Inspection on 09/06/05 for Edinburgh House

This inspection was carried out on 9th June 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Edinburgh House 26/05/06

Edinburgh House 09/11/05

Edinburgh House 25/01/05

Similar services:

Chestnut Walk

Dunwood Manor Nursing Home

Excelsior

Cherwood House Care Centre

Durban House Nursing Home

Dawson Lodge

Court Lodge Nursing & Residential Home

Ferendune Court

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

CARE HOMES FOR OLDER PEOPLE Edinburgh House Sundridge Close Cosham Portsmouth PO6 3JL Lead Inspector Clare Jahn Unannounced 9 June 2005 10:00 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 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. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Edinburgh House Address Edinburgh House, Sundridge Close, Cosham, Portsmouth, Hampshire, PO6 3JL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 9284 1155 Portsmouth City Council Miss Sara Helen James Care Home 32 Category(ies) of Dementia - over 65 years of age (32) registration, with number of places Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25/1/05 Brief Description of the Service: Edinburgh House is a Portsmouth City Council run home providing a service for older persons who have dementia. The home has the facilities to accomodate up to 32 residents providing long stay residential care as well as offering respite and short stay care. The service is in one building with the accomodation on 2 floors. Each floor has two units each with its own lounge/dining area and kitchenette. Service users bedrooms are within easy reach of each lounge, and there is a designated staff group for each unit. Edinburgh House is close to the shops and is on a bus route. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken over one day. Considering clients abilities the inspector spoke with seven service users, six staff members including the manager and duty/deputy manager. The clients were observed making full use of the facilities, taking their meals, and enjoying full use of the gardens. Letters in respect of the service were also viewed and questionnaire responses in respect of the meals provided. Staff were spoken with in pairs and individually and observed throughout the day providing support to the clients. Feedback from two relatives was also received and a tour of the premises undertaken. What the service does well: What has improved since the last inspection? What they could do better: The quality assurance process needs expanding to seek the views regarding all of the service provided and seek the views of the clients and their relatives in relation to care provision and environment. The process for assessing the need of the client group must be expanded to clearly identify the support for communication, behaviours and preferences. The opinions of care staff must be sought and the opportunity for regular meetings undertaken. Staff must be provided with the relevant induction to introduce them to the specific needs of the client group and this must be recorded. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 6 The home needs a specific ongoing plan for redecoration and refurbishment and concerns identified in the report addressed. Any complaints made in respect of the service must be recorded and the process undertaken to investigate and record outcomes documented. Terms and conditions of residency must demonstrate the fees to be paid and agreement of the client. 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. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 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 standard(s) 1,2,5, Clients and their relatives are not provided with up to date information. This is currently under review and the terms and conditions of residency do not demonstrate client agreement. EVIDENCE: Portsmouth City Council are currently updating and reviewing the home’s service user guide. The manager stated that homes statement of purpose will have client’s personal items and the inventories of items brought into the home included and both these documents will be reviewed at the next inspection. Both documents and other relevant information are kept accessible in the client’s rooms and in the communal areas. Relatives spoken with acknowledged information given to them in respect of the home. The terms and conditions of residency were not signed by the clients or their representatives and did not reflect the fees. Advocacy was not demonstrated. Relatives confirmed they were given the opportunity to visit the home prior to their relative making a decision to reside there. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 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 standard(s) 7,8,9,10, The home’s philosophy of care ensures that residents are treated with respect, that their dignity is preserved and that their choices are respected. Staff value resident’s privacy, dignity, choice, rights and independence. The mental health needs of the clients are not addressed in enough detail. EVIDENCE: Residents plans of care were being referred to by care staff and review of these documents identified they were generated from a comprehensive assessment. Four plans were reviewed and case tracked to the care being provided. These identified that further improvement is needed in the assessment and needs of the client for communication; mental health issues and descriptive intervention to meet identified individual needs. Plans did not describe adequate details relating to interventions for communication, memory loss, disorientation, change in personality and challenging behaviours. Nor did they adequately reflect the use of non-verbal techniques for effective communication. The plans did reflect good physical care needs with detailed interventions. Discussion with staff and observation of medication administration identified a flexible and considerate approach to administration. Medications are given consensually and the staff use innovative methods to seek compliance on an Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 10 individual basis. The staff do not use covert methods. Good record keeping was observed .The manager agreed to improve the identification process. Staff were observed seeking consent, offering choice and interacting with residents in a respectful manner. Residents spoken with described the staff as “always very polite, punctual and willing” and stated that “I do get quite good care”. One lady informed the inspector that” “we can do what we like, we are not dictated to or anything”. Sixteen cards sent from relatives to the home thanked the staff for their care and kindness and stated that they couldn’t have wished for better care and attention. One card thanked the staff for the understanding shown to their mother and another thanked them for “showing such kindness, he was treated with such kindness and respect”. Through out the day the residents were observed getting up when they wished, having breakfast throughout the morning as they preferred and getting dressed when they wanted. One resident was observed having his breakfast at 11.20am after he rose and taking it in his pyjamas and dressing gown at the dining table. One service user who became unwell during the inspection was supported, seen by the duty doctor and later admitted to hospital. Other residents were seen freely accessing all parts of the home safely and freely moving around the gardens. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 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 standard(s) 12,14 Service users choices and preferences are considered but these need to be recorded. EVIDENCE: The routines of daily living were observed through out the day and it was clearly evident that residents activities made available are flexible and varied to suit service users’ expectations, preferences and capacities. Staff were sympathetic to the noise levels, needs of the clients on an individual basis. Staff were also observed seeking the opinion of residents to having the television on and how loud it was and to providing reading materials. Residents were enjoying the gardens and making use of their private space to sit quietly. Relatives and visitors were also seen freely moving around the home and informed the inspector that they are able to bring in family pets. On the day of the visit the residents were observed enjoying the presence of the home’s cats and birds. Service users were observed having the opportunity to exercise their choice in relation to: • leisure and social activities. • food, meals and mealtimes; • routines of daily living; • personal and social relationships; Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 12 Activities participated in are recorded. The manager agreed to further improve the details of the preferences and capacities of residents Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 13 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 standard(s) 16 The home has a complaints procedure but there needs to be an audit trail and log of the complaints received. EVIDENCE: There is a complaints procedure accessible in the homes information documentation held in the resident’s room and communal areas. The manager said there is not a complaints log and agreed to address this. There is one complaint currently being addressed by Portsmouth City Council but the details are not held at the home. Relatives and service users spoken to stated they would report all complaints to the manager. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 14 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 standard(s) 19,20,23,24,26 There is need for a specific plan to address the internal and external refurbishment, redecoration and renewal of the home and service users needs /satisfaction regarding the environment must be sought. EVIDENCE: Since the last inspection some carpets and flooring have been replaced and some new furnishings purchased. There is a general five-year plan for the home but this does not indicate specifics in regards of continuing redecoration of wear and tear and replacement and renewal. Concerns regarding the homes environment were that, • The external grab rails need redecorating. • Service users rooms need redecoration. • Toilet/bathroom floors are in need of replacement • The staircase to the back of the home has wallpaper hanging off the ceiling and the floor is bare concrete. This area needs attention. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 15 • • One dining table is in need of replacement /adjustment as it wobbled considerably when lent on and could potentate spills/hazard. An area in the garden has recently been assessed by health and safety and requires work to make it safe. All the homes rooms are single and vary in size. A number of rooms are limited in size, which limits the furnishings in these rooms. The minimum standard of furnishings cannot be provided, as this will restrict the floor space. One resident stated he didn’t have adequate seating, as his only seating available was to sit on the commode. Resident’s rooms are personalised but the resident is limited to the amount of possessions due to the space provided. Residents described the home as clean and did not have concerns regarding the cleanliness. Discussion and a tour of the premises demonstrated that colour; layout and décor were sympathetic to the clients needs. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The staffing levels meet the residential forum recommendations but must be flexible in meeting the varying demands of this client group. Staff recruitment files are not held on the premises. Staff do receive appropriate training but the induction process needs further review. EVIDENCE: There are four units provided for which accommodate seven/eight residents. There is one member of staff to each unit. On the day of the visit the staff were observed meeting the demands of the service users in their care. One member of staff highlighted that in view of the unpredictability of the clients needs, concerns are raised when the unit member of staff is dealing with one resident /bathing or in private, the other service users are not supervised directly but staff of other units are requested to cover two units. The staffing levels meet residential forum guidelines but this does not consider the specialist needs of the client group. This will need further discussion. Staffs files are not held on the premises and Portsmouth city council are currently addressing this. Staff and records confirmed that service specific and necessary mandatory training is undertaken. Staff also confirmed a period of induction is undertaken and following discussion with the manager it was agreed that the records of the homes based induction would be expanded to ensure that staff are orientated to the specific client group and their associated needs whilst in their period of being shadowed. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 17 Staff were observed interacting with residents using appropriate techniques and during discussion it was very evident they were very knowledgeable to the needs of this client group. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,36,38 Portsmouth City is still holding client monies in holding accounts. The manager is proactive in seeking the opinions of clients and staff but this needs to be expanded. Staff are provided with appropriate training and supervision. Service checks are undertaken. EVIDENCE: The manager of the home holds the necessary management certificates. Quality assurance audit questionnaires have been undertaken in respect of meals but these need to be expanded to audit the other areas of service provided. 25 responses in respect of food services and quality were very positive. Records identify regular meetings are undertaken. Meetings held were for catering staff, managers, domestics and relatives. Care Staff said they would like more frequent meetings. Records indicate that these have been infrequent. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 19 The service is still holding client monies in city holding accounts. Portsmouth City Council is currently addressing this. Supervision records indicate this is undertaken regularly and staff confirmed this. Inspection tests and safety certificates were audited and are being undertaken appropriately. Over 50 of staff employed holds an NVQ 2 in care or equivalent. Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 x x 3 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 x 14 3 15 x COMPLAINTS AND PROTECTION 2 2 x x 2 2 x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 3 3 x 2 2 3 x 3 Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 21 no Are there any outstanding requirements from the last inspection? 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 2 Regulation 5(1)b Requirement Timescale for action 30.09.05 2. 7 15(1) 3. 33 24 4. 19 23(2)b Service users must be provided with a statement of terms and conditions which include the fees and which have been signed by them or their representative. Care plans must be developed to 30.09.05 include the mental health needs of the clients in relation to specific communication interventions ,behaviours ,preferences and therapies. The views of the service users 30.09.05 ,their representatives and visiting healthcare professionals must be sought in relation to the home and the service it provides. A plan of action must be 30.09.05 provided to address the homes programme for the redecoration and refurbishment of the home,internally and externally on an ongoing (monthly)basis.This programme must demonstrate that the redecoration refurbishment and renewel is undertaken and addresses the concerns identified in the report, continuously and not just in the long term plan. Version 1.30 Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Page 22 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. Refer to Standard Good Practice Recommendations Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 23 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Edinburgh House H55-H03 S44195 Edinburgh House V219810 070605.doc Version 1.30 Page 24 - 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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