Inspection on 31/01/06 for Eastleigh Care Homes, South Molton

This inspection was carried out on 31st January 2006.

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

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

Other inspections for this house

Eastleigh Care Homes, South... 06/12/07

Eastleigh Care Homes, South... 12/10/06

Eastleigh Care Homes, South... 07/07/05

Eastleigh Care Homes, South... 06/12/04

Eastleigh Care Homes, South... 08/06/04

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

CARE HOMES FOR OLDER PEOPLE Eastleigh Care Homes, South Molton 90-91 East Street South Molton North Devon EX36 3DF Lead Inspector Ms Rachel Fleet Unannounced Inspection 31st January 2006 10:05 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 Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 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. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eastleigh Care Homes, South Molton Address 90-91 East Street South Molton North Devon EX36 3DF 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) 01769 572646 01769 579098 Mr Garry John Wilson Pauline Margaret Alford Care Home 56 Category(ies) of Dementia - over 65 years of age (41), Old age, registration, with number not falling within any other category (56) of places Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Notice of Proposal to Grant Registration of staffing/environmental conditions of registration issued 18/8/2000 Authorised Person in Charge Mrs Pauline Alford RGN Up to 41 service users in the category DE[E] [Dementia over 65], not requiring nursing care, can be admitted 7th July 2005 Date of last inspection Brief Description of the Service: Eastleigh offers a total of 56 residential and nursing care places, providing some hotel-style services with quality care. The Home is situated in the market town of South Molton, local to shops and amenities, approximately 12 miles from Barnstaple, and in easy driving distance of the countryside. It has its own minibus, suitable for wheelchair users, which is used regularly for residents outings, etc. The original building, dating back to pre-1839, accommodates residents with personal care requirements. Extensions, added in 1999-2000, accommodate up to 23 residents with nursing requirements. The Home was awarded the TCB/Pinders Healthcare Design Award in 2003. There are garden areas at the rear of the home, and some parking space near the home’s entrance. There are plans to refurbish the ground floor of the residential wing, to provide seven en-suite rooms (including two double rooms for couples) instead of the current 12 bedrooms. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was at the home for just under seven hours for this unannounced inspection. She spoke with residents and staff around the home – talking to seven of the 56 residents in some depth, as well as meeting with others more briefly and sitting with some who were too frail to speak about their experiences. She spoke with four staff, and looked at documentation – including six care plans and associated records for case-tracking purposes. A CSCI comment card was returned from a visitor – they were positive about the home. Standards that were met at the last inspection have not been re-inspected on this visit. The report from that inspection, carried out on 7 July 2005, should therefore be read along with this report, for fuller information. What the service does well: What has improved since the last inspection? Care plans for residents who have dementia had sufficient information in relation to their specific needs. No issues were noted in relation to use of medication from shared stock – each resident having their own supplies kept by the home, where checked. Robust recruitment practices are now in place, helping to protect residents by ensuring suitable staff care them for. Action plans are being produced with ‘quality of care’ surveys carried out by the home. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 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. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 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 Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 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): These core standards were met at the last inspection. EVIDENCE: Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 9 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&9 Some care plans need more detail to guide staff appropriately and ensure continuity of care for all residents. Some practices are insufficient to ensure safe medication management and promote residents’ welfare. Other core standards were met at the last inspection. EVIDENCE: Care plans were very individualised, and those for residents with dementia had relevant detail. Next-of-kin had been involved in some reviews, where the resident was not fully able to participate. Residents’ social care is recorded elsewhere by the activities staff; care notes included the level of the resident’s interest or participation in activities offered, and evidenced activities appropriate to the frailty of residents. Some care plans lacked detail – for example, where mood was said to affect mobility, it did not specify how. Information gained from assessment tool was not always used to inform care planning. For example, where a high risk for pressure sores was identified, the care plan did not include pressure-relieving equipment. Planned care was not always evaluated in written reviews – the latter often being dates and signatures only. Consent forms seen for bedrails and lapbelts did not include guidance on time limits for their use. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 10 No record was kept of medications disposed of, unless they were controlled drugs or individual items refused by a resident. One administration chart had handwritten entries but without two signatures to identify who had written them and verify their accuracy. A skin cream was seen with instructions for application three times a day, but the administration chart stated it should be given twice a day; the inspector was told the resident was no longer being given the preparation. The temperature of one drug fridge was recorded irregularly. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 11 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): 14 Residents are enabled to exercise choice and have control over their lives. Other core standards were met at the last inspection. EVIDENCE: Regarding meals, a resident said, “If you don’t like a particular thing, you don’t have to go without”, speaking about choices being available. Another said they felt able to control their daily routine, and there were usually enough staff to assist them when they wanted help - to go out to the garden, for example. Bedrooms were personalised with the resident’s own belongings. Staff spoken with evidenced a sympathetic, flexible approach in meeting residents’ needs, appreciating that their needs and preferences might vary. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 12 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): 18 Effective steps have been taken to protect residents from abuse. Including time limits in plans for use of potentially restraining equipment would strengthen existing practices, further safeguarding residents’ welfare. Other core standards were met at the last inspection. EVIDENCE: Staff said relevant training or updates took place at least yearly. They were aware of their responsibilities, including whom they might contact outside of the home about concerns, if necessary. Risk assessments were seen for potential restraints such as wheelchair lap belts and bedrails. Such equipment was not in common use, but the risk assessments did not include how often they should be released/removed, as is good practice in relation to restriction of liberty or freedom, as well as for health reasons. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 13 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): These core standards were met at the last inspection. EVIDENCE: Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 14 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): 28 & 29 Residents are cared for by a competent staff team. Robust recruitment practices help to protect residents by ensuring they are cared for by suitable staff. Other core standards were met at the last inspection. EVIDENCE: Residents were positive about the qualities and capabilities of the staff. One resident appreciated that the nightstaff checked on residents overnight. Of approximately 50 care assistants, 13 have a Care NVQ2 or higher (- eight have NVQ3) qualification, and 19 are currently undertaking the course. In-house training sessions take place every week. Staff said they had attended training on continence matters, palliative care. Those spoken with knew residents’ needs. A new staff described how their application to work at the home had been dealt with, evidencing that the home had followed good recruitment procedures. They were supernumerary during their current period of induction. Three staff files were checked. Required information was seen, including ‘POVAfirst’ checks. The file for one new staff was not available because the administrator dealing with it had not left it in an accessible place. Such records must be available at all times for inspection, and this matter will be monitored again on future inspections. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 15 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 & 38 Residents and staff benefit from the experience and skills of the manager. The home is run with the residents’ interests at heart. Aspects of fire safety must be addressed to ensure the health and safety of residents and staff is fully promoted. Other core standards were met at the last inspection. EVIDENCE: The registered manager/Matron, a registered nurse, has been in post for seven years. She hopes to complete the Registered Mangers Award by March 2006. Residents and staff felt the home was well managed. Staff said senior staff including the matron were always available to them. The home had a relaxed but organized atmosphere on the day of the inspection. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 16 Comprehensive ‘quality of care surveys’ are carried out six-monthly, involving residents and their relatives. The views of new residents are sought six weeks from their admission to the home. Residents knew where to find the minutes of the last residents’ meeting, but one commented, “You don’t have to wait for a meeting – you can always speak to someone”. Some said a lounge was regularly used for staff training but that this didn’t affect their usual routine. They felt the home was run for the benefit of the residents. The fire log included action taken to deal with any faults found, and the fire risk assessment had been updated in recent days. However, the emergency lighting had not been tested monthly as recommended, and the fire alarms were not tested when the person responsible was on holiday. Almost a third of the staff have not had fire training in the previous six months. A requirement was made at the last inspection about ensuring all staff have fire training according to fire authority guidance. An electrical appliance had last been tested for safety more than a year previously. Senior staff said re-testing was due to take place in March 2006. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 17 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 1 Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 18 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 OP9 Regulation 13(2) Requirement Timescale for action 10/03/06 2 OP38 23(4)(d) 3 OP38 23(4)(c v) You must make suitable arrangements for recording, handling, safekeeping, safe administration & disposal of medicines received into the care home. This is particularly regarding a) Keeping a record of all medicines disposed of; b) Administering medication according to the prescriber’s instructions; c) Maintaining accurate records of current medications for each resident, and d) Regular monitoring of drug fridge temperatures. You must, after consultation with 30/04/06 the local fire authority, make arrangements for persons working at the Home to receive suitable training in fire prevention. This is with regard to ensuring all staff have fire safety training at recommended intervals. You must, after consultation with 28/02/06 the local fire authority, make adequate arrangements for DS0000026713.V271975.R01.S.doc Version 5.1 Eastleigh Care Homes, South Molton Page 19 testing fire equipment at suitable intervals. This is especially with regard to ensuring fire alarms & emergency lighting are tested at recommended intervals. 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 You should ensure all care plans have sufficient detail of the action to be taken by care staff to meet residents’ needs. You should include time limits, or related information, for use of potentially restraining equipment (such as wheelchair lap belts and bedrails) in risk assessments. Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Eastleigh Care Homes, South Molton DS0000026713.V271975.R01.S.doc Version 5.1 Page 21 - 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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