Inspection on 16/05/06 for Eventide Residential Home

This inspection was carried out on 16th May 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

Eventide Residential Home 22/01/09

Eventide Residential Home 23/01/08

Eventide Residential Home 18/10/05

Eventide Residential Home 11/05/05

Eventide Residential Home 17/01/05

Eventide Residential Home 02/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Eventide Residential Home 22 Downs View Bude Cornwall EX23 8RQ Lead Inspector Philippa Cutting Key Unannounced Inspection 16th May 2006 09:45 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 Eventide Residential Home DS0000009173.V293613.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. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eventide Residential Home Address 22 Downs View Bude Cornwall EX23 8RQ 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) 01288 352602 Bude-Stratton Aged Peoples Welfare Society Limited Mrs Ann Georgina Cousins Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Eventide is an older property offering care and accommodation to 18 older people. It is run by a committee of local people in conjunction with the registered manager. The home is near the beach and overlooks the golf course at the front. Accommodation is provided on three floors connected by a shaft lift, although a few rooms on the first and second floor have two additional steps to reach them. Nine rooms are en suite. There are handrails and a variety of pieces of equipment to aid independence throughout the home. There is an assisted bath on the ground floor and a large shower on the first floor. Externally seating is provided in front of the home. This is a popular venue where residents sit in good weather and watch people, holiday makers and golfers passing by. There is also a small paved rear garden for peoples use. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Eventide is a small home that offers a homely environment to service users. Those with whom the inspector spoke said that this was one of the main reasons that they had chosen the home, plus they had heard good reports of its reputation locally. The Committee who assist in the home’s management visit regularly and have made a concerted effort in recent years to upgrade the facilities in the home so that rooms now present well with en suite provisions in as many rooms as possible. The service users were satisfied with their diet, indicating that they had choice and variety. As with many care homes, Eventide has found that the people who are seeking accommodation are now more dependent than those who did so 10 years ago. Nevertheless Eventide continues to attract people who enjoy a reasonable level of independence and are enabled to exercise this. What the service does well: What has improved since the last inspection? What they could do better: Record keeping in relation to care plans and reviews of service users’ needs has not been kept up to date and does not reflect the level of care that service users receive. Similarly staff supervision is not being recorded and must therefore be presumed not to have taken place. Time management for the Registered Manager and senior staff may have to be reviewed to enable these important aspects of care to be resumed and Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 6 continue properly. The home is warned that failure to address the care plans & record keeping could affect the home’s rating. 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. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 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 Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 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): 1,3,4,5 The home provides information to interested parties and visits prospective service users to assess their needs prior to offering accommodation. EVIDENCE: The family of a new permanent service user said they had received sufficient information prior to their relative’s admission to enable them to make a decision about accepting a room, having looked at other establishments. They had made the choice on their relative’s behalf due to her fraility. They had kept the statement of purpose etc. as they felt they were more likely to refer to it than she would be. A statement of purpose and information about Eventide is given to everyone who makes an enquiry. Service users told the inspector that either they had chosen Eventide as they wished to remain in their familiar community or a son or daughter had selected the home because it was near them. The inspector was told that the registered manager visited prospective service users to assess their needs and Eventide’s ability to meet these prior to Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 9 admission. In view of the delays that service users awaiting funding by the local authority are experiencing, the registered manager is advised that it would be prudent to check that a person’s needs remain as they were when first assessed, once funding has been arranged The day before the inspection the home had accepted a service user for urgent admission under the RAS scheme, with information being provided by the community nurse. Further information was being sought on the person to complete records. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,10,11 The care that was seen to be provided by the home is good and service users say that they are satisfied and it meets their needs but the documentation & recording is not up to date to support this. There are elements of the home’s medication procedures that need to be reviewed. EVIDENCE: There is a care plan for each service user, most of which had been completed, but not all details for all service users had been. Following comments made about recording at the last inspection in October 2005 the registered manager produced a new care plan format which the Commission agreed would give a clearer picture of each person’s care needs. On this occasion there was no evidence that these have been introduced uniformly for all service users. Consequently there is a mixture of recording. This needs to be sorted out and an agreed format introduced and maintained. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 11 Observation, discussion and people’s comments (from service users, relatives & staff) indicated that the care was good and people were satisfied with the help they received but as before, this is not properly reflected in the records. Reviews of service users’ care have lapsed. Service users receive support from their GPs and other ancillary medical professions as required. This includes advice from a Community Psychiatric Nurse if necessary. The process and procedures for administering medication was generally satisfactory with medication being supplied in a Nomad pack by the pharmacist. There are some improvements that should be considered. Medication administration record sheets are produced by the home. They would benefit from a code to indicate the reason if a medication has not been given. For instance the current sheets do not indicate if a person is in hospital, or had refused a tablet or if it was not given for some other reason. Best practice includes the person administering a medication and signing for it immediately as it is given, rather than en masse at the end of a round or, worse, later in the day. Two white unnamed tablets were found in a medication pot in a cupboard in the kitchen This should not occur. Any unused or unwanted medication is recorded prior to being returned to the pharmacist. Staff need to ensure that creams are included in an audit as an out of date one was found. It would also be prudent to count & record the number of tablets etc a person brings in with them if coming for a respite stay so that the correct amount can be verified returned when they leave. One person was seen to have three proprietary medications in her room. There was no indication in her care plan about these. This person was also receiving a dietary supplement, which had been prescribed, but again there was no record of the reason for this in her notes nor any guidance about when it should be given. The list of service users’ who self medicate was out of date. It needs to be revised with evidence of the home’s assessment of a service user’s ability to perform this task properly, provided. There were no controlled drugs in the home at the home of this inspection but there are adequate storage facilities if needed. Service users reported that they were treated with respect by staff when receiving personal care. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 12 The home cares for service users until their life’s end, whenever possible, with support from medical services etc. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users are encouraged to remain independent and keep in touch with their families and the local community but for some this is more difficult and the home may wish to review the amount of stimulation provided in house. EVIDENCE: The routines in the home are flexible and can accommodate most people’s preferences and idiosyncrasies, which was appreciated by the service users and relatives. People are encouraged to attend churches/clubs etc as they wish and go out with families and friends but it is noticeable that people coming to Eventide in recent times are frailer than in the past and not so many are able to exercise this level of independence. It was good to see that people were using the sitting room or sitting together in chosen groups either knitting, reading or watching the television. The level of activity organised within the home for service users needs to be kept under review to reflect the needs and wishes of the service users. At present, the inspector gained the impression that there is a bingo session or exercise class every two weeks alternately but that staff did not have a lot of time to spend with service users apart from when they were attending to personal care needs. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 14 It was noted that one person was expressing a wish to go out but staff knew that this person needed to be carefully observed to make sure she did not wander outside alone. This needs a thorough recorded risk assessment to ensure her safety and show how her need is met. It may be necessary to involve family members in any decisions that are made. Service users said that the food was good; they were offered a choice and had variety in sufficient quantities. Any special dietary requirements are noted. Meals can be served in the dining room or in a person’s own room, according to personal preference. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Eventide is aware of its responsibilities towards the protection of vulnerable adults and takes this seriously. EVIDENCE: The home has not received any complaints since the last inspection. The complaints process is displayed on the home’s notice board. When asked, staff were aware of PoVA and its implications. The home prefers not to handle service users’ benefits etc. It still performs this task for two people who have been resident for a long time and do not have other people to assist them but it does not wish to be appointee for any new service users. A recommendation that a family member, trusted friend or solicitor should undertake this is usually made. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Service users’ rooms reflect their preferences with personal mementoes etc. They are well presented with beds that service users said were comfortable. Adequate furniture and cupboard space is provided. The communal space was seen to be clean, warm & tidy and being used by people when they wished. The presentation of the bathroom and shower room could be improved; a dual function as storage, albeit limited, does not create a homely atmosphere. EVIDENCE: The Committee employs people to ensure that the home is maintained properly with maintenance and routine repairs undertaken swiftly. There are limitations within the home due to its layout but bedrooms have been upgraded as far as possible with en suite facilities being installed where possible. A through floor lift provides access to the first and second floors as well as stair access. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 17 People are encouraged to bring pieces of their own furniture in with them if they wish. A tour of the premises was made. Rooms are decorated when vacant and new carpets laid when needed. The inspector was told that the home has its own carpet-shampooing machine. One room was noted to be in need of treatment but the occupant had been unwell the previous day and was still recovering so marks were going to be attended to once she was better. The dining room floor also needed attention to remove a large stain under a table. The bathroom and shower room need to be looked at objectively as, at the time of this inspection, they were also being used for storage purposes that did not enhance the overall impression. A large sink and the notice regarding its purpose in the ground floor bathroom did little to create a homely environment. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Eventide provides a staff team who all appeared to enjoy their work and were liked by the service users. The encouragement given to staff to undertake training and improve their knowledge and skills has resulted in a workforce that is stable. This in turn provides continuity for the service users. EVIDENCE: A selection of five staff records was sampled. These were satisfactory and indicated that a sound recruitment process is followed with statutory checks on staff being undertaken. Staff had been given employment contracts and training is encouraged. It was gratifying to see that the home attracts and retains staff thus providing continuity for service users. The home will need to provide evidence that it is implementing the new induction process for new staff – ‘Skills for life’ which has replaced the TOPSS scheme. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 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 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): 31,32,33,35,36,7,38 The home is managed by an experienced, qualified person with support from the Committee. The well being of the service users underpins the home’s philosophies. EVIDENCE: The Registered Manager was absent at the time of this inspection but the Deputy Manager was in charge. The Registered Manager has gained her Registered Manager’s Award and is experienced, having worked with older people for a number of years. The Committee are closely involved with the management of Eventide and the registered manager discusses the home’s progress with them at their regular meetings. The Committee and Registered Manager need to note the increased emphasis that is being placed on quality assurance and monitoring and ensure that they have a robust system in place for the future. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 20 All staff have had supervision files set up and this was instituted on a regular basis. On inspection however the supervision recording has stopped and there have been no entries since Septembers 2005. Coupled with the deficits in the care plan recording this indicates that the Registered Manager’s time needs to be adjusted to enable her to either have more time for administrative tasks or to delegate some of her responsibilities to other senior staff. Staff said they were up to date with their moving & handling training and that they had had occasion to use this knowledge with a service user recently. First Aid is in hand. Fire records were current apart from the last week’s test that had not been recorded. Any accidents are entered in a book compliant with the Data Protection Act. Reports that accord with the requirements of Regulation 26 are received from Committee members. Committee members have different responsibilities within the home and their reports reflect this. Health & safety is reviewed. It was noted that not all radiators have had covers fitted yet and hot water outlets had warning notices alerting users to the fact that the water could get very hot when run, which the inspector found to be true. Advice from the Environmental Health Officer is that the temperature of hot water should be controlled by thermostatic valves on showers or baths where the water temperature is 43°/46°C. Whilst this does not apply to taps on wash hand basins the risk, especially where there are very vulnerable people in the home, needs to be kept under review with a risk assessment made and updated. Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 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 3 18 3 3 3 2 3 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 2 3 3 Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 12 Requirement The registered manager must prepare clear care plans for all service users which are comprehensive, clear and reviewed monthly. The previous time scale for action was 02/01/06 This requirement is repeated, as the format needs to be consistent for all service users. Risk assessments must be included where a need is indicated. The medication policy must be reviewed to ensure that the records indicate: - if and why a medication is not taken, - the list of those who self administer is kept up to date - a fuller record of medication brought in by people having respite care is kept. Staff supervision must be restarted & recorded. Timescale for action 14/07/06 2 OP9 17(1)(a) Schedule 3 14/07/06 3 OP36 18(2) 14/07/06 Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 23 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 OP3 Good Practice Recommendations The registered manager is advised to check that where a prospective service user’s admission is delayed for a considerable time, for what ever reason, the home should check that his or her needs remain compatible with the care offered by the home. The home should ensure that it has information about the new induction process. 2. OP29 Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Eventide Residential Home DS0000009173.V293613.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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