Inspection on 16/09/05 for Eglantine Villa Residential & Nursing Home

This inspection was carried out on 16th September 2005.

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

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

Other inspections for this house

Eglantine Villa Residential &... 24/04/07

Eglantine Villa Residential &... 22/02/06

Eglantine Villa Residential &... 08/12/04

Eglantine Villa Residential &... 21/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Eglantine Villa Residential & Nursing Home Eglantine Lane Horton Kirby Dartford Kent DA4 9JL Lead Inspector Eamonn Kelly Announced 15/16 September 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. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Eglantine Villa Residential & Nursing Home Address Eglantine Lane Horton Kirby Dartford Kent DA4 9JL 01322 863019 01322 860552 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) BUPA Care Homes Limited Mrs Gerry Martin Care Home with Nursing 51 Category(ies) of Dementia Over 65 - (25) registration, with number Old age - (26) of places Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 14 of the 26 older people bedspaces are provided for people requiring nursing care. Date of last inspection 08 December 2004 Brief Description of the Service: The home, owned by Bupa Care Services Ltd., provides accommodation and personal care for people with residential and nursing needs and those with dementia. The main premises (Jasmine Lodge) has accommodation and other facilities on 3 floors (served by a shaft lift and stair lift). The other premises (Lavender Cottage, access to which is gained directly from Jasmine Lodge) is single storey and has its own bedrooms and communal facilities. Lavender Cottage offers 25 ensuite single rooms: Jasmine Lodge offers 22 ensuite single and 2 ensuite double rooms. The home has some 60 members of staff: a manager and administrative staff, registered nurses, care assistants/senior care assistants/team leaders/activities organisers, and catering/housekeeping/ staff. There are extensive grounds and gardens (including a sensory garden) surrounding the home and there are good car-parking facilities. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit comprised meeting with service users, members of staff and visitors. Some of the home’s records were inspected and a visit to most parts of both premises was made. Use was made in the report of information provided by the manager (matron) via pre-inspection questionnaires. The Commission received a number of completed questionnaires (outlining their views) from service users and their supporters. During the inspection visit, detailed comment about services at the home was received from a visiting physiotherapist and from a GP. What the service does well: What has improved since the last inspection? What they could do better: An on-going programme of quality assurance measures has led to the development of suitable procedures and policies (supported by the reEglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 6 development of the premises for the specific reason of caring for people with dementia) to enable good care to be provided for service users with varying degrees of care and accommodation requirements. The work underway for reviewing the service user’s guide, displaying a revised complaints/comments poster, development of procedures for assisting people with dementia and involvement of all members of staff in “personal best” initiatives are examples of this. In addition, revised procedures have been adopted with regard to the obtaining of CRB (criminal record bureau) checks and for disposal of unwanted medicines. 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. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 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 Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 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, 3, 4 & 6 Prospective service users and their supporters have the benefit of good preadmission written information and other support. EVIDENCE: There is a range of general BUPA information available to prospective service users and their supporters. A service user’s guide produced specifically for the home supports this information (the guide is currently being updated). This is an important quality assurance measure because the types or levels of care provision are complementary: service users could in practice move from residential care to nursing care or require care designed for those who develop dementia. There is a detailed assessment process to enable both parties (the prospective service user/supporter and the home) to determine if suitable care and accommodation can be provided. At this stage, a care plan record is begun for the purpose of identifying and recording the broad goals of care determined by assessed needs. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 9 There are suitable procedures in place for enabling prospective service users and supporters to visit and obtain various assurances and answers to enquiries before taking up residence. The home does not cater for people with shorter-term needs (ie. rehabilitation). It does however (if occupancy levels and initial assessment outcomes permit) admit people for short periods of respite care. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Service users care needs are identified and (with information about how these needs are met) recorded in care plan records. This information assists members of staff to know the particular needs and circumstances of individual service users. EVIDENCE: The care plan records seen in both units reflected the general dispositions of those service users to whom they referred. The records comprised a summary of care needs for the individual, biographical and other information, care needs and how these are met [partly expressed through allocation of scores and reassessed/compared regularly (eg. Barthel/Waterlow)] and a daily summary of progress. Care plan records included information about each service user’s health and social care requirements. A GP (who covers the whole home with support from the community matron) provided a good insight into how all service users receive medical support. He allowed part of the process to be observed. Service users, apart from having regular access to GP services and nursing supervision (via the home’s registered nurses), also have good access to other Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 11 health services (dentistry, chiropody, hearing clinic). A visiting occupational therapist (providing care each day in a privately funded capacity) also gave some insights into medical/paramedical services at the home. In the case of service users with hearing loss, the manager is reviewing how best to persuade them how to use and look after their hearing aids. The methods of working with service users with dementia have been closely determined by BUPA research and observation of results: the manager and GP outlined the benefits of what they described as low arousal approaches to meeting care needs. The outcome of such approaches by members of staff were observed in the cases of people with dementia causing lesser and greater degrees of mental confusion. The home’s training co-ordinator outlined how members of staff receive support and guidance in understanding how to work successfully with people who have dementia. A visiting Ellenor Foundation nurse, present to assess the palliative care needs of two patients, gave an outline of how she works with the home. In the cases under review, she recommended that the actions already underway should be continued. The inspection visit concentrated over 2 days primarily on meeting individuals (service users, staff and visitors), observing their needs and how these were being met and looking at essential records that directly supported these objectives. The issues associated with providing general and personal care were seen in some detail: personal care, meeting visitors and visiting medical staff in private, knowledge of preferred names, accommodation standards contributing to privacy, use of bathrooms/ensuites with assistance did not give rise to any cause for reflection. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Services users, whether they are receiving residential and/or nursing care or care for requirements caused by dementia, are helped and encouraged to retain a capacity for social activity and integration. Service users benefit because the home is able to take this wide variation in preferences and capacity into account. EVIDENCE: “Maps of Life” were seen in those instances where service user’s care plan records were checked. These maps showed a history of the service user’s previous work, preferences and lifestyle. The information assists members of staff understand the pattern of service user’s lives up to the point of entering residential care and informs aspects of their future lifestyles. Members of staff have received additional support in organising routines and providing leisure activities. Since the major re-organisation of the home earlier in 2005 there has been many themed events organised by staff. Organised events for the coming week are shown in a displayed calendar. The home has a hair salon and therapy room as well as quiet rooms/conservatory/lounges. In the grounds, a sensory garden/remembrance garden/vegetable garden are available. Service user’s supporters referred to the benefit (in Lavender Cottage) of a relaxed and generally peaceful atmosphere supported by music and the use of Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 13 pastoral colours. They referred to teamwork amongst staff in the organising of events for residents. Visitors visit at any reasonable time and many gave their views in person or via questionnaires returned to the CSCI. A number of written plaudits from families and friends were seen. Members of staff indicated that the arrival of a new chef in November 2004 “turned catering around”. The menu gives choice and flexibility and 3 meals availability of supper has met with approval from carers, service users and families. Some residents go longer than 12 hours as they go to bed earlier but their preferences and needs are individually assessed and agreed. The intake of food is observed and used as a partial measure of service user’s current health and disposition. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Service users and their supporters can be confident that their views are taken into account as part of the home’s quality assurance measures. EVIDENCE: As the current BUPA complaints procedure displayed in 2 places at the home is difficult to read easily, the information about the Commission is out of date and the number of individuals or organisations to whom service users or their families may refer their concerns to is confusing, the manager has prepared a simple complaints notice which shows only the name, address and telephone number of the local CSCI office. As well as being prominently displayed, this will be included as an appendix in the revised residents/patients guide. A small number of adverse comments about services were received by the home over the past year: these were checked and resolved through discussion with the persons involved. A significant number of plaudits were received by the home during the same period and copies of some of these were seen during the inspection visit. There was evidence that the home welcomes comments about the care they receive or about concerns relating to any aspects of procedures or premises. These are used as another method of reviewing the standard of services and facilities. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 15 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 & 26 Service users, members of staff and visitors have the benefit of suitable premises and surrounding gardens that meet the needs of patients and residents with diverse care and accommodation needs. EVIDENCE: All bedrooms have en-suite facilities. There are also communal bathrooms. Jasmine Lodge has 2 lifts servicing facilities on 3 floors. Lavender Cottage has ground floor accommodation that provides safe and special facilities for people with dementia. The home was previously assessed by a qualified occupational therapist. There are suitable offices (and work stations) for management, administrative staff, team leaders and staff nurses. Bedrooms seen were well furnished. Communal areas likewise were comfortable for service users and visitors. Radiators have been guarded or have low surface temperatures. Water temperature regulators have been fitted to reduce the risk of scalding. Particular measures have been taken to deduce risks of infection (eg. washing Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 16 procedures for clothes and sheets, specially designed cleaning trolley, hand washing, restrictions on entry to kitchen). Specialist equipment is available depending of the needs of service users (eg. profiling beds, special mattresses, hoists, bath hoists, special baths, medical equipment). The home was redesigned earlier in the year to further enable the care of people with differing levels of care and accommodation requirements. The external parts of the premises also offer opportunities for relaxation and activities. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 17 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 and 30 The requirements of service users are met through the provision of different types of skilled and trained members of staff. EVIDENCE: There are 64 people employed by the home: manager and administrative staff, nurses, team leaders and care assistants, activities organisers, catering and housekeeping staff, and maintenance staff. 63 of care assistants have achieved NVQ Level 3 in Care. There are 3 care team leaders. There are 4 senior care assistants all of whom have either achieved or are undertaking NVQ Level 3. The senior sister who leads the clinical team is an enrolled nurse who has met all the required competencies for this role. 84 of the housekeeping team have achieved NVQ Level 1 in Cleaning & Support Services. The training co-ordinator (21 hours per week is allocated to this activity) carries out supervised practice for nurses and care assistants. The examples seen indicated that each member of staff under this scheme undergo an assessment (described and recorded) in some 22 activities with nurses required to demonstrate competence in a further set of 7 activities. In addition, the training co-ordinator either provides direct training in a number of core training topics or arranges the training (eg. via input from 3 members of staff with trainer qualifications in safe lifting/use of hoists for frail people). Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 18 The staffing roster indicated that the following members of care staff are on duty: Jasmine Lodge Morning 5 (08.00am-02.00pm) Afternoon 4 (02.00pm-08.00pm) Night 3 (08.00pm-08.00am) (inc. RGN) (inc. RGN) (inc. RGN) Lavender Cottage Morning 4 (08.00am-02.00pm) Afternoon 4 (02.00pm-08.00pm) Night 2 (08.00pm-08.00am) (inc. care team leader) (inc. care team leader) (inc. care team leader) Where difficulties in meeting assigned staffing rotas (eg. because of staff illness or individuals failing to report for duty) occur, recourse to agency staff is made. The general reports by senior members of staff relating to agency staff are that they are increasingly reliable and well trained (and examples were provided where agency staff who were familiar with procedures and standards and recognised as particularly competent were requested to return). Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 19 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, 33 & 38 Service users, their visitors and members of staff benefit from a well managed home where service user’s personal interests, health and safety are safeguarded. EVIDENCE: The management structure comprises the manager (1st level nurse and registered managers award), 1st level nurses and enrolled nurse, team leaders and senior care assistants. The manager has completed “Introduction to Quality Dementia Care” [a BUPA programme (developed with the University of Sunderland, The Joseph Rowntree Foundation and Alzheimer’s Society) for senior members of staff in supervising care for people with dementia]. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 20 BUPA home managers have support from the wider organisation (eg HR, legal, quality assurance, finance, maintenance). A BUPA service manager carries out detailed performance reviews every 1-2 months. This includes an evaluation of how procedures continue to meet corporate operational requirements. The summarised results are sent to the Commission at regular intervals. There are a number of self-audits (eg. effectiveness of bedsides, dealing with behavioural difficulties, quality assurance outcomes, maintenance standards) carried out by the manager. The pre-inspection questionnaire listed the maintenance checks carried out and all certificates and records checked during the inspection visit were up-to-date. The focus of this inspection visit was on meeting service users and their visitors and assessing how their care needs were being met. There was no doubt that the re-positioning of facilities over the past year and provision of services for people needing residential and nursing care and those with dementia has resulted in procedures that have the interests of service users as paramount. Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 21 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 3 x 3 3 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x x x x 3 Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 22 Yes 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 Regulation Requirement Timescale for action 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 Eglantine Villa Residential & Nursing Home H56-H06 S26161 Eglantine V242394 150905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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. 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