each resident, using a nursing model, despite the residents individual condition and needs. It was discussed that this should be reviewed as the amount of information made the plans not easy to follow, difficult to review and keep up to date. There was an example where it was not clear if a catheter was fitted or not due to conflicting information being recorded. Assessments for the risk of pressure sore development and moving and handling were present on the files examined. These had not been updated and Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 11 did not reflect the current situation. For one resident with a pressure sore the assessment was not dated and it stated the skin was healthy with no increase in risk due to the sore. For another resident the assessment was last reviewed in March 2004 when they were at “high risk.” Routine observations charts were present. These had not been completed for one resident since May 2004 with one resident’s weight last recorded in August 2003. There were no nutritional assessments present to identify any residents at high risk of potential weight loss and associated problems. Wound assessment charts were incomplete with no clear description of the wound or improvement or deterioration. Some risk assessments were present though not all identified risks were assessed. There were no specific bed rail risk assessments which identified alternatives explored. There were no falls risk assessments. All residents must have their individual risks identified, assessed and action taken to minimise these. These must be reviewed. In order to fully meet the health care needs of the residents these must be first assessed, a plan of action to meet them devised and kept under review. At the last inspection a requirement was made that when a variable dose of medication is prescribed the amount given must be documented on the administration sheet. This had not been done for all residents with a variable dose medication prescribed. Some residents wish to store and administer their own medication. This choice is respected. There were no risk assessments in place for this which identified the resident’s ability to carry this out safely. These must be completed. Handwritten changes and additions to the medication administration sheets should be witnessed and signed as a safeguard that the correct medication is written on the sheet. Oxygen should be stored in line with Royal Pharmaceutical Society guidance, including warning signs which meet the fire regulations. Medication was seen to be safely stored within the home. All medication is administered by the qualified nursing staff. The residents said the staff respected their privacy and dignity when assisting them with personal care. They said they knocked on the door prior to entering a bedroom, closed bedroom and bathroom doors during personal care and addressed them in a polite manner. Staff said they were trained about respect and privacy when they first started working at the home. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 12 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) 15 The food was nutritious and appealingly served with a variety and choice which suited the residents. It was served in a pleasant environment. EVIDENCE: Residents said they had their breakfast at a time to suit them, within reason bearing in mind the lunch time. They could have their meals in their bedrooms or the dining room as they wished. Tables were provided in the bedrooms for this purpose. The dining room was bright and airy with plenty of space between the tables for those residents in wheelchairs. A choice of meal was offered. Visitors were welcome to stay for lunch if they wished and were seen to do so. A rolling menu was in place which provided a varied diet for the residents. Hot and cold drinks were provided throughout the day and this included sherry should anyone wish to have it. Residents said they liked the meals served, the food was always good and there was plenty to eat. Those residents requiring assistance with their meals were given this on a one to one basis in a calm manner. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 Any concerns or issues raised would be taken seriously and appropriate action would be taken. The procedures for reporting allegations of abuse did not adequately protect residents. EVIDENCE: Residents spoken with said they would approach the manager or any senior member of staff with any issues, concerns or complaints they might have. They said if they had done this the matter had been dealt with swiftly to their satisfaction. No complaints had been made since the last inspection. A record of any issues brought to the attention of the staff was present though staff said they would try to sort the problem out and not always record it. This should be done. Staff were aware of their responsibilities to protect the residents from abuse. Some had received training regarding this and the recognition of potential abusive situations. One incident of abuse had taken place in the home and the correct procedures had been followed with a satisfactory outcome which protected the residents. Staff were aware of the whistle blowing policy. The written procedure for a senior member of staff to follow if an allegation of abuse is made to them should meet the West Sussex guidelines. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 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 standard(s) 19 and 26 The home and gardens were well maintained, nicely decorated, clean, tidy and safe. EVIDENCE: The home was clean with no offensive odours. The décor was tasteful and to a high quality with homely furniture, fixtures and fittings. The residents said they liked the environment of the home and it was always clean. There were sufficient numbers of domestic staff on duty. All areas of the home and gardens were well maintained with bedrooms being re-decorated when they became vacant. One bathroom close to the lounge was used for storing wheelchairs. It was recommended following the last inspection that an alternative should be found. The registered manager stated that alternatives were being explored and there were plans in place to use alternative storage. This bathroom should be safely accessible to residents at all times. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 15 Staff were aware of the fire procedure and had received up to date fire safety training. All fire safety checks were carried out and recorded. There had not been a fire drill for some time and it was recommended these re-commence. Staff were aware of the measures they should take to control the spread of infection. Plastic gloves and aprons were available and in use. Alcohol hand gel was used. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 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 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 and 29 The number of staff was adequate to meet the needs of the residents. The recruitment procedures were not adequate to ensure protection for the vulnerable adults in the home. EVIDENCE: The duty rota for week commencing 4th July 2005 was examined. This showed a variation in the number of care staff on duty, especially in the mornings, between 6 and 9. At the lowest number it should be sufficient to meet the resident’s needs. It was discussed with the registered manager that although the number of staff on the duty rota would indicate sufficient for the resident’s accommodated there were issues of being short of staff brought up with the inspector. These issues were raised by residents, staff and relatives. The main problem was highlighted by residents and relatives as being a long wait for the call bell to be answered and less staff on duty at weekends. The rota did not show reduced numbers at weekends. It was discussed with the registered manager that a review of the deployment of staff and the system for answering call bells should be reviewed. The number of staff on duty must be kept under review in light of the dependency of the residents. Two staff files were examined for the most recently recruited staff. These did not contain all the information required to ensure adequate checks had been carried out to verify the suitability of the person to work with vulnerable Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 17 adults. For one staff member one reference had been obtained for another there were none. A disclaimer that the management of the home accepted responsibility for employing these staff members without references was on file. There was no evidence that every attempt had been made to obtain these references. This must be done. The application forms were unavailable for inspection as they were kept elsewhere. A blank application form was seen. This did not ask for a full employment history which must be obtained. A copy of the application form must be kept in the staff files. A Protection of Vulnerable Adults (POVA) check or Criminal Records Bureau check had not been obtained for one of these staff members. It was discussed with the registered manager that no person must start work in the care home without a POVA check having first been carried out. This person was already working in the home and it was agreed by the registered manager that they would not work without supervision until satisfactory checks had been obtained. The registered manager should confirm to the Commission, in writing, when these checks are obtained. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 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 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) 38 The health and safety of the residents was protected. EVIDENCE: There were no health and safety issues or concerns raised at this inspection. The registered manager said a window restrictor which was identified as being missing at the last inspection had been fitted. A radiator which had posed a risk of burns to a resident had been covered. The accident book was seen and was completed correctly. Staff were documenting any incidents of aggression towards them by residents. Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 19 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 20 NO 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 3 Regulation 14 Requirement No resident must be accommodated in the home without having their needs assessed and agreement reached that the home can meet their needs. All health care needs of the residents must be identified, assessed and have a plan of care documented. This must be kept under review. When a medicine is prescribed at a variable dose the actual dose administered must be recorded, at each administration. All residents who administer their own medication must have a risk assessment completed. Uneccessary risks to the health or safety of residents must be identified and so far as possible eliminated. Wheelchairs must not be stored in the bathroom near the lounge. All staff must be recruited so as to ensure they are fit to work with vulnerable adults. Timescale for action 31/7/05 2. 7 and 8 14(2)(a) 15(2)(b) 30/8/05 3. 9 13(2) 31/7/05 4. 5. 9 8 13(4)(b) 13(4)( c ) 31/7/05 30/8/05 6. 7. 19 29 13(4)(a) 19 and Schedule 2 31/7/05 31/7/05 Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 21 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 9 Good Practice Recommendations Handwritten changes to a medication administration sheet should be witnessed and signed. Oxygen should be stored in line with the Royal Pharmaceutical guidelines. Correct signage should be in place. The procedure for reporting an allegation of abuse should be in line with the West Sussex guidelines. 2. 18 Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Drumconner H60-H11 S24138 Drumconner V227873 050705 Stage 4.doc Version 1.30 Page 23 - 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. 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