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Inspection on 24/01/06 for Eastleigh (Residential) Care Home

Also see our care home review for Eastleigh (Residential) Care Home for more information

This inspection was carried out on 24th 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.

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

What the care home does well

Service users confirmed they were well cared for at Eastleigh. There were many very positive comments. For example one service user said "I am very happy here". Several service users commented on staff kindness. Service users benefit from the contributions made by all members of the support staff. Service users are supported to spend their days as they wish. One service user was "contented" in her room as she liked "peace and quiet". Visitors are welcomed and were seen to be relaxed in the home. Service users enjoy a wholesome and varied menu which takes into account the needs and preferences of people in the home in a very individual way. Although there is one main choice at lunch time it is clear efforts are made to ensure all enjoy their meals. The home environment is well maintained. It safe, clean and comfortable. The home is in an enviable position and the views of the hills and the sea from some bedrooms provide a source of great pleasure to service users. The home has good support from the local GP and district nurses. There is continuing investment in the home to upgrade the facilities and create a smart but homely environment.

What has improved since the last inspection?

An activities co-ordinator visits the home regularly and her visits are enjoyed.

What the care home could do better:

The home should develop a range of simple afternoon activities when the coordinator does not visit the home. Service users commented that it was sometimes "a long afternoon". Care plans are in place and do demonstrate service users needs. They should be developed to give clearer guidance to the staff of the care to be provided. They could also be developed to give guidance with regard to short term health needs and psychological support. Some care plans provide very detailed assessment of service users needs but the ways in which the needs should be met are not as clear. The hoists had not been serviced in line with LOLER regulations on the day of inspection. This was amended on 14th February 2006.

CARE HOMES FOR OLDER PEOPLE Eastleigh Periton Road Minehead Somerset TA24 8DT Lead Inspector Shelagh Laver Unannounced Inspection 09:30 24 January 2006 th 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 DS0000044220.V280234.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 DS0000044220.V280234.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eastleigh Address Periton Road Minehead Somerset TA24 8DT 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) 01643 702907 01643 707649 Mr Garry John Wilson Mr Richard Mackie Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. A management structure for an additional 51 hrs per week to be provided by the Reg. Proprietor and Reg. Manager from Eastleigh Care Home, South Molton Services users accommodated in category DE(E) to remain in the home providing the home continues to meet the assessed needs of each person. No further service users in the DE(E) category to be admitted as from the date of registration. The Registered Provider to provide a minimum of 50 hours per week to support the Registered Manager The Registered Manager to have a minimum of 7.5 supernumerary hours each week In the event of a new Service User being admitted to bedroom 1, measuring 7.92 sq. metres, the ensuite facility will be removed. 9th August 2005 Date of last inspection Brief Description of the Service: Eastleigh is registered with the National Care Standards Commission to provide personal care to twenty-one people over the age of 65 years. The proprietor is Mr Gary Wilson and the Registered Manager is Mr Richard Mackie. Mr Wilson took over the home (previously known as Boyd House) on 1 June 2003. Eastleigh is situated on the outskirts of Minehead and enjoys views over the sea. Accommodation is provided over two floors, with a passenger lift to the first floor. There are some rooms only accessible by stairs and these are kept for service users who are independently mobile. The home is set in three acres of paddock and gardens. The extention that will provide forty one additional nursing beds is progressing on schedule. It is anticiapted that the building will be completed in May 2006. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on one day over five hours and was conducted by one inspector. The manager Richard Mackie was on duty and matron Pauline Alford also visited the home during the inspection. A tour of the premises took place where the bedrooms, bathrooms and all communal areas were seen. There were 19 service users in residence. Twelve service users were spoken with individually. The inspector met staff on duty and two visitors. Records relating to care, staff and health and safety were examined. The building of the 41 bed nursing home is nearing completion. The management team has arranged recruitment days and are planning for opening in May 2006. On the day of inspection landscape gardeners were planting shrubs around the front of the house. The building of the new extension has been a large undertaking and inevitably the external environment of he home has been disrupted. At times parking was difficult and noise has been unavoidable. There were no complaints about the building from service users and it was clear that their needs had continued to be met. Rooms most affected by the building had not been used. One lady had been offered another room but had refused because the view of the new building taking place was “interesting.” Service users spoken with were again very positive about the care received at Eastleigh. One service user felt the home had helped her to recover after an illness. Staff are “very good to me”. A long standing service user said the home “still suits me well.” What the service does well: Service users confirmed they were well cared for at Eastleigh. There were many very positive comments. For example one service user said “I am very happy here”. Several service users commented on staff kindness. Service users benefit from the contributions made by all members of the support staff. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 6 Service users are supported to spend their days as they wish. One service user was “contented” in her room as she liked “peace and quiet”. Visitors are welcomed and were seen to be relaxed in the home. Service users enjoy a wholesome and varied menu which takes into account the needs and preferences of people in the home in a very individual way. Although there is one main choice at lunch time it is clear efforts are made to ensure all enjoy their meals. The home environment is well maintained. It safe, clean and comfortable. The home is in an enviable position and the views of the hills and the sea from some bedrooms provide a source of great pleasure to service users. The home has good support from the local GP and district nurses. There is continuing investment in the home to upgrade the facilities and create a smart but homely environment. What has improved since the last inspection? What they could do better: The home should develop a range of simple afternoon activities when the coordinator does not visit the home. Service users commented that it was sometimes “a long afternoon”. Care plans are in place and do demonstrate service users needs. They should be developed to give clearer guidance to the staff of the care to be provided. They could also be developed to give guidance with regard to short term health needs and psychological support. Some care plans provide very detailed assessment of service users needs but the ways in which the needs should be met are not as clear. The hoists had not been serviced in line with LOLER regulations on the day of inspection. This was amended on 14th February 2006. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 7 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 DS0000044220.V280234.R01.S.doc Version 5.1 Page 8 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 DS0000044220.V280234.R01.S.doc Version 5.1 Page 9 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): 1, 2, 3 & 5. The manager and matron ensure that the home can fully meet the assessed needs of prospective service users prior to making a decision about admission. The pre-admission process is detailed and well managed. The manager ensures that prospective service users are provided with appropriate information which will assist them in making a decision about admission. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide which is made available to service users, prospective service users and their representatives. The home’s current fee range is dependant upon the room to be occupied and the assessed needs of the service user. Current fees are £380 - £410 with the higher fee being for en-suite rooms. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 10 The manager ensures that prospective service users are fully assessed prior to admission. The inspector observed assessments both from external staff and staff within the home for the three service users that were case tracked. The manager stated that a service user is visited if possible and information from other health professionals and for example hospital care notes are taken into account. Service users are invited to visit the home whenever this is possible. The assessment period extends to a one month and service users are issued with a contract at the end of this period. Documentation relating to pre-admission assessments was seen in the three care plans examined. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 11 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 & 10. The home takes appropriate action to ensure the health care needs of service users are met. The home’s procedure for the management and administration of medication was found to be satisfactory. Service users are treated with respect. Care practices support privacy and dignity. Care plans are completed in a methodical way using an appropriate format. EVIDENCE: All service users have care plans maintained. Three were examined. Two had not been fully completed as the service users had been admitted the day before but clear admission details were recorded and care planning had begun. Documents were in place to complete the file. A completed care plan showed clearly the physical needs of service users. Psychological needs must be more Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 12 fully recorded and care needed must be stated. Some good care practice was not recorded. Care plans are compiled from appropriate assessments which include preadmission assessment, prevention of pressure sores, moving and handling needs and nutrition. All entries in care plans must be signed. Community nurses attend regularly and there was evidence of attention to health needs and appropriate treatment from health professionals including chiropodists and dentists. Short term care needs and interventions should be recorded in the care plan. All staff attended to and addressed service users with respect and in a dignified manner. All service users asked confirmed that they are well cared for at Eastleigh. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 13 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 & 15. Service users are able to chose a variety lifestyle patterns in the home. The home provides a wholesome and varied menu which takes into account the needs and preferences of service users. Arrangements for service users to maintain contact with family and friends is good. The home could develop the range of activities and entertainments to further enrich the service users lives. EVIDENCE: Staff were observed to encourage and support staff to maintain independence and mobility. Service users choose how they spend their day. Some were in the sitting rooms others prefer to spend time in their rooms. The home menu is wholesome and appetising, varied and takes in to account the needs and preferences of service users. The inspector observed the home Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 14 made chicken and leek pie and fresh vegetables being prepared for lunch. Other menus indicated home cooked main dishes and fresh vegetables. The menu does not indicate a choice of main meal each day although there is a list of likes and dislikes on the kitchen notice board. Service users confirmed that if they did not want a meal an alternative was available. All service users were pleased with the standard of food in the home. The dining room is pleasant and tables are set with smartly. Visitors are made welcome at any reasonable time in accordance with the wishes of the service user. There is a choice of sitting rooms ensuring there is always “a quiet spot”. Some service users prefer to meet visitors in their rooms that were seen to contain sufficient seating. Social interaction between members of staff and the service users was polite and friendly. Service users were smartly dressed and have the regular services of a hairdresser. Service users clothes appeared well cared for. The activities co-ordinator visits twice a week. Service users are pleased with these activities and records are well maintained. The home should consider ways in which entertainment and stimulation can be provided between visits. Simple short interactions in the sitting room should happen most days. A list of activities that has included dominoes, reminiscence and trips out to local places of interest was seen. A magazine detailed past trips, birthdays and items of interest. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 15 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, 17 & 18. The complaints procedure in this home is good with evidence that the views of service users/visitors are listened to and acted upon. Procedures and policies aim to protect service users from abuse. EVIDENCE: There had been no complaints. Service users spoken to knew who they were able to speak to if they wished to complain. Staff recruitment procedures, training, supervision contribute to the protection of service users from abuse but see comments in staffing section. The inspector observed systems of administering service users finances that included detailed and accurate records at the last inspection. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 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, 21, 22, 23, 24, 25 & 26. Service users live in a comfortable, safe and clean environment and are able to personalise their own bedrooms. The home’s environment is able to meet the assessed needs of service users. The home provides specialist equipment to ensure the needs of service users are met. EVIDENCE: All communal areas and most bedrooms were seen at this inspection. Bedrooms were pleasant and comfortable and it was evident that service users were encouraged to bring personal possessions into their rooms. Bathrooms, toilets and en-suites were very clean. There are plans to up-grade one assisted bathroom. This is becoming more pressing as the water temperature is variable. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 17 Specialist beds and pressure relieving equipment were seen to be in place where there was an assessed need. Service users informed the inspectors that they were very satisfied with their rooms. There is a choice of sitting areas and the standard of decoration and furnishing is good and in keeping with the building. The home has two lounges and a dining room overlooking the hills. Tables are set smartly. Overall the home is very pleasantly decorated and well maintained. The standard of cleanliness was very good. Domestic staff on duty were satisfied with the time provided to care for the home and the equipment provided. There are very attractive gardens surrounding the home and work was being undertaken on the day of inspection to replace borders affected during the building programme. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 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, 29 & 30. The home ensures that there are sufficient staff on duty to meet the service users needs. The home’s recruitment practices are robust and designed to protect the service users. Staff are well trained and have access to a range of mandatory and developmental training opportunities. Staff supervision should be formalised. EVIDENCE: On the day of inspection there were three care staff on duty. Also on duty was the cook and two domestic staff. The duty rota showed permanent staff working in numbers to meet the needs of service users although it was important to review staffing at times when there were very dependent service users. Staff spoken to confirmed they had received manual handling up-dates and fire training. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 19 There is an in-house trainer able to address specific training needs and an annual training plan. Topics included prevention of pressure sores, communication and catheter and stoma care. One recruitment file was observed. It contained evidence of a thorough recruitment process however the manager must be aware that since June 2004 CRB checks are not transferable and each new member of staff must have a POVA check. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 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, 33, 35 & 38. The home is effectively managed by the registered manager who promotes a clear and inclusive style of management. Measures are taken which ensure the needs and well-being of service users takes priority and that staff are appropriately supported. The home’s systems for ensuring the health, safety and welfare of service users and staff are structured and well managed but at this inspection hoist services were overdue. EVIDENCE: There are systems in place to manage the care of service users. Key staff are identified to review care plans. Two services commented on the support they Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 21 received from the manager. While staff confirmed that support was available from management supervision is currently informal. This must be developed over the next year. At the time of this inspection, the home was taking appropriate steps to ensure the health & safety of service users, staff and visitors to the home. The following records were examined: FIRE – Records indicated that appropriate checks were being carried out on the home’s fire detection and fire fighting equipment. Regular training is conducted for all staff. SERVICING – Servicing schedules indicated that hoists were not serviced according to LOLER at this inspection. The servicing took place on 14th February. There are planned dates for all servicing. ACCIDENT– The home maintains appropriate records relating to accidents at the home. The accident records include action to be taken and evidence of analysis. HOT WATER/SURFACES – Bath hot water outlets are thermostatically controlled to reduce the risk of scalding. There is some instability in the water system that must be addressed. First aid training is provided for staff. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 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 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x 2 1 Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 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 2 3 Standard OP7 OP38 OP29 Regulation 13 (4) c 13 (4) b c (5) 19 Requirement Care plans must reflect clearly the actions to be taken by staff to meet service users needs. Hoists must be serviced according to LOLER regulations The home must undertake a POVA and CRB check for all new staff. No CRBs can be “transported.” The hot water supply to the bathroom must be reviewed and maintained. Timescale for action 31/03/06 14/02/06 02/02/06 4 OP25 13 (4) b c 31/03/06 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 OP37 OP12 Good Practice Recommendations All records including induction records must be signed and dated. There should be activities and entertainment provided in the home when the visiting co-ordinator is not available. Eastleigh DS0000044220.V280234.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 DS0000044220.V280234.R01.S.doc Version 5.1 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. 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