Random inspection report
Care homes for older people
Name: Address: Halsey House 31 Norwich Road Cromer Norfolk NR27 0BA two star good service 02/03/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Craig Date: 2 0 0 8 2 0 0 9 Information about the care home
Name of care home: Address: Halsey House 31 Norwich Road Cromer Norfolk NR27 0BA 01263512178 01263513630 smills@britishlegion.org.uk www.britishlegion.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Royal British Legion care home 74 Number of places (if applicable): Under 65 Over 65 74 0 old age, not falling within any other category physical disability Conditions of registration: Date of last inspection Brief description of the care home 0 1 0 2 0 3 2 0 0 9 The Royal British Legion is the leading charity safeguarding the welfare of those who have served in the Armed Forces, and their dependants. A major part of its work is to provide short and long term care for ex Service men and women and their dependents. Halsey House is one of the Legions seven nursing/residential care homes. Previously a school, the Home was opened by the Legion after the Second World War and now accommodates 74 people. It is set in delightful gardens and is a short walk from the centre of Cromer on the North Norfolk Coast. Halsey House comprises of an original house that has recently been refurbished, and a large extension. Most of the rooms are en suite and all rooms have access to a wide range of bathrooms and toilets. Lifting equipment is available when needed. The service caters for people who have nursing
Care Homes for Older People Page 2 of 8 Brief description of the care home needs as well as those requiring personal care. There is 24 hour qualified nursing care, supported by the local medical practice. A licensed bar with pool table is enjoyed by people using the service and their guests, there is also a private chapel that is used for Sunday Services or for quiet contemplation. At the time of this key inspection the home was undergoing building work to enhance the accommodation. Information is sent out to anyone making enquiries about admission. The latest inspection report is available from the manager. At March 2009 the fees ranged from 420 to 660 pounds per week. Extras were charged for toiletries, hairdressing and private newspapers. Care Homes for Older People Page 3 of 8 What we found:
We carried out this random inspection after concerns were raised about staff practice in regard to an incident involving a particular resident. We also looked at staffing levels, staff recruitment and management of incidents. The incident involving the resident had been fully investigated by the manager and a full report was sent to the Care Quality Commission. During our visit we looked at records and spoke to staff. We concluded that the managers actions following the incident were appropriate and her investigation had been thorough. We were provided with a report of the incident by the staff involved. However, during the visit we found there was a lack of nighttime progress reports, which meant there was no record of the residents nightly routines and care provided. The manager told us that there was an expectation that staff would make an entry on each shift. Records showed that the manager responded to complaints and other incidents appropriately. With the exception of staffing levels, most staff told us there were no problems with the way management handled incidents in the home. A member of staff said they would be confident that if they went to the manager with any worries they would be sorted out. Another said the managers in the home were open and honest. We looked at a random sample of four staff files. All had been recruited in the past five months. All the required pre-employment checks, including references and Criminal Records Bureau disclosures, had been obtained before the staff started work at the home. The staffing rosters we received showed consistent levels of staff were planned and most unexpected absences were covered. The manager told us the number of care staff was calculated on the numbers and dependency levels of residents. However, we talked to seven staff who told us that there were not always enough staff for the amount of care the residents needed. On Danbury unit there were 18 residents and two staff on duty. The manager told us that a high proportion of the residents did not need physical assistance from staff. Staff told us that sometimes two staff was not enough to supervise and assist residents. For example, one resident always needed care from two staff and another resident, who was very anxious and needed reassurance, took up a large proportion of staff time. Staff told us that some of the other residents became anxious because of the shouting and then also needed reassurance from staff. Staff from the other unit said they were able to provide the basic care and residents were not suffering. However, they all mentioned specific times when they felt there were not enough staff, which had an impact on residents. The common themes were: Mealtimes, when staff said there were too few staff to serve meals and assist people to eat which resulted in residents having to wait. Mornings and evenings, when staff were assisting people to get dressed and undressed. A number of staff said that because there were not enough staff to answer call bells at those times, residents became frustrated at having to wait. One member of staff said that they felt they were having to rush when giving personal care. Most staff said they felt they did not have enough time to spend with residents to meet their social care needs. One told us that they felt residents who were cared for in bed did not receive enough mental stimulation because of lack of staff time. Staff told us that morale was very low and there were high levels of sickness, which they
Care Homes for Older People Page 4 of 8 attributed to staff shortages. The manager told us they would review staffing levels again to ensure that there were sufficient staff. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 8 13 There must be risk assessments in place to support the use of bed rails. The assessments must be kept under review. In order to ensure that bed rails are appropriate and safe. 31/03/2009 2 9 13 There must be complete records of all medication administered to residents. To ensure that residents receive their medication as it is prescribed and to continue the audit trail. 31/03/2009 3 9 13 People who administer their own medication must have risk assessments in place. The assessments must be kept under review. To protect the health and safety of residents who administer their own medicines. 31/03/2009 Care Homes for Older People Page 6 of 8 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 27 18 The staffing levels in the 30/09/2009 home must be reviewed to ensure that there are sufficient staff on duty at all times of the day and night to meet the needs of the people using the service. This is to ensure the health, safety and welfare of people using the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 7 There should be a nightly record of care provided to residents and any unusual or untoward occurrences. Care Homes for Older People Page 7 of 8 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
