Inspection on 04/10/05 for Havelock House

This inspection was carried out on 4th October 2005.

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

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

Other inspections for this house

Havelock House 01/09/09

Havelock House 18/12/08

Havelock House 17/01/08

Havelock House 26/04/07

Havelock House 03/05/06

Havelock House 19/04/05

Havelock House 21/12/04

Havelock House 06/07/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Havelock House 57 - 59 Victoria Road Polegate East Sussex BN26 6BY Lead Inspector Kathy Flynn Announced Inspection 4th October 2005 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 Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Havelock House Address 57 - 59 Victoria Road Polegate East Sussex BN26 6BY 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) 01323-482291 01323-484183 Mr Bhardwaj Dhunnoo Mrs Tarramattee Dhunnnoo Care Home 27 Category(ies) of Old age, not falling within any other category registration, with number (27) of places Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is twenty seven (27). The service can provide up to twenty-six (26) nursing place and one (1) social care place. Service users must be aged sixty-five (65) years of age or over on admission. 19th April 2005 Date of last inspection Brief Description of the Service: Havelock House is registered to provide nursing care for up to 26 older people and personal support for one. Situated in a residential area of Polegate, it is within walking distance of the high street and the railway station, with a library, GP and dentist surgeries easily accessible. The home is on two floors with a shaft lift and stair lift giving residents access to all parts of the home. There are 21 single rooms, 3 double rooms with no en suite facilities, although there are two assisted bathrooms, an assisted shower and a number of assisted toilets. There is a large lounge, looking out to the rear garden that is accessible to wheelchairs and is used when weather permits, and a separate dining room. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the home was informed of the date and the time of the inspection several weeks before it was carried out. The requirements from the previous inspection, the monitoring visits, the information provided in the pre-inspection questionnaire completed by the manager, and the comment cards completed by the residents or their representatives, were used to plan this inspection. The aims were to assess if the home had met the requirements, identify the aspects of the service that have improved and if the service could be improved for the benefit of the residents. The inspection was carried out over eight hours and included a tour of the building, an examination of care plans, staff records and training, administration charts, policies and procedures, including the statement of purpose and service users guide. All the residents were encouraged to discuss the care provided at the home, three relatives, two friends, the registered provider, the acting manager, the staff on duty, the chef and the maintenance man were happy to discuss the services provided at Havelock House. There were no organised social activities at the home during the inspection although staff were spending time with residents during the inspection and there were opportunities to sit in the lounge with staff, residents and visitors to observe the support provided. The acting manager has been in place since August and during this time a number of registered nurses have left the home and their posts have been filled with new staff. The manager advised that admissions to the home would be restricted until staffing levels are appropriate to meet the assessed needs of residents. What the service does well: The home encourages residents to make choices about how they spend their time, with some choosing to remain in their rooms to watch TV or enjoy some quiet time on their own or with visitors. Residents and relatives were positive about the care and support provided, those who expressed an opinion said they felt that the staff were supportive and understood their preferences and choices. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 6 Staff were equally positive and said that with the reduced number of residents they have more time to spend with them and there is a much more relaxed atmosphere in the home. There are ongoing issues concerning the opinions of different members of families about the care provided, the acting manager and the staff are trying to deal with these at the home when they arise. What has improved since the last inspection? 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. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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 Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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, 2, 3 and 4. Standard 6 is not applicable. The statement of purpose and service users guide is inadequate, it does not provide correct, up to date information for prospective residents and their representatives to be clear about the services provided and how the home will meet their needs. EVIDENCE: The statement of purpose and the service users guide are combined as one document in booklet form. Although a considerable amount of information is included the booklet it is not easy to read and some of the details are incorrect. The residents who were spoken with during the inspection said that they have not been given a statement of purpose although they feel that the home provides the care and support they receive. Contracts and terms and conditions are provided for all residents, these are signed with a copy given to the residents or their representative, and a copy kept by the home. A pre-admission assessment is available for staff to use to identify the needs of prospective residents to ensure that the home can meet their needs, although there have been no new admissions to the home. The acting manager and Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 9 registered provider discussed the appropriateness of admitting individuals to the home as a number of staff have left the home in recent weeks. They advised that rooms would not be offered to prospective residents until new staff have completed induction courses and are assessed as competent, so enabling the home to meet the assessed needs of residents. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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): 10 and 11. The staff have a good understanding of the residents support needs. This is clear from the positive relationships, which have been formed between staff and residents. Personal support is offered by the care staff in this home in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: It was noted during the inspection that staff work with the residents to provide appropriate care in a relaxed and friendly atmosphere. Residents who expressed an opinion said that the staff are very caring, providing the support they need and treating them with respect by asking what assistance they need and how they can make their lives more comfortable. The acting manager and care staff have a good understanding of the needs of residents as they change. Relatives are encouraged to participate in service provision and can stay at the home if they wish. Those who expressed opinions during the inspection said that the care is good and felt that the residents have appropriate support. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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 and 15. Residents would benefit from a varied programme of in house activities and visits to the local community. The routines at the home are flexible this enables the residents to have control over their lives and encourages them to make choices about their day to day living. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The home does not employ an activity person at the home, therefore a programme of activities is not provided for residents. There was no evidence to show that residents are asked what interests they have and how the home can meet their particular social and cultural needs. However it was noted that one of the residents was playing dominos with a member of staff and other staff spent time talking to residents in the lounge after lunch. There were 17 residents in the home at the time of the inspection and the staff explained that with these reduced numbers they have time to spend talking to residents and visitors. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 12 Residents are able to choose how to spend their time and some prefer to remain in their rooms. They explained that they like to spend their time watching television or reading, although some join the other residents in the dining room for lunch. There is open visiting at the home and a number of relatives and friends visited during the inspection. One stated that the care is good at the home and her relative’s health has improved since she was admitted. Residents are encouraged to exercise choice within their limitations with the support of relatives. At the time of the inspection a family had arranged for the manager of another home to assess a resident for admission, on the request of the family. The manager explained that residents and their relatives are encouraged to make choices about all aspects of their care, including where they live, and in some instances they may choose to move to another nursing home. The meals provided at Havelock House are good and the residents are offered choices for each meal. The residents who expressed an opinion spoke positively about the food and felt that they are offered a choice. On the day of the inspection the AGA cooker was broken and the chef was preparing lunch on an electric cooker with only three rings working (Refer to Standard 19). The chef demonstrated that she understands the nutritional needs of the residents and although she was restricted in what she could offer she prepared a nutritious meal. It has been noted during this and previous inspections that residents sitting in the dining room are given their meals at different times. Consequently residents on the same table may wait until other residents have nearly finished to have their meal. To ensure that the meals are taken in a congenial setting meals should be served at the same time for residents sitting in the same area of the home. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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 and 17. The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. EVIDENCE: There is an appropriate complaints procedure in place at Havelock House and there have been two complaints since the last inspection. These were investigated and were resolved. The acting manager explained that if residents or relatives have any concerns then she would try and deal with them as they arise through discussion with the relevant individuals. Residents who expressed an opinion said that they had no reason to complain about the care provided at the home. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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, 23, 24, 25 and 26. The standard of the environment within the home is satisfactory. However there is no evidence of improvement through maintenance or future planning and some repairs are required to ensure the safety of staff and residents. There are sufficient facilities in the home to enable staff to meet residents’ needs with regard to personal hygiene. As part of the infection control system that protects staff and residents a deep cleaning programme has been developed and introduced. EVIDENCE: Although minor repairs are recorded and dealt with on a daily basis there was no evidence of an ongoing maintenance programme. This was highlighted with the breakdown of the AGA cooker, which as the engineer suggested had not been maintained on a regular basis, and the provision of an electric cooker that is of limited use when one of the rings does not work. A programme of ongoing maintenance at the home should be produced and followed to ensure that the breakdown of the essential machinery can be prevented as much as possible. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 15 The carpets in the hall and the lounge have been repaired but it was clear that the seams where carpets are joined should be assessed regularly, to ensure that staff and residents walking along the corridor on the ground floor and across the lounge can do so safely. There is a large lounge to the rear of the building that is used by some residents, and a separate dining room. There are attractive gardens to the rear of the home, that are accessible to wheelchairs and are used when the weather permits. There is a no-smoking policy in the home, however one resident who has been at the home for several years has used the staff room as a smoking area since admission, which was before the no-smoking policy was introduced. The manager advised that a risk assessment has been completed and staff monitor her use of the room. It was noted during the inspection that the extractor fan in the staff room was not switched on. Consequently smoke was in the corridor outside the staff room, which is close to the kitchen. This was discussed with the manager. The residents who were in their rooms and expressed an opinion stated that they are happy with the services provided, they feel that their rooms are comfortable, and they can personalise them if they wish with small pieces of furniture, pictures and ornaments. The provider advised that rooms are updated when empty and the residents’ rooms were clean. There are assisted bathrooms, toilets and a shower, which enable staff to support residents to maintain their personal hygiene. A deep cleaning programme has been developed and introduced, with an additional part-time member of staff employed to carry this out. The manager advised that the current member of the cleaning team will also be given a cleaning schedule to ensure that all parts of the home are cleaned on a regular basis. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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 and 30. Care staff morale is high resulting in an enthusiastic workforce that works with residents to provide a good quality of life. The procedures for the recruitment of staff are not robust and do not provide the safeguards to offer protection to residents. EVIDENCE: The number of care staff at the home was felt to be appropriate for the needs of resident, some have worked at Havelock House for some time and have a good understanding of their needs and have developed good relationships with the residents. However a number of registered nurses have left Havelock House and although their posts have been filled it was felt appropriate to advise the manager and provider that it is their responsibility to ensure that the registered nurses they employ have the appropriate skills and expertise to meet the assessed needs of the residents. The acting manager explained that the nurses have been working through an induction programme that she has introduced and will not be expected to take on any responsibilities that she feel would be inappropriate, and admissions to the home will only be accepted if she feels the home can meet their assessed needs. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 17 Five of the care staff, 45 , have completed NVQ training and the acting manager advised that all new staff will be encouraged to work towards these qualifications. It was noted during the inspection that staff are employed at the home without appropriate POVA/CRB checks being completed and with references provided by friends rather than previous employers. This failure to follow recruitment procedures was highlighted during a recent monitoring visit and the homes ongoing inability to complete the checks potentially puts residents at risk. Induction training in line with TOPSS is not provided at the home, new staff including registered nurses, are given information about the home and work with experienced staff until it is felt they have the appropriate skills. The manager advised that a programme will be developed and introduced for the new members of the care staff. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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, 34, 35, 36, 37 and 38. The manager is supported well by the staff who demonstrate an awareness of their roles and responsibilities in providing appropriate care and support for residents. The manager has a good understanding of the areas in which the home needs to improve to ensure the residents’ needs are met. Some practices in the home do not promote and safeguard the health, safety and welfare of residents. EVIDENCE: The acting manager at Havelock House was appointed in August, she is a registered nurse, has some experience of working in a nursing home, and is working towards the Registered Manager Award. She is required to apply to the Commission to be the registered manager of the home. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 19 The expectation is that the management approach developed at the home will encourage the participation of residents and their relatives in all decisions about the services provided. Appropriate liability insurance is in place with a certificate evident on the corridor wall just inside the entrance. The home does not accept responsibility for residents’ finances’ with the majority supported by relatives or solicitors. Supervision is not provided at the home, quality assurance and monitoring systems are not in place and there is no evidence of a business and financial plan, which shows how the service will develop. The policies and procedures in place at the home require updating and those available to staff do not cover all areas identified in the NMS. Residents doors were propped open using chairs, stools and zimmers, this was discussed with the acting manager and the provider and in line with Fire Service advice alternative safe systems are to be introduced. The acting manager has a good understanding of the changes that are required to ensure that the home is run in the best interests of residents, she is also aware that it will take some time to bring about all these changes. However the feedback obtained from residents, relatives and staff show that the home provides appropriate care and support for residents, that the home is comfortable and the atmosphere is relaxed. Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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 2 3 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 2 3 3 X 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 2 3 2 2 1 Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 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 OP1 Regulation 4&5 Requirement That a statement of purpose and service users guide meet the regulations, Schedule 1 and the NMS is provided and made available to all residents. Previous timescale of 19/04/05 not met. That the service users social, cultural, religious, recreational interests needs are assessed and provision made to ensure these needs are met. Previous timescale of 19/04/05 not met. An ongoing maintenance programme to be developed and introduced to ensure the safety of residents. Staffing numbers to be reviewed in line with the assessed needs of residents. The homes recruitment policies to be followed at all times. An induction programme in line with TOPSS to be developed and introduced. Previous timescale of 19/04/05 not met. The home’s manager to register with the CSCI. DS0000013997.V249499.R01.S.doc Timescale for action 16/01/06 2 OP12 16 (2)(n) 16/01/06 3 OP19 13 28/11/05 4 5 6 OP27 OP29 OP30 18 (1)(a) 19 18 1 a c I 19 5 b 9 01/11/05 01/11/05 16/01/06 7 OP31 16/01/06 Havelock House Version 5.0 Page 22 8 OP32 12 & 15 9 OP33 24 & 26 10 11 OP34 OP36 25 (2) 18 (2) 12 OP37 17 Schedules 3&4 13 (4)(c) 13 OP38 14 OP38 13 (4)(c) A management approach to be developed to ensure the involvement of residents and relatives in developing the services provided. An effective quality assurance and monitoring system to be implemented. That the registered provider visits the home in accordance with Regulation 26 and provides a written report to the CSCI. Business and financial plans to be available to the Commission on request. A programme of formal supervision to be developed and introduced. Previous timescale of 19/04/05 not met. Policies and procedures to be reviewed and updated. Previous timescale of 19/04/05 not met. Advice to be sought from the Fire Service regarding the provision of safe systems for keeping residents doors open. Previous timescale of 19/04/05 not met. Action to be taken to meet the requirement of the risk assessments regarding window restrictors. Previous timescale of 19/04/05 not met. 16/01/06 06/03/06 16/01/06 16/01/06 06/03/06 01/11/05 28/11/05 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 Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Havelock House DS0000013997.V249499.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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