Inspection on 13/07/06 for Estherene House

This inspection was carried out on 13th July 2006.

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

Estherene House 04/07/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Estherene House 35 Kirkley Park Road Lowestoft Suffolk NR33 0LQ Lead Inspector Mike Usher Key Unannounced Inspection 13th July 2006 10:00 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 Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 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. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Estherene House Address 35 Kirkley Park Road Lowestoft Suffolk NR33 0LQ 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) 01502 572805 01502 580444 Estherene House Limited Mrs Yvonne Barbara Titterington Care Home 21 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (21) of places Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Estherene House is a privately owned care home providing personal care and accommodation to a maximum of 21 older people, situated in a residential area of Lowestoft, near to shops and other amenities. It is a three storey converted domestic dwelling, set in it’s own grounds with a garden at the rear and car parking to the front. Service users are accommodated on the ground and first floors of the building. There are eight single (one with en suite facilities) and six double bedrooms. There is a chair lift linking the two floors used by residents. Bathrooms and WC’s have been adapted to assist people with mobility problems. The home provides a comfortable and caring environment for older people, and benefits from being a small scale, family-run establishment, with the owners on site on a daily basis. This helps to make it very popular with the service users. The owners recently formed a limited company to take over the running of the home. Whilst the building has much character, the facilities are somewhat dated, and in need of refurbishment. The owners are aware of this, and there are plans for a new extension, which will include a refurbishment of the existing facilities, including the provision of a passenger lift. The home’s fees range from £331 - £385. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first Key Inspection of the service following the recent developments in the regulation of care services. It focused on the key National Minimum Standards identified by the Commission, previous requirements and recommendations, and the management of the home. The inspection used observation, discussion with the manager, staff, and service users, and examination of records and other documentation to evaluate the current standard of service provided. In addition, a number of survey forms were distributed to service users and their relatives, and the results have been included in the various sections of this report. Although the inspection was unannounced, the manager, Mrs Titterington, was able to assist throughout the visit. The home achieved a very high degree of compliance with the National Minimum Standards, with 30 standards deemed fully met, and minor shortfalls on only 3 others. What the service does well: What has improved since the last inspection? Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 6 As detailed above, a new company has been created and registered as the owner of the home. The most significant development has been the approval of plans for the extension to the rear of the home, which will create a specialist care unit for people with dementia. Some preliminary work has started on the foundations. Improvements continue to be made to the existing service, with the installation of a new call bell system, and further refurbishment and redecoration of bedrooms and communal areas. 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. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5,6 Quality in this outcome area is adequate. Service users are suitably assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Manager of the home undertakes a full assessment of each individual’s needs. In some instances this is preceded by a professional health or social care assessment from a hospital or local social care services. The home’s assessment includes an initial assessment through the first 48 hours, then a more comprehensive assessment including manual handling and health and safety risk assessments, and further personal information. Residents and relatives consulted during the inspection confirmed that they had been able to visit the home prior to admission and consider the service to be offered. One relative described how they had compared the home with several others locally after initially agreeing for their relative to enter another home. On hearing that a vacancy had arisen at Estherene House they cancelled the previous arrangement in order that they could move their relative into the home, which was their first choice. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Service users’ health and personal care needs are well met, in a friendly and efficient manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans contain all essential information, laid out in a simple and easy-touse format. Appropriate assessments are in place and daily records were informative about the care provided. The home has introduced the use of yellow information sheets about each resident, which can be removed and sent with them if they are admitted to hospital. Records evidenced a good level of contact with health professionals, with residents able to access their GP easily, and Community Nurses visiting where required, and which was confirmed in discussion with residents. An examination of the arrangements for the storage and administration of medications confirmed that this continues to be carried out satisfactorily. Records were neat, accurate, and well laid out. A Monitored Dosage System is used, with the majority of tablets being issued by the supplying pharmacist in blister packs for ease of administration. Storage is suitably secure. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 10 All the residents and relatives consulted during the inspection process were satisfied with the care provided by staff, and felt that they were sensitive to their needs, behaving in a manner which was polite and respectful, whilst remaining warm, friendly and supportive. Residents’ choice to spend time on their own, or join others in communal areas was respected. This was confirmed by observation during the inspection, with staff demonstrating a good knowledge of individuals’ needs and assisting residents in a sensitive and respectful manner. There was a good deal of friendly banter between staff and residents, and between the carers, who maintained a friendly and effective communication at all times. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. Routines are relaxed and meet the individual needs and preferences of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A schedule of activities is displayed in a number of places, and indicates that an organised activity takes place on most afternoons. Residents spoken with during the inspection described various entertainments and activities that are put on from time-to-time, and said that they were encouraged to take part. A number of residents prefer to remain largely in their rooms, and the daily life of the home is relaxed, enabling them to make choices without any pressure, as to how they would like to spend their days. There is a constant stream of visitors to the home, and those spoken with commented on how welcomed they feel, and how relaxed and friendly the atmosphere in the home is. The relaxed routines extend to all aspects of the home’s daily life – with residents able to rise and retire as they please. Meal times were popular, with the majority of those spoken with describing the food provided in glowing terms –“home-cooked”, “tasty”, “in good portions”, “varied, and with a good choice”, and catering for special diets. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 12 On the day of the inspection there was a board outside the sitting room displaying the lunchtime menu, and the weekly menus were displayed on the notice board in the kitchen. Staff were observed to spend time with residents, sitting and chatting, providing a manicure, commenting on TV programmes or newspaper stories. When providing assistance, staff were patient, and took care to support residents making choices and expressing themselves. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 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 the following standard(s): 16,18 Quality in this outcome area is adequate. The home is run in a manner, which promotes the well-being and safety of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken with during the inspection were confident that any complaints they may have would be addressed and resolved to their satisfaction. They were appreciative of the attention and support provided by Mrs Titterington, and felt able to discuss anything with her, and the other staff. They all agreed that they felt safe and secure living in the home, and this contributed to the very high level of satisfaction they felt with the service provided. The home has a suitable complaints procedure that is displayed, and a proper record is kept of any significant complaints (none since the last inspection). Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 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 the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. The home is comfortable and homely, and well maintained. Accommodation is to a good standard, though lacking a shaft lift, and with some areas (specifically bathrooms and WC’s) in need of further improvement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection, the home was clean, tidy and in good order throughout. There was little evidence of wear and tear, and the building was being well maintained. There was no odour, and standards of hygiene were generally good. There have been no significant developments since the last inspection, apart from a new call bell system that has been installed, that can be monitored from the manager’s computer, and links into pressure mats that can be placed in specific areas (such as bedrooms) to alert staff to movement indicating that residents may require assistance (for instance during the night). Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 15 Many doors in bedrooms and communal areas have been fitted with special restraining devices to enable them to be held open for convenience, but that release automatically if the fire alarm is activated. The lounge is spacious and comfortable, with 2 TV’s to enable all residents to be able to watch, and a new fish tank recently installed. The dining room tables were nicely laid out with linen tablecloths and napkins, condiments and flowers. Elsewhere, a programme of redecoration and refurbishment of bedrooms and communal areas continues. A number of bedrooms were viewed. These were nicely personalised with residents’ own furniture, pictures, photographs, and ornaments. Residents spoken with during the inspection were satisfied with their rooms, finding them comfortable and homely, and felt that the accommodation met their needs appropriately. Final plans for the new extension to the rear of the property have now been approved by local planners and work was about to start on the foundations. Mr and Mrs Titterington anticipate that the work to build the extension will take about 12 months, and agreed to supply a copy of the most recent plans to the Commission for advice. Mrs Titterington confirmed that an independent Occupational Therapist had been employed to advise them on the plans and this resulted in a number of changes being made to the original plans. It is intended that improvements to the bathrooms and WC’s will be carried out as part of the refurbishment associated with the building of the new extension, which will include the provision of a shaft lift. In the meantime, the current standard is deemed adequate. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 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 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 Quality in this outcome area is good. There are adequate staff on duty, who are well trained and competent, and provide a friendly and personal service. Recruitment and training procedures are satisfactory. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection there were 3 care staff on duty, supported by Mr and Mrs Titterington, and ancillary staff (3 cleaners, and a Cook). This is the usual level of care staff, and was confirmed by examination of the staffing rotas. A number of staff files were inspected, confirming that the home’s recruitment procedures were operating satisfactorily, with all the required checks being undertaken on new staff. Files were well kept with clear records and documentation. Staff are given a local induction to the home, and then attend the induction training course for care staff run by Suffolk County Council. Further training is provided, including refresher training for subjects such as Fire Safety and Food Hygiene. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 17 Staff spoken with during the inspection felt that they were adequately trained to carry out their duties, and residents and relatives consulted agreed. Staff observed during the inspection were friendly and helpful towards service users, taking their time to assist residents without rushing them, and responding appropriately to their needs. Where two carers were required, they were attentive to residents’ needs, explaining to them what they were doing, and giving appropriate guidance and instruction. Carers were knowledgeable about residents, being able to describe their care needs, and having strategies for coping with problematic behaviour (e.g. where one resident tended to roam around at night time). These approaches gave due weight to maintaining residents’ dignity. Staff were well turned out, and used disposable aprons and gloves when necessary, and were observed to cleanse their hands frequently. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 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 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): 31,32,33,35,36,37,38 Quality in this outcome area is good. The home is well run, and focuses on the needs and preferences of the service users. Policies, procedures and records are kept in good order. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mrs Titterington has managed the home for many years, and is an experienced and capable manager, supported by her husband, a fellow director of the company, who is also closely involved in the day-to-day running of the home. She is currently undertaking the NVQ level 4 Care Manager’s Award. The home continues to be run as a family business, ensuring that the atmosphere is friendly and informal. Residents and relatives consulted during the inspection were appreciative of the close personal involvement of the owners, and described them as approachable, and interested in their welfare. They felt confident that the home was run for their benefit. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 19 The home obviously benefits from the close personal supervision of Mr and Mrs Titterington, who discuss the care provided to service users with them on a daily basis. Residents consulted commented on this fact, and how responsive (and therefore personal) the service was as a result. Minutes of a meeting with service users were displayed in the kitchen with advice for different staff shifts on where aspects of the service needed improving, and the action to be taken to achieve this. The home’s records that were examined during the inspection were in good order. This includes a record of all money handled on residents’ behalf by the home, a valid certificate of insurance, staff rotas and training records, and menus. A schedule of staff supervision sessions was displayed, and individual supervision records were kept on file. Mrs Titterington has agreed with the local fire service for them to visit the home in the near future to advise on fire safety within the home, and in other respects, the home is well managed to ensure the safety and well being of service users. Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP19 OP21 OP22 Regulation 23 Requirement The poor state of some areas of the home must be addressed as part of the planned refurbishment. This requirement is carried forward from the previous inspection. Timescale for action 01/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Estherene House DS0000065125.V302154.R01.S.doc Version 5.2 Page 23 - 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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