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Inspection on 12/12/05 for Eastwood House Care Home

Also see our care home review for Eastwood House Care Home for more information

This inspection was carried out on 12th December 2005.

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.

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

Positive practical care is provided by a consistent staff group and residents feel that staff are helpful and hardworking. Most staff have received training in care practices. Needs are assessed prior to a new resident moving into the home and they receive reassurance and encouragement form staff during the settling in period. Staff listen to service users views and offer appropriate protection.

What has improved since the last inspection?

The gardener has been re-employed and the gardens are tidier. A stain has been removed from a carpet, but no other improvements have been noted. There were insufficient dining chairs at the last inspection, but as there are currently only eight residents and one of these eats meals in the lounge, the seven chairs are now adequate.

What the care home could do better:

There are three major areas of improvement needed: 1. A suitable manager must be appointed to ensure all aspects of the home are managed responsibly and in the interests of the residents. It is illegal to run a home without a manager. 2. The premises are not currently maintained to an acceptable standard and there are several areas detailed in this report that need urgent attention for the comfort and safety of residents and staff. Urgent maintenance must be carried out to avoid legal action being taken by the Commission. 3. There are some good examples of written plans for the care of individuals, but these are not in place for all residents and need to be updated to ensure needs are not neglected.

CARE HOMES FOR OLDER PEOPLE Eastwood House Care Home 24 Church Street Eastwood Nottingham NG16 3HS Lead Inspector Meryl Bailey Unannounced Inspection 12th December 2005 12:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Eastwood House Care Home DS0000031673.V271705.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. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eastwood House Care Home Address 24 Church Street Eastwood Nottingham NG16 3HS 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) 01773 712003 01773 530386 Forthmeadow Ltd Manager post vacant Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The person accommodated under the age of 65 is a named individual Date of last inspection 12th August 2005 Brief Description of the Service: Eastwood House provides care for up to 14 men and women over 65 years, with the exception of one named person under 65years. The entrance is accessible for wheelchairs. The accommodation is on two floors and there is a passenger lift. There are twelve single bedrooms, four of which have an ensuite facility and there is one double bedroom. There is a bathroom on each floor and toilet facilities are within easy access of the communal and private accommodation. There are car-parking facilities and a garden area with benches. The home is situated close to the facilities and amenities that Eastwood has to offer including a wide range of shops, public houses, a library and market place, churches and a community centre. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one day. Eight current residents were at home and three staff were seen. The home had six vacancies. Care plans were examined and other records relating to residents were checked. There were no visitors during the inspection. Some residents and staff gave their views about the care provided. Most areas of the home were inspected. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 6 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 Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 7 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): 3 Service users needs are assessed prior to moving into the home and receive reassurance and encouragement during the settling in period. EVIDENCE: Detailed assessment information had been accessed in respect of the most recently admitted service user, but this did not lead to a plan of care to meet individual needs (see Standard 7). The service user herself said that she was settling now, having changed rooms. She chose her room from those available when she moved in, but moved to a larger room when it became available. She felt that the staff had been very understanding of her needs. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 8 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 and 9. For the majority, needs are set out in an individual plan of care, but recent plans are missing and updating is not consistent. As a result, needs may not all be appropriately met. Generally, medication is well organised, but attention to detail is needed. EVIDENCE: Three care plan files were seen and two of these set out in detail the action needed to be taken to meet needs. These concerned residents who had been at Eastwood House several years and plans had been in place prior to the departure of the previous manager. Some adjustments were seen on their assessments, but these were not dated and it was not clear if the plans had been fully reviewed. The third plan concerned a service user, who had been in residence for three weeks. There was some detailed assessment information, but no full plan of care. This must now be put in place to ensure all needs are met. Medication is organised and all medication administered is witnessed by a second staff member using a duplicate file. However, regarding eye drops, there was some discrepancy between the files regarding instructions for administering. Also, there were some gaps where no signature had been inserted in the main file. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 9 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 Limited activities are provided and this satisfies some, but not all service users. EVIDENCE: There were currently eight service users and staff arranged bingo for them on two days a week. There were plans for a pianist to come in on 14th December and the local minister was to attend to provide a Christmas Blessing on 18th December. At the same time there would be a visit from local school children to sing carols. There was some socialising, but some service users had very little contact with the others. Some were happy with their own routines and others said that it was lonely and boring at times. It is recommended that more regular daily activities be planned. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 10 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 Staff listen to service users and offer appropriate protection. EVIDENCE: A copy of the complaints procedure was on the Residents Notice Board. No complaints have been recorded since the last inspection. None of the service users spoken with wanted to make any complaint and said that the staff take good care of them. There was a copy of the Nottinghamshire Committee for the Protection of Vulnerable Adults policy and procedures. Some service users money was looked after with appropriate records kept. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 11 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, 24, 25 and 26 The premises have been seriously neglected and pose risks to people residing and working there. Some bedrooms are comfortable, but the need for maintenance has not been met. Heating and ventilation are not sufficiently controllable and, therefore affect comfort. The home is mostly clean, but not entirely hygienic. EVIDENCE: None of the maintenance problems identified at the previous inspection (12th August 2005) had been attended to and further serious problems had arisen. The kitchen required maintenance, as areas of damp were visible on interior walls at the previous inspection. Through lack of attention the walls had further deteriorated and greater remedial action will now be needed. The refrigerator handle was still missing and records of fridge and freezer temperatures showed that these appliances were not working efficiently. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 12 Carpets still needed to be replaced on the first floor landing and a previous damp problem had caused ceiling paper to peel off outside room 4. There were towels lying at the base of the fire exit door, as water was coming in under the door. On examining the external area, the lower part of this door was found to be rotten. Not all bedrooms were inspected in detail, but some maintenance problems were identified in those seen. In room 1 there were electrical sockets on a damp wall, with pealing wallpaper. An old sign warned staff not to use the sockets. This room was occupied by someone with high dependency needs. The sliding door to the ensuite in room 10 was not functional due to sticking and the occupant was unable to move it. There was still no carpet edging strip at the entrance to room 11, where the edge of the carpet is damaged and remains a potential trip hazard. This was identified at the previous inspection. The occupant had mobility needs and used a Delta walking aid. In room 13, the washbasin was cracked and a further leak had caused the bottom of the surrounding unit to become rotten. Additionally, a wall strip light was still missing in Room 2, though this room was not currently in use. There were several empty bedrooms with no carpets or curtains and, therefore, not ready for occupation. One window in room 9 did not fully close and one of the fasteners was missing from the other window in the room. Window openings in occupied bedrooms were not all restricted for safety and security. Temperature controls on covered radiators were still not accessible and there was a general problem in regulating temperatures through the day. An additional oil filled radiator in room 4 was in use to supplement heating for the occupant and this was unsteady. Staff kept the premises clean and tidy in communal areas, though the stairs had not been cleaned. The laundry floor was still damaged and needed replacing or covering with a non-porous surface to prevent risk of cross infection. The sound of water was found to be from a storage cupboard in the laundry. Water was continually trickling in due to a plumbing problem. All these concerns were reported to the company immediately following this inspection for urgent attention. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 13 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 Needs of the current service users are met by the numbers of staff provided. Staff are trained in care practices. Protection is given by appropriate checking of staff. EVIDENCE: The number of service users had dropped to eight, but staff confirmed the staffing level remained the same. There were two care staff from 7.30am to 4.30pm, with one senior care staff working 9am to 12noon. Then two care staff worked from 4.30pm to 9.00pm and two at night. A cook and a housekeeper were employed part-time in addition. This appeared to be meeting immediate care needs, but would need to be reviewed if needs and numbers of service users increased. Most staff have completed their National Vocational Qualification level 2 in Care, but are waiting for verification. One has commenced level3. Staff files are organised. There was evidence of all staff having been checked with the Criminal Records Bureau, but, in the absence of a manager, personal references were not available for inspection. There have been no new staff since the last inspection. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 14 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, 34, 35 and 38 There is no fit person in charge of this home. No system is in place to consult service users and assure a quality service. Service users’ money is safeguarded by staff, but insufficient petty cash is made available for essential items. The health and safety of service users and staff within these premises are not protected. EVIDENCE: There has been no registered manager since January 2005. The job was advertised in the Nottingham Evening Post in October 2005 and there were applicants. The visitors’ record showed that a director of the company had visited the home on twelve occasions since the last inspection in August 2005. No written reports of visits have been received at the Commission. The day-today running of the home was left to the senior care staff. It is an offence to carry on a care home without a registered manager. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 15 There was no evidence of a quality assurance system in place to regularly and systematically seek the views of service users and their representatives in order to monitor and improve the service provided at the home. Some money was looked after securely for service users and staff took care to record transactions and retain receipts. However, there were also two other cash tins. One was for petty cash and the other for the Residents’ Fund. Petty cash received was from a relative paying cash for respite care, but none had been received since October 2005. Petty cash was used for essential items including food. The Residents’ Fund was made up of accumulated donations and money from fundraising. Records of transactions and receipts showed that this fund has been used for essential items, for example bread and fish and chips for service users when there has been insufficient Petty Cash. These amounts must be repaid. There was a security camera at the rear of the building and a monitor in the office, but at night there is no external light therefore the area cannot be seen. In room 1 there were electrical sockets on a damp wall, with pealing wallpaper. An old sign warned staff not to use the sockets. Labels on the electric plug on the above and other appliances clearly stated that testing was overdue. Also, as stated earlier, records of fridge and freezer temperatures showed that these appliances were not working efficiently. Window openings in occupied bedrooms were not all restricted for safety and security. The fire officer needs to be consulted on the efficiency and safety of the fire door on the first floor as the lower section is rotten, as reported under Standard 19. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 16 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 3 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 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X 1 1 2 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 1 2 2 X X 1 Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 17 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. Standard OP7 OP9 Regulation 15(2) 13(2) Requirement Ensure individual care plans are fully reviewed and revised. Ensure staff are given accurate and consistent instructions for administering medicines as prescribed and that accurate records are maintained. Ensure that the premises are of sound construction and kept in a good state of repair externally and internally and reasonably decorated. Areas that must be attended to: Replace carpets on the first floor landing; treat damp areas and redecorate the kitchen; eliminate damp to the ceiling outside room 4 and redecorate; replace the refrigerator handle. These are outstanding Locate the cause of water leaking into the Laundry cupboard and make necessary repairs. Replace the wall strip light in room 2 and fit a carpet edging strip at the entrance to room 11. These are outstanding Repair window fasteners in room 9 and ensure both windows can be fully closed. DS0000031673.V271705.R01.S.doc Timescale for action 31/01/06 31/01/06 3. OP19 23(2)(b) (d) 31/01/06 3. OP19 23(2)(b) 13/12/05 4. OP24 16 and 23(2)(b) 23(2)(b) and (c) 31/01/06 5. OP24 31/01/06 Eastwood House Care Home Version 5.1 Page 18 6. 7. 8. OP24 OP24 OP25 23(2)(b) and (c) 23(2)(b) and (c) 23(2)(p) 9. 10. OP26 OP31 23(2)(d) 8(1) and (2).. 11. OP31 26 12. OP33 24(1) 13. OP34 16(2)(i) 14. OP38 13(4) 15. 16. 17. OP38 OP38 OP38 13(4) 13(4) and 23 13(4) and 23 Ensure the sliding door to the ensuite in room 10 is functional. Repair or replace the cracked washbasin and damaged surrounding unit in room 13 Ensure that service users are able to control the temperature in their own bedrooms. This is outstanding from a target date of 30th November 2004. Ensure all parts of the home are kept clean (including stairs). Under regulations 8(1) and (2) and Section 11 of the Care Standards Act 2000. Appoint an individual suitable to manage the home and inform the Commission of the name of the person and date appointed. This is outstanding The responsible individual must prepare a written report of visits to the home and supply a copy to the Commission. Establish and maintain a system for reviewing and improving the quality of care at the home, seeking views of service users and their representatives. Make sufficient Petty Cash available for food and repay money borrowed from the Residents’ Fund. Ensure all parts of the home are free from hazard by, in particular, replacing the laundry floor covering. This is outstanding Ensure the electrical sockets on the damp wall in room 1 are made safe. Electrical equipment – arrange Portable Appliance Testing Ensure the freezer and refrigerator are in good working order to store food at the appropriate temperatures DS0000031673.V271705.R01.S.doc 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 31/03/06 31/01/06 31/01/06 13/12/05 31/01/06 31/01/06 Eastwood House Care Home Version 5.1 Page 19 18. OP38 13(4) and 23 Ensure the fire exit door satisfies fire safety regulations. 31/01/06 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. 3. Refer to Standard OP12 OP38 OP38 Good Practice Recommendations Ensure suitable activities are planned each day. All window openings should be restricted to 100mm for safety and security. Fit an external light for security. Eastwood House Care Home DS0000031673.V271705.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Eastwood House Care Home DS0000031673.V271705.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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