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Inspection on 10/08/05 for Eagle House Nursing Home

Also see our care home review for Eagle House Nursing Home for more information

This inspection was carried out on 10th August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users said that they were comfortable at the home. Four service users and a relative confirmed that the staff delivered good care and they were committed to giving their best. It was noted that the staff were friendly and respectful of the residents. The service users said that if there were any changes to their Individual Life style agreement they were informed by staff in good time. Service users had a choice of meals and they enjoyed snacks and drinks when they wanted. Those service users who were unable to feed themselves were given help discreetly by the staff. The service users and the relative said that if they had any concerns they would feel comfortable talking to their key worker or the manager. It was evident that the staff worked well within their teams and were supported by the manager and her deputies.

What has improved since the last inspection?

The cleanliness of the home and the equipment has improved. All staff were seen interacting with the service users whilst sitting with them in the lounges.

What the care home could do better:

Staff supervisions need to be formalised and increased in frequency. Staff must be recruited to the vacant posts and the home must aim to reduce the use of agency staff. The staff must be encouraged to attend training sessions.

CARE HOMES FOR OLDER PEOPLE EAGLE HOUSE 43 Stalker Lees Road Sheffield South Yorkshire S11 8NP Lead Inspector Marina Warwicker Unannounced 10 August 2005 11.30. 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. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Eagle House Address 43 Stalker Lees Road Sheffield South Yorkshire S11 8NP 0114 268 7001 0114 268 5288 Townendc@anchor.org.uk Anchor Trust 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) Carole Elaine Townend Care Home with Nursing 41 Category(ies) of Mental Disorder: 41 registration, with number of places EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. All 41 beds are for use by persons who are 55 years and over. Any of the 41 could be used alternatively in the category MD/E, mental disorder for persons 65 years and over. 2. 25 beds are registered for nursing or personal care and are in one building. 3. 16 beds are in the category PC - personal care only and are located in the bungalows. Date of last inspection 02 February 2005 Brief Description of the Service: Eagle house is a registered care home providing care for 41 service users over 55 years of age with a mental disorder. The home is situated in a relatively quiet area within easy reach of the lively social and shopping area of Ecclesall Road. It is also near a major bus route to the city centre. The home has been registered to provide nursing care for 25 service users and personal care for 16 service users. There is a pleasant garden at the rear of the building. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection took place on 10th August 2005. This inspection took place over six hours between 11.30am and 6pm. The inspector took the opportunity to tour the premises, examine records and talk with service users, a relative and the staff. The inspector met most of the service users during the day. The inspector was able to speak to only one visitor during the day who gave his/her views of the service. There was a friendly atmosphere at the home. Staff and service users were friendly and welcoming and there was a positive rapport between staff and service users. What the service does well: What has improved since the last inspection? The cleanliness of the home and the equipment has improved. All staff were seen interacting with the service users whilst sitting with them in the lounges. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 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. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,4 and 5. Standard 6 not applicable to this home. Sufficient information is provided by the home for prospective service users so that they can make an informed choice. Service users, before moving into the home, are assured by the staff that their needs will be met. The staff encourages trial visits by prospective service users, their families and friends to help them decide on the suitability of the home. EVIDENCE: Four service users, a relative and four staff said that information in the form of the Service User Guide was made available before admission. Three service users said that they found the information helpful. Three service users and one relative reported, that at the time of admission to the home they were confident that the home would meet the care needs. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 9 Two service users said that they were able to visit the home, prior to admission, to assess its suitability. Staff said that they encourage prospective service users to visit the home and have lunch with the residents and get to know the residents and the staff at the home. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 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) 8,9,10 and 11. The staff and the service users said that the individual lifestyle agreements set out in detail the action to be taken to ensure all aspects of care needs are met. The staff administered the medication to all residents since most of them were unable to self-medicate. The ones who were able to self-medicate did not want the responsibility. This standard was partially checked on this inspection. The residents are treated with respect and their right to privacy is valued. Those service users who are terminally ill are comforted and kept company by staff in the absence of relatives. This is to ensure the service user is not left on his/her own during their last hours. The staff are given support by their colleagues to respect the residents’ last wishes and treat the families with empathy. EVIDENCE: Three service users and four care staff informed the inspector that they were involved in the planning of care and any changes to it. The service users said that they had key workers who took care of them and that they liked their key EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 11 worker. Two service users said that they missed the key workers when they were away. Two service users and a relative said that the quality of care could not be faulted. The service users said that they also received health care from general practitioner, district nurse and psychiatrists. The staff said that the service users had access to optician, chiropodist, tissue viability nurse and continence advisor. The inspector was informed that all service users at the home at present had their daily medication administered to them by the staff. During interview of staff it was noted that the health care workers on the residential side had a good understanding of the medication administered to the service users. The staff said that they had received training on how to care for the dying and that one of the carers always stayed with the service user and kept him/her comfortable. They also said that the manager rotated the staff so that they were given a break. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 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) 12,13,14 and 15 There are arrangements for those who are able to participate in social and recreational activities. Visitors are encouraged and residents are able to maintain contacts with family, friends and the local community. The home allows access to the personnel record of the service users in accordance with the Data Protection Act 1998. The home has made provision by involving an outside agency to manage the finances of those service users who do not have the capacity to handle their own finance/money. Meals served at the home are of a good quality and the residents are offered a good choice. The residents are offered snacks and drinks when they request them. EVIDENCE: The service users had activities co-ordinated by key workers. The service users and the staff said that it was difficult to motivate some service users to take part in activities. In the residential unit most service users were independent EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 13 and had their own routine. There had been summer fares and other activities for the service users at Eagle house organised by the staff. Some service users said that they had help from the Residents Finance Service and the others said either they handle their own finances or their relatives helped them. Two service users knew that they had access to their records. One of the relatives said that he/she was always made welcome by the staff. All service users spoken to commented on the choice of food and how good it was. Staff were seen helping residents with feeding discreetly. Some staff ate with service users making meal time a shared occasion. They were heard discussing; the type of day the service users have had, any appointments the service users needed to attend and general news of the day. The service users said that they were able to make a drink anytime and have a snack if they wished to. One resident commented that their kitchen was always well stocked by the staff. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 14 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) 16,17 and 18. The service users and their relatives are given the opportunity to raise any concerns and complaints to staff or the manager. The complainants are not penalised and corrective action is taken without delay. The residents are enabled by the staff to exercise their legal rights, and for those who lack in capacity, an advocacy service is offered. The staff are familiar with the home’s complaint policy. Therefore complaints are handled efficiently. There is formal training on Adult protection and recognising and dealing with abuse of vulnerable people offered to staff. However not all staff had taken advantage of the training. EVIDENCE: The home had a complaints policy. The service users said that if they had any concerns they would feel comfortable talking to their key worker or the manager. They did not feel the need to make formal complaints. Staff said that when someone complains they try to resolve it by taking immediate corrective action. They then inform the person in charge. Staff were aware of the procedure and the approximate timescales. During the checking of the staff training records it was noted that not all staff had received formal training on adult abuse and protection of vulnerable people. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 15 During staff interview it was evident that they understood and respected the legal rights of the residents at Eagle House. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26. The layout of the home is suitable for its stated purpose. It is accessible, safe and generally meets the needs of the residents who live at Eagle House. The home is in the main clean and some residents’ rooms are personalised. This made it homely. A programme of routine maintenance was underway, in order to keep the home in good condition. There are pleasant outdoor areas, which are for the use of residents. EVIDENCE: The home was clean and welcoming. Service users looked comfortable and relaxed. They had access to the communal areas. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 17 The staff said that although they encourage the relatives to bring in possessions to personalise the bedrooms of residents, not all residents like this. Therefore only some rooms were personalised. The home had a full range of appropriate aids and adaptations. These included grab rails, adapted baths and mobile hoists. Some service users who had the capacity to use their bedroom locks had their own keys. The domestic staff maintained a good standard of housekeeping and the home was clean. It was a lovely sunny afternoon and the service users were out in the garden area enjoying the weather. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 18 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) 27,28, 29 and 30. Staffing numbers and skill mix are in accordance with the agreed staffing levels prior to April 2002. The home provides some in-house and outside training facilities for staff. Staff are offered training on service specific areas so that they are able to provide competent and comprehensive service to the service users. Staff recruitment was based on equal opportunities and the protection of service users. Most of the health care staff are working towards NVQ level 2. This is to provide care by trained staff. EVIDENCE: There were appropriate numbers of staff on duty in both units. Service users and staff said that there was a high use of agency staff and this put extra pressure on the regular staff since the agency workers did not know the service users and their routines. The manager said that they were actively recruiting staff in order to address this issue. The staff said that training opportunities were available and were mostly inhouse. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 19 The service users said that the staff were always visible and busy. There were some comments made by the service users about the lack of commitment from some of the agency staff. These were passed on to the manager. The staff interviewed said that they had undertaken induction when they first started working and that they had to complete an induction package during the first three months, which they found very useful. Copies of these were seen during staff training file checks. Five staff recruitment files were checked. The information held on the whole was satisfactory however, there were some gaps found and these need to be attended to. He manager was aware of the areas. There was evidence of training programmes offered to staff and some staff had not attended these days. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 20 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) 31,32,33,34,36 and 38 The registered manager is experienced and competent in managing the home. The home has a positive, relaxed and inclusive sentiment, which promotes a transparent and healthy atmosphere. There are student nurses on placement from universities; since Eagle House is considered a suitable environment for the students to gain experience by the universities. The views of the relatives and service users are sought by regular questionnaires. Any issue raised within the replies helps the home to address areas of concern. Staff receive supervision and support. However, this is infrequent and not satisfactory. To maintain consistency of care the staff need to be supervised frequently (at least six times yearly). EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 21 Safe working practices are in place to promote the health, safety and welfare of service users and staff. EVIDENCE: The manager is a Registered first level Nurse with many years of experience in this field. She is in the process of completing NVQ level4 in management. Service users knew the manager and had a good rapport with her. The relatives and the staff made positive comments about the management. The staff said that they had received regular support from the management but on average they had received formal supervision twice a year. During interview the staff were able to explain what was involved and the reason for supervision. The staff had mentorship and there were records of the activities between the supervisor and mentor. The records held by the home were securely stored and the relatives knew that the service users had access to their records. The manager ensured that risk assessments had been carried out for safe working practices. The manager recorded and reported all accidents, incidents to the appropriate authorities including CSCI. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 22 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 3 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 2 3 3 x 3 2 3 3 EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 23 Are there any outstanding requirements from the last inspection? None 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 30,18 Regulation 18 Requirement The staff must attend mandatory training and development sessions so that the manager can ensure that at all times suitably qualified, competent and experienced staff are working at the home. All staff must attend mandatory training on Moving and handling, fire safety, health & safety by the stated time scale. The manager must recruit staff for the vacant posts and ensure more permanent staff are on duty. All of the information and the documentation required by regulations on the recruitment of staff must be available on each staff file. Timescale for action 17/10/05 2. 27 18 12/12/05 3. 29 19, Schedule 2 17/10/05 4. 36 24,18 All staff must receive supervision 17/10/05 on a regular basis. there must be documentation to support this. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 24 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 31 Good Practice Recommendations The manager should completed NVQ level 4 in management. EAGLE HOUSE J55-J07 S21777 Eagle House V219880 100805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield. S9 2LR 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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