Inspection on 27/10/05 for Eastlands

This inspection was carried out on 27th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Eastlands 10/07/07

Eastlands 21/09/06

Eastlands 07/06/05

Eastlands 25/01/05

Eastlands 18/08/04

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 Eastlands Beech Avenue Taverham Norwich Norfolk NR8 6HP Lead Inspector Ruth Hannent Announced Inspection 27th October 2005 09:30 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 Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Eastlands Address Beech Avenue Taverham Norwich Norfolk NR8 6HP 01603 261281 01603 869995 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) County Healthcare Ltd, a wholly owned subsidiary of Four Seasons Health Care Ltd Claire Corrigan Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Thirty-five (35) Older People, not falling into any other category, may be accommodated. 7th June 2005 Date of last inspection Brief Description of the Service: Eastlands is a care home providing personal care and accommodation for 35 older people. The home is a single storey detached building, situated in the village of Taverham. The accommodation consists of six double and twenty-three single bedrooms, twenty-five of which have en suite facility. Various communal areas are available for service users. A drive way leads to the property with car parking facilities and gardens to front and rear of the premises. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection which was carried out over a period of 8 hours. (3 hours on the day previous and 5 hours on the actual day). The Manager and Deputy Manager assisted throughout the day. The pre questionnaire, comment cards and rota’s were discussed. Staff and residents spent time talking to the Inspector. A meal was taken with the residents. Records were looked at. What the service does well: What has improved since the last inspection? What they could do better: The Home needs to think of ways of offering choice of meals but minimising waste. The Home needs to improve the call bell system to make it less noisy and intrusive. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 6 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. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4 Each resident is now issued with the terms and conditions and asked to sign them on admission. A full assessment determines if the Home can manage the needs of the individual. EVIDENCE: Each resident now has a copy of the terms and conditions, which has created some questions but no challenges to date. Residents and/or their families are asked to sign the agreement if they are happy with the terms and a copy will be kept on file by Four Seasons. A thorough assessment of need is carried out by the Manager on any prospective residents to make sure the needs can be met by the service offered within the Home. Two copies of assessments were seen that helped compile a care plan. From two initial assessments seen the residents were admitted to the Home and cared for by the staff in the correct way. One Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 9 resident remembered visiting and talking to ensure the care on offer was correct for them. “Not looked back since. All very good, kind and caring here”. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 Residents care plans are in place but need to be more detailed, especially the social needs support required. The residents health needs are met by a supportive community health care team. The medication administration procedure is carried out safely with support and availability for residents to self medicate if they wish to. Residents do feel they are treated with respect and their privacy is upheld. EVIDENCE: Although the Home has comprehensive care plans some paperwork was not in place to highlight the social care needs. (Requirement) The stimulation for each individual is not recorded and plans not in place to cover the social needs. The Home is supported by a community health team, who work with the staff at Eastlands, to give the correct medical care to the residents. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 11 In place are specialist beds, pressure mattresses, bed rails and protectors. The manager said the nurses are in daily and will assist with any areas of concern the staff team may have. The GP’s are happy to offer advice over the phone and will call out if requested by the staff. This was witnessed on the day of inspection, of a resident requiring a doctor. The administration of medication was overseen at lunchtime. The procedure followed was correct and handled professionally. The Senior Carer was confident and measured all liquids carefully and checked all bottle labels to ensure correct name, dose and frequency. The practise was good but could have been improved if the eye drops had been issued in the persons bedroom and not sitting at the dining table. (Recommendation). Two residents manage their own medication and have a risk assessment in place plus a locked drawer in their room for safe storage. In total seven residents had a conversation with the Inspector. Every one was asked an open, non leading question as to the way the staff carried out their care support. Everyone said the staff do a great job and always treat them with respect. One resident sometimes has to wait for help but staff do come and inform her when the carer will be available. It was good to see the Cook interacting with the residents and the way he offered them individual attention over their meals. All doors were knocked on before entry and privacy was maintained throughout any care attention required. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 and 15 The Home is working towards improving the lifestyle to match the expectations and preferences. Residents families and friends are actively encouraged to be involved in the life of the Home. The meals are nutritious and enjoyed but a way to offer more choice for the midday meal would improve the service more EVIDENCE: The Home is working towards getting more stimulation and activities happening. A volunteer worker is about to start covering one afternoon a week when activities can be planned. Trips out have happened over the summer and a Halloween party is planned for the weekend. One staff member is about to train on the Memory Lane training course to help with stimulation and activities for those residents who are beginning to show signs that their memory is failing them. On talking to some residents they would like to have more stimulation and activities to suit them, which the Home is listening to and aiming to achieve. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 13 Two relatives spoken to on the day of the inspection were full of praise for the care offered in the Home. They are regular visitors and are always offered a friendly smile by any of the staff team and always made to feel welcome. One relative said “the home goes out of the way to make us feel welcome and they always have time to talk to us”. A meal was taken with the residents, which consisted of shepherds pie, carrots and cabbage with fruit crumble and custard to follow. Although the menu is now on the table for all residents to see the offer of what they would like to eat if they did not like the main meal, choice was not evident. (Recommendation) The cook will ask what likes and dislikes the person has when they first move into the Home and alternatives are available for puddings. The records are also available in the kitchen to note how well someone has eaten or not eaten. It was also noted how some residents had a small plate and some had a large. On asking them one lady stated “I am put off my food if it is too much so I prefer a small plate”. Another gentleman prefers cranberry juice with his meal and another a glass of wine. All these were available with the midday meal. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 From evidence gained it is clear that residents and families will be listened to and action taken if they have a complaint. Residents are protected from abuse but staff need the training and understanding of what is abuse. EVIDENCE: The Home has a complaints procedure that is available for all residents and their families. The Home has not received complaints that they have recorded but concerns are dealt with as appropriate and on discussing any concerns with residents and reading the comment cards x 4 from relatives they all feel able to talk to the Manager and any issues would be resolved. The Home will be starting a comments, compliments and complaints folder to record all issues and how they are dealt with. Throughout the inspection six residents were asked who they would talk to if they were unhappy about anything. All of them said they would talk to the Manager and that the concerns would be dealt with appropriately. None of them had needed to complain although one resident was having to wait a while for his toilet to be repaired, the manager had kept him updated and had reassured him. The Home has a whistle blowing policy and on talking to four staff members they all said they would have no problems in discussing any worries with the Manager. There have been no concerns regarding unsuitable staff for the Protection Of Vulnerable Adults register to date. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 15 The staff have yet to have the Adult Abuse training. (Requirement). To date only the manager has attended a training course on this subject. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 24 and 25 The Home is maintained to a reasonable standard but needs to be updated and have a refurbishment programme. The communal areas are in need of brightening up with colour. The bedrooms are comfortable with residents own possessions around them. The amount of lighting is not safe and needs to be replaced. EVIDENCE: A tour of the Home took place with some of the areas looking a little shabby and tired. The colour scheme in the corridors is dark and with the poor lighting is made even darker. (See standard 25) The grounds are tidy and the areas are clean. There are no plans on paper for a renewal of fabrics and decoration although plans are in hand to change the furniture in the dining room. The carpet is stained and inappropriate for the use as food and drink is trodden in. The flooring needs replacing and some form of drapes placed at the windows to Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 17 allow people to eat in private and not be looked at as people walk up and down the corridor. (Requirement). Ten bedrooms were seen in total. Each one was slightly different giving it an individual look. On talking to residents all of them said how much they liked their room with their own ornaments, pictures and some items of personal furniture. One of the shared rooms it was noted had a plastic shower type curtain dividing the two beds and needs to be replaced (Requirement). The double rooms need to be made to look more homely and attempt to personalise each side of the room to prevent it looking too institutionalised. (Recommendation) The Home has low wattage bulbs along the corridors, which cannot be changed due to the bulbs blowing. The electrical wiring must be looked at and replaced by a professional electrician to ensure the correct level of lighting is in place for people to be able to walk safely from area to area. (Past Requirement) Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 The residents have their needs met by staff that are adequate in numbers and have the skills required. Staff are supported and aiming towards qualifications to ensure residents are cared for by safe hands. The residents are protected by the Homes policy and procedure when recruiting the staff for the Home. EVIDENCE: The pre questionnaire completed by the Manager before the Inspection included a four week rota. The week of the inspection showed a shortfall of a number of staff but on the day of the inspection and the day prior to that all areas were covered and staff, were seen in the building to cover all annual leave or sickness. This is seen as four carers plus a senior in the morning and three carers plus a senior in the afternoon/evening and two waking staff overnight. A cook and kitchen assistant were on duty as was a laundry assistant and domestic. This was seen as adequate to cover the tasks required. The Home is working hard to encourage all staff to obtain the NVQ qualification. At present 7 staff have gained the certificate with one aiming to finish her NVQ 3 shortly. On talking to two staff members they told of how the Manager is encouraging and supporting them with their training. It was noted Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 19 that the paperwork for one candidate was in the office being collated with the Managers help, ready for presentation. Two recruitment files were inspected and all relevant paperwork was seen. This included the application form, two references, POVA and CRB checks with at least two forms of identification with a photograph. The Home is waiting for two CRB’s with one of these outstanding for a long period of time. (Requirement). Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 36 The residents do live in a Home that is managed by a person who is fit to be in charge. The manager has an open, supportive leadership style that should benefit the residents in her care. The staff are regularly supervised and supported to carry out their job appropriately. EVIDENCE: The Manager has been in post for a number of years and has the recognised qualification in management. She has recently been on a training course to be able to cascade training on adult abuse to the staff team. On talking in length and listening to the interaction between residents and staff it was evident that she knows the residents well and is able to recognise changes and then update Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 21 care plans to meet those changing needs. For example she could see the physical and mental deterioration in one resident and set action in motion to monitor and involve the health professionals. In total six staff were spoken to in detail. Each one was able to state the open and supportive style held by the Manager. They felt they were listened to and could take part in the decision making of the Home. Ideas are shared at supervision and staff meetings, which are held regularly. The residents all reacted well whenever the Manager was near them with smiles and appropriate conversations. Supervision dates are planned between the staff member and the Manager for every two months, which was again clarified by the six staff spoken to and notes taken were held in a locked cabinet. Each one gave an explanation of what happens in supervision and that they are all due shortly for their annual appraisals. One staff member who had many years experience elsewhere but was new to Eastlands had not started her induction but had gone straight into the care role. Induction and support for new staff need to be in place regardless of experience. (She was not able to say what would happen in the event of the fire bells ringing). (Requirement). Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 x 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 2 x x x 2 1 x STAFFING Standard No Score 27 3 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 2 x x Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 23 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 OP7 Regulation 15 Requirement It is a requirement that all care plans reflect the social care needs along with the health and personal care needs. It is a requirement that staff are aware and competent in the protection of vulnerable adults It is a requirement that the dining area be refurbished with flooring and curtains for cleanliness and privacy. It is a requirement that double bedrooms are divided between the beds with a suitable and homely drape/curtain/screen. It is required that the lighting in the main corridors is improved to make a brighter more evenly lit area for the safety of residents. (Past Requirement) It is a requirement that all staff have a CRB check and records must be on file for inspection. It is a requirement that all new staff are offered induction from the onset of their employment and are made fully aware of the fire procedures.. Timescale for action 31/12/05 2 3 OP18 OP20 13 6 23 (2) 31/12/05 31/01/06 4 OP24 23 (2) 31/12/05 5 OP24 23 (2) p 31/12/05 6 7 OP29 OP36 19 (1) sc 2 18 (1) a 31/12/05 31/12/05 Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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 2 3 Refer to Standard OP9 OP15 OP24 Good Practice Recommendations It is recommended that eye drops are not placed in resident’s eyes in the dining room but done in the privacy of their own bedroom. It is recommended that a way of offering choice of the main meal be considered to ensure all residents are aware that there is choice available. It is recommended that double rooms are made to look more personalised and homely. Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Eastlands DS0000027462.V250737.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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