Inspection on 23/08/06 for East View Residential Home

This inspection was carried out on 23rd August 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

East View Residential Home 22/08/07

East View Residential Home 05/01/06

East View Residential Home 27/09/05

East View Residential Home 14/07/04

East View Residential Home 03/11/03

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE East View Residential Home 406 London Road South Lowestoft Suffolk NR33 0BH Lead Inspector Claire Hutton Unannounced Inspection 23rd August 2006 08:30 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.V307865.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.V307865.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.V307865.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 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 £331.00 and this includes hairdressing and chiropody payments. East View Residential Home DS0000024378.V307865.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 8.30am and 2.00pm. The process included a tour of most of the building, discussions with residents, staff and the manager who was present all day, observations of staff and service user interaction, and the examination of a number of documents including residents care plans, medication records, the staff rota, and records relating to maintenance, health and safety, recruitment and training records. The report has been written using accumulated evidence gathered before and during the inspection. One completed survey was received back from the current resident group. An immediate requirement was left on the first day of inspection and a second visit to the home was required to ensure compliance. This was carried out on 6th September 2006. What the service does well: What has improved since the last inspection? The manager has taken steps to address the requirements from the last inspection. Fire precautions are being maintained, ancillary staff have been CRB checked (criminal records bureau). Equipment at the home such as a bed for one resident and a fax machine is in place. Medication Administration Recording has improved. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 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. East View Residential Home DS0000024378.V307865.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.V307865.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5. 6 is not applicable. Quality in this outcome area is adequate. People who use this service can expect to visit before deciding and be provided with terms, conditions and a contract. However, the home may not routinely assess needs before a resident moves in therefore all concerned cannot be certain that the home can meet the care needs. EVIDENCE: Records and information for four residents was examined. This found that contracts for individuals were in place and appropriately signed. The terms and conditions and a care agreement that was ‘the service users guide’ were in place having been signed or been prepared to be signed by those appropriate. Residents and their families were enabled by the manager to visit and stay for meals before deciding if they wanted to move into the home. In terms of a thorough assessment being completed by the home before a resident moved in, this was not routinely found to be in place. There was evidence that reports from other professionals were sought, but in the case of two people assessments were not found to be completed. Therefore the home East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 9 could have not been certain that they could meet their needs before the residents moved into the home. East View Residential Home DS0000024378.V307865.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. Residents can expect that their healthcare needs will be met, but may not find that their needs are routinely set out in a care plan and reviewed regularly. Residents and their relatives can be assured that staff will uphold residents right to respect, dignity and privacy. Residents can expect that their medicines are stored and administered in line the home’s medicines policy, but records may not be as accurate as they could be. EVIDENCE: Four residents and three staff were met and spoken with. Records relating to four residents were examined. The care planning format used was that provided by a company called ‘training matters’. These were in the format of a book. All the information requested meets the national minimum standard. Two care plans were completed but had not had consistent review since May 2006. One care plan was partially completed and the fourth was not completed, this was said to have been in the process of compiling information. Staff had information available to them to in the form of a daily care plan. These were a record by staff of care given and had information such as visitors including GP. There were also manual handling assessments available to staff, so they knew the level of support required when moving a resident. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 11 One resident spoken with said ‘ you would have to go a long way to find a home as good as this one. Staff really care for you’. Residents were able to get up when they wanted. Staff were seen to routinely knock and wait before entering a bedroom. Residents spoken with stated how they were enabled to access healthcare appointments. The manager of the home transported residents to appointments, which they appreciated. Records showed that all residents are registered with a GP and have access to opticians and chiropody. The district nursing service regularly visits the home. Medication at the home is generally well managed. It is stored appropriately and securely. The home has a monitored dosage system in which the staff have all received appropriate training. The lunchtime drug round was observed. The senior carer did this in line with the homes written procedure on administration of medication. Each resident was asked if they would like their medication and the whole process was unhurried and showed respect to each individual. Records were on the whole good, but on the medication administration sheet the quantity of medication received into the home was not completed, nor the returned medication. Therefore an audit of medication could not be undertaken. The home does have a resident who self-administers medication therefore they should have a medical fridge in which to store this securely. East View Residential Home DS0000024378.V307865.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. 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: Four residents and three staff were spoken with during inspection. One resident survey was received back and all the above standards were responded to in a positive way. One resident said how they loved their books and had a new one recently to read. In the main lounge were a television, but also music for residents to enjoy. Another resident and staff member explained about preparing for Christmas and the entertainment they plan to have. There was discussion around a new shop development and a recent visit to the shops. This had been arranged and residents transported /accompanied by the manager. Choice and control over individual’s lives was evident in how residents freely behaved and how they spoke of their daily routines. Choice was present in deciding what time to get up, if medication should be taken and what to eat and when to eat lunch. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 13 Lunch on the day was a roast chicken dinner and those residents said they were looking forward to it. The Inspector had previously eaten meals at this home and found them to be of good quality. Residents spoken with said they were of good quality still. The dining room is spacious and able to accommodate all residents if requires. Two residents chose to eat lunch in their room. Menus were examined and these tend to be tradition home cooking with such meals as fish and chips on a Friday, Shepard’s pie and vegetables, roast beet and Yorkshire pudding and ham, eggs and chips. The kitchen was visited and the cook spoken with. All recordings of food and health and safety monitoring were in place. The kitchen was clean and food stocks good. East View Residential Home DS0000024378.V307865.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. Residents and relatives can expect the home to have policies and procedures in place to protect them. However, they cannot always be assured processes for safeguarding residents are routinely followed. 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 but has not received any concerns to note. The commission has also not received any complaints about this home. In relation to protection of residents at this home, the manager has obtained the up to date procedure on how to deal with possible protection issues. This is a county procedure agreed with local social services and police. The manager gave assurances that this procedure is gone through with all new staff as part of their formal induction. There was evidence of skills for care induction. Upon examination of staff recruitment records there was evidence to show that not all staff were routinely checked on the national POVA (protection of vulnerable adults) list before entering the home to work. However once this was brought to the attention of the manager he placed a POVA 1st check on a staff member during the inspection. These generally take 24 hours to process. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. Residents can expect that they live in a home, which with some exceptions is generally well maintained. EVIDENCE: A tour was made of all communal areas and some bedrooms with the permission of the residents. The home through out is comfortable, clean and generally meets the resident’s needs. In order to make the home level access the home has two stair lifts in place. The manager was in the process of obtaining quotes to have a shaft lift installed at the side of the house. 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. Toilet roll holders have not been repaired or replaced as previously required. If as had been suggested that residents are using these to help them off the East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 16 toilet, then a handrail should be put in place and the toilet roll holders would not be repeatedly broken. Tiles in the kitchen remain cracked and not repaired and plastering in room six en-suite has not been attended to. Hot water temperatures for the baths were taken. The outcome along with hoist servicing is noted in standard 38 as part of health and safety matters. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 17 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, 28, 29 and 30 Quality in this outcome area is adequate. Residents and relatives can be assured that the numbers and skill mix of the staff will meet their needs and that staff are trained and competent to do their jobs. The home does not use agency or relief staff. However, residents may not be safeguarded as far as is possible, because the recruitment procedure for staff is not routinely as robust as it could be. EVIDENCE: Staff rosters for the current week and week to come were examined. All staff employed at the home were included upon the rosters and were available to staff to see. The home currently accommodates twelve residents and during the day there are two care staff available from 8am until 10pm at night there is one carer with an on call designated person and a sleep in person on the premises. In addition there is the deputy manager and the manager both of whom work full time. The home does not use agency staff and work hard at covering the roster from staff within the home. In addition the home employs catering and cleaning staff. In relation to training of staff the home has concentrated on staff obtaining their NVQ qualification. One person has NVQ 3, four staff have NVQ 2 and two staff are currently doing NVQ 2. Six staff are waiting to start in the coming months either NVQ 2 or 3. Therefore the home has achieved the target of 50 . One staff member spoken to spoke about the good availability of training to staff and said she had training in medication and first aid. There was evidence of staff completing manual handling and food hygiene training. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 18 Recruitment records for three staff that had recently started at the home were examined. There was good practice such as photographic identification and an interview assessment form. However, there were gaps in recruitment such as a second reference and POVA 1st checks even where a CRB had been sent for. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 19 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, 35, and 38 Quality in this outcome area is poor. Residents and relatives can expect that a person who is fit to be in charge and of good character manages the home. However, the home does not operates a quality assurance system therefore is unable to demonstrate that the home is run in the best interests of the residents. Residents cannot be assured of their safety with regard hot water temperatures, as currently there are poor safeguards in place. EVIDENCE: The manager has a good knowledge of each individual resident and is very supportive of staff. One staff member said ‘if there is anything I need I just ask Mr Jarvis and he gets it’. Several residents made positive comments about the registered manager throughout the visit. Residents felt that if they had any problems then the manager would help them to resolve matters. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 20 With regard to a quality assurance system, the manager stated that currently the home do not have any systems in place. This was discussed with the manager and he agreed to take steps to implement a system that would meet the homes needs. With regard the residents finances the home does not keep any money on behalf of residents. Residents are supported to go to the bank/post office and deal with their own financial matters, or families’ deal directly for residents. Health and safety matters were examined. The home had received a visit from the fire service. All fire precautions were found to be acceptable save one comment on staff not being expected to fight fires with extinguishers unless they had been trained. The manager was going to amend the fire risk assessment to reflect this matter. Following a food safety inspection in May 2006 all matters raised had been actioned. Servicing and safety certificates were examined for gas and stair lifts and found to be in order. An immediate requirement was left with the manager to ensure that the mobile and bath hoists were serviced and that hot water in the two baths was restricted to around 43°c to prevent possible scalding. Within a short time the manager had written to the commission and confirmed that action had been taken to safeguard residents. Therefore a second visit was made to the home to ensure compliance. All hoists were serviced however hot water temperatures were not within safe limits. The manager made further adjustments to one bath that brought it into safe limits. However the second bath was not within safe limits and had a temperature of 54.4°c. Therefore the second bath was requested to be taken out of action until a plumber could make it safe. At the time of writing this report the home only had one safe bath for residents to use. The Commission will require and take action to ensure that a second bath is available for residents to use. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 21 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 3 1 2 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 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 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 1 East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (1) Requirement New service users must only be admitted on the basis of a full assessment to determine if the home can meet their needs. Timescale for action 09/10/06 2. OP7 15 A service user plan of care must 09/10/06 be generated from a comprehensive assessment (see Standard 3) for with each service user and must provide the basis for the care to be delivered. Care plans must be regularly reviewed. The medication administration 09/10/06 record must be completed in full and show the amount of medication received at the home and the amount returned if any, thereby allowing medication to be audited. Staff must not start work at the 09/10/06 home without checks relating to CRB and POVA 1st being completed, for the home to judge their suitability based upon evidence. Minor repairs must be carried out 09/10/06 to: toilet roll holders, tiles on DS0000024378.V307865.R01.S.doc Version 5.2 Page 23 3. OP9 13 (2) 4. OP18 OP29 19 5. OP19 23 (2)(b) East View Residential Home kitchen floor, plaster around ensuite in room 6. (This is a repeat requirement) 6. OP26 13 (2) Either sufficient cleaning or replacement of the carpet must eliminate the lingering offensive odour in room 6. The registered person must operate a thorough recruitment procedure ensuring the protection of service users. Effective quality assurance and quality monitoring systems, based on seeking the views of service users, must be in place to measure success in meeting the aims, objectives and the statement of purpose of the home. The registered manager must ensure so far as is reasonably practicable the health, safety and welfare of service users and staff. Therefore hot water temperatures from baths must be around 43°c. 09/10/06 7. OP29 19 09/10/06 8. OP33 24 09/10/06 9. OP38 13 (4) 06/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP18 Good Practice Recommendations Care staff should fully adopt the new care plan format chosen by the home. The manager should obtain the up to date copy of the protection of vulnerable adults policy. East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 24 East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 East View Residential Home DS0000024378.V307865.R01.S.doc Version 5.2 Page 26 - 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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