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Inspection on 22/08/07 for East View Residential Home

Also see our care home review for East View Residential Home for more information

This inspection was carried out on 22nd August 2007.

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

What has improved since the last inspection?

At the random inspection significant progress was seen: there was evidence that the home had assessed new people and obtained information about their needs from a previous care home and Social Services. Care plans were in place and staff maintained up to date daily statements on residents. There was a history of consistent monthly review. To ensure the continued effectiveness of medications a fridge had been purchased to store any medication that required storage at lower temperatures. The recruitment records for staff were examined and found to be in order, which safeguards the people who use the service. Environmentally there had been some developments. Both temperatures of the two baths were within safe limits and finally, the manager had also obtained and started to implement a quality assurance package specific to Eastview. All these improvements have been maintained at the key inspection. These improvements have maintained safety and added quality to the care on offer at Eastview. The key inspection found more progress had been made with the quality assurance package developed by the home with quality monitoring taking place and views of residents, relatives, staff and professionals being sought. Therefore the overall quality of this home has improved by ensuring those that use the service are listened to and action taken to respond to their contribution.

What the care home could do better:

Eastview has made good progress over the last year and should concentrate on maintaining the quality of service it has achieved and move forward with matters that are planned such as reviewing documentation and developing the quality assurance package further.

CARE HOMES FOR OLDER PEOPLE East View Residential Home 406 London Road South Lowestoft Suffolk NR33 0BH Lead Inspector Claire Hutton Key Unannounced Inspection 22nd August 2007 11:00 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 East View Residential Home DS0000024378.V349306.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. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service East View Residential Home Address 406 London Road South Lowestoft Suffolk NR33 0BH 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) 01502 565442 01502 565442 eastview@fsmail.net Mr Dennis Jarvis Mr Dennis Jarvis Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2006 Brief Description of the Service: East View Residential Home is a residential property in South Lowestoft. The current owner/manager took over the home in 1989 as a going concern. Since then it has had a number of extensions and environmental upgrading and is now registered to provide personal care for 14 older people. Six residents individual rooms are on the ground floor and the others are on the first floor. Rooms are either available with en-suite or a wash hand basin. The home provides 11 single bedrooms and 2 double bedrooms. There are two stair lifts to the first floor. There is a small garden around the property. There is parking available in the streets close to the home. Fees for this home are £341.00 and this inclusive fee with matters such as hairdressing and chiropody payments included. Information regarding the service is available in the service user guide, this and the most recent inspection CSCI report are available on request. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that focused upon the core standards relating to Older People. It took place on a weekday between the hours of 11:00am and 4:00pm. The process included a tour of communal areas, discussions with two residents, one relative, five staff and the manager who were present all day, observations of staff and service user interaction, and the examination of a number of documents including residents care plans, medication records, and records relating to maintenance, health and safety, recruitment and training records. The report has been written using accumulated evidence gathered before and during and after the inspection. One completed survey was received back from the current resident group. One completed survey from the staff group and the completed Annual Quality Assurance Assessment (AQQA) from the manager. A random inspection was carried out at the home on 12th January 2007. At that inspection significant progress was noted on requirements made. What the service does well: People who use this service have good information about this home before they move in. They can also expect the home to assess their needs and therefore be assured needs can be met. One relative said “very happy with the home – lucky to find it”. People who use the service are given a very good level of support with healthcare. The personal care offered is clearly set out in plans and residents are pleased with the support given. Residents at this home are able to choose a lifestyle that suits them. One resident spoken to said “All the staff are very caring – they are lovely to me. What I really like is the laundry that is done each day. My clothes are beautifully cleaned and then hung back in my wardrobe”. People who use the service can be confident that their concerns and complaints will be listened to and taken seriously. Eastview has safeguarding procedures in place that offers protection for the people who use this service. Residents and relatives can be assured that the numbers and skill mix of the staff will meet the needs of residents and that staff are well recruited, trained and competent to do their jobs. The home has a long-standing record of not using agency staff. Residents and relatives will find a person who is fit to be in charge and of good character managing the home. One resident said ‘You just ask the boss man East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 6 and he does it’. A relative said, “Mr Jarvis is easy to talk to. I know he’ll sort things out”. All staff spoken to thought very highly of the manager. The home is run in the best interests of the residents. The safety and the welfare of the residents and staff is promoted. 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. The summary of this inspection report can be made available in other formats on request. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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 East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5. Standard 6 does not apply. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about this home before they move in. They can also expect the home to assess their needs and therefore be assured needs can be met. EVIDENCE: Evidence of service users guide and contracts were seen to be in place for three residents. Contracts both for Social Services and private residents were seen and were of the same fee that includes all services and needs a person may have. The manager had a new format for the Service Users Guide that he was intending to review to provide even better information for people who use the service. One relative spoken with was very happy with the service and the support and information given before their relative moved into the home. They said “very happy with the home – lucky to find it”. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 9 The manager carried out assessments before the residents moved in. The manager visited the individual in their previous residence. Where appropriate other information form Social Workers and hospital was also obtained. In the AAAQ the manager stated that “ All our new residents are seen in their own homes or come to Eastview for the day”. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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. 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. People who use the service are given a very good level of support with healthcare. The personal care offered is clearly set out in plans and residents are pleased with the support given. EVIDENCE: Care plans and all other individual records were examined for four individual residents – some new to the home and some who had been there a long time. The home use a format that meets all the national minimum standards and these documents were found to be completed and up to date. Staff completed the daily statements each day and a handover from one shift to another was seen on the day of inspection. The care plans included assessments on mental health, physical needs, personal care, manual handling, pressure care, nutrition and falls. From care plans, discussions and observations access to health care was seen to be well facilitated. Access included: opticians and chiropodist who visited East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 11 the home, two residents had ear drops as they were planned to have ears stringed, one resident spoke about a blood test they had the previous day, whilst there a call was received from the diabetic nurse at the hospital and another call was received from the GP and two visits were planned to the hospital. The manager tends to escort the residents to hospital if they wish. The manager was very knowledgeable about each residents medical conditions and what support they needed. One resident spoken to very much appreciated the support and help given to them from the manager. One survey received said “the medical support is excellent”. The medication systems in place were examined. Medication is kept secure with medication appropriately locked in medical cabinet and the key is secure. Records were examined and found to be well kept. Medication for two residents was audited and a trail found to show that residents received medication that was prescribed for them at the required times. Controlled drugs records were examined and found correctly recorded. The storage of controlled drugs was discussed and the manager agreed to store this type of medication in the medical cupboards supplied to the home that were secured to the wall. One resident spoken to said, “All the staff are very caring – they are lovely to me. What I really like is the laundry that is done each day. My clothes are beautifully cleaned and then hung back in my wardrobe”. Another resident said “Yes, the staff are all good here, they know me well by now”. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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. 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. Residents at this home are able to choose a lifestyle that suits them. Residents and relatives can expect that the home will provide a wholesome and appetising meal in a calm and sociable setting. EVIDENCE: The routines of each resident were quite individual with one person having a set routine whereby they were not disturbed (by choice) until late morning. The AQQA received stated that “Our aim is to enable our residents to lead there life in a way they choose”. Records showed visitors were regularly received. This included a hairdresser. One person regularly went out to the Salvation Army for luncheon. Another resident regularly went to the Methodist church that they belonged to. One resident spoken to said “I’m very happy here. The meals are very good. You have a choice from up to three things. There is plenty of it and it is very well cooked. My daughter can visit any time she likes – there is no restrictions”. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 13 The inspector had previously eaten meals at this home and found them to be of good quality. A resident who had been at the home for sometime confirmed the meals were just as good and that they had enjoyed a cooked lunch. The dining room is spacious and able to accommodate all residents if requires. Some residents choose to eat their meal elsewhere. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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. 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. People who use the service can be confident that their concerns and complaints will be listened to and taken seriously. Eastview has safeguarding procedures in place that offers protection for the people who use this service. EVIDENCE: Eastview has a complaints procedure in place that forms part of the terms and conditions given to each resident. This is also displayed in the entrance to the home. The home has a complaints book in which to record these events, which was examined during the inspection. One complaint was received by the Commission and passed on to the home for investigation. The manager undertook the investigation in line with the homes procedure and the outcome was recorded. The outcome was that the complaint was not founded. Elements of the complaint were examined during this inspection and support the findings that the complaint was unsupported by evidence at the home. In relation to safeguarding adults the home have a procedure in place and were updated about the new policy and revision of procedures by the local authority. There have been no safeguarding referrals from this home. The manager gave assurances that the safeguarding procedure is gone through with all new staff as part of their formal induction. There was evidence of skills for care induction, contracted through the local social services. Records from recruitment show that staff are routinely checked East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 15 against the national protection of vulnerable adults listings to verify they are suitable to work at the home. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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. 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. Residents can expect to live in a home that is comfortable, meets their needs and is clean and generally well maintained. EVIDENCE: A tour was made of all communal areas and some of the bedrooms with the permission of the residents. The home throughout is comfortable, clean and generally meets the resident’s needs. One relative spoken to said “when you visit you can always see the place is clean and someone cleaning”. In order to make the home level access the home has two stair lifts in place. The kitchen and laundry room are well equipped. Individual bedrooms are personalised and those that are shared have sufficient space, privacy curtains and appropriate furnishings. Cleaning has improved the offensive odour in one bedroom. However, further negotiation with the resident is needed for this progress to be maintained. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 17 General maintenance has continued at the home with non-slip cushion flooring put in en-suites, room 11 has new flooring and toilet extractor fans have been replaced. The aerials within the home have been replaced to ensure every resident can now access freeview on their televisions. A green house has been purchased for residents use. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives can be assured that the numbers and skill mix of the staff will meet the needs of residents and that staff are well recruited, trained and competent to do their jobs. EVIDENCE: Five staff were met on the day of inspection and one questionnaire was received back. All response were very positive about Eastview. Staff like working here, they feel well supported and feel there is good training on offer. One staff member said “The manager listens to anything we have to say”. The home has not used any agency and is proud that they are able to maintain staffing levels from their regular staff group. The manager states in the AQQA “Our staffing levels are appropriate to the assessed needs of our residents with a high level of NVQ 2 trained staff on duty at all time”. The home employs twelve staff. Five of these have NVQ 2. Two staff are currently going on NVQ 2 and three staff were due to start in the following weeks. The deputy manager is doing her NVQ 3. There was evidence from files of supervision and appraisals. There was evidence in the form of certificates that staff had undertaken training in first aid, food hygiene and manual handling. The deputy manager confirmed staff had training in medication from a local pharmacist and were awaiting their certificates. More East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 19 training was planned along with an in-house workbook. Only trained staff administered medication. The recruitment records for three staff were examined and found to have all the checks required before they started work at the home. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives will find a person who is fit to be in charge and of good character managing the home. The home is run in the best interests of the residents. The safety and the welfare of the residents and staff is promoted. EVIDENCE: The manager has a good knowledge of each individual resident and is very supportive of staff. One resident said, “You just ask the boss man and he does it”. A relative said, “Mr Jarvis is easy to talk to. I know he’ll sort things out”. All staff spoken to thought very highly of the manager. In relation to qualifications the manager confirmed he is currently doing the NVQ 4 and Manager Award. He has been doing these qualifications for some East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 21 time and he explained the delays he has experienced. However, he agreed to notify the Commission of his intended completion date of these qualifications. In relation to quality assurance the home have made great progress in both monitoring the quality of the service they offer and listening to those people who use the service. The home have invested in a quality assurance manual that allows them to collate information and view at a glance matters such as training, supervision and maintenance. There are auditing processes such as accidents, medication and health and safety. The home has surveyed residents – six residents in April 2007. They have surveyed five relatives in March 2007 and three staff as well as professionals who come to the home. Developments that are taking place include reviewing the Service Users Guide and developing an emergency plan for the home. In relation to residents finances the home does not deal with any finances on behalf of any resident. With regard to health and safety in the home staff are trained as detailed in the staffing section. With regard to equipment the hoists at the home were serviced the day before the inspection and the engineers servicing date was seen on the hoists. Evidence was also seen for gas safety, stair lifts, electrical wiring and electrical appliances. The home has a fire risk assessment in place. Some detectors and a fire door were replaced in April 2007. Fire detection and fire fighting equipment was last reviewed in June 2007 - as stated in the AQQA. All the required policies and procedures are in place with the last review dated as June 2007. The hot water temperatures were tested during inspection and found to be at a acceptable level. East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 East View Residential Home DS0000024378.V349306.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!