Inspection on 26/09/05 for Homelands

This inspection was carried out on 26th September 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

Homelands 14/10/08

Homelands 09/10/07

Homelands 19/04/06

Homelands 27/05/05

Homelands 07/12/04

Homelands 15/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homelands 21-23 Richmond Avenue Bognor Regis West Sussex PO21 2YE Lead Inspector Mrs J Wright Unannounced Inspection 26th September 2005 07:00 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 Homelands DS0000014577.V252344.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. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homelands Address 21-23 Richmond Avenue Bognor Regis West Sussex PO21 2YE 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) 01243 828122 Mr Tony Robert Puttick Mrs Elizabeth Hawkins Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (20) Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 20 in the registration category MD(E) (persons with past or present mental disorder - over 65 years) 27/05/05 Date of last inspection Brief Description of the Service: Homelands is a care home able to provide personal care and support for up to 20 service users in the category of Dementia and Mental Disorder, excluding learning disabilities – over 65 years of age. The home is situated in a residential area on the outskirts of Bognor Regis, within walking distance of local shops and other community facilities. The accommodation is situated on three floors, the upper floors having passenger lift access. There is a communal lounge and a dining room which both open out onto a well-maintained rear garden. Accommodation consists of 14 single bedrooms and 3 double bedrooms. The double bedrooms have en-suite facilities. The Registered Provider of Homelands is Mr Tony Puttick, however Mr Puttick is currently taking a period of absence from his duties as the Manager of the home. A Management Company, Personnel Solutions, is over seeing the running of the business, and Mrs Elizabeth Hawkins has recently been appointed as the Registered Manager of the Home. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. The first inspection, which was announced, was undertaken earlier in the year. At this inspection there were two inspectors, one being a Pharmacy Inspector, Mrs J Datoo, who concentrated on Standard 9. At this inspection the second Inspector looked at standards that were not looked at during the previous inspection, as well as any outstanding issues from the last report. The reader is advised to look at the reports of both inspections for a fuller picture of the home. During this inspection the Inspector examined records of care being provided to residents; as well as records of any accidents, issues, concerns or complaints, to make sure that the residents at Homelands were being taken care of. The inspector met many residents, but due to their mental frailty, they were not all able to tell the Inspector what it was like living at Homelands, they were, however, seen to be comfortable and well cared for, and appeared happy. A GP spoken to on the day of inspection told the Inspector that he had no concerns at all about the care being provided by Homelands. At this inspection Homelands was audited against the National Minimum Standards for Older Persons. Many of the elements in each of the standards assessed were met, however it was found that two of the requirements made following the last inspection were still unmet, and two further requirements have been made following this inspection. The Inspector would like to thank everyone who cooperated with her on the day of this inspection. What the service does well: The residents and a GP that the Inspector spoke to, all said that they were satisfied with the care being provided by Homelands. Residents told the Inspector that they liked their room, they enjoyed their food, and the staff members were “very kind” and “lovely”. There was a happy atmosphere at Homelands on the day of inspection, and the Inspector observed a good interaction between residents and staff members. There is a secure garden to the rear of the property for residents to walk and sit out in. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 6 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. Homelands DS0000014577.V252344.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 Homelands DS0000014577.V252344.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): 2 and 4 Prospective residents have the information they need to make an informed choice about where to live. Residents and their representatives know that the home they enter will meet their needs EVIDENCE: There is an up to date statement of purpose and service user guide, which gives residents and their relatives information on the facilities in the home. Some residents do not have a statement of terms and conditions at the point of moving into the home (or contract if purchasing privately). A requirement is made in this report for this matter to be addressed. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 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 and 9 The resident’s health, personal and social care needs are set out in an individual plan of care, which should be signed by the resident or their representative. The care plans also need to include resident’s photographs, and evidence that residents are being weighed on a regular basis, added. Further training is needed to improve medication handling. EVIDENCE: On the day of inspection care plans looked at by the Inspector did not all include a photo of the resident or a record of their weight, neither were they signed by the resident or their relative or representative. A requirement is made in this report for these matters to be addressed. A CSCI pharmacist reviewed medication handling. Medication policies and procedures had been reviewed in February 2005. Storage was in lockable cupboards and a trolley. Lids had been removed from several dispensed boxes of tablets in the trolley. One box did not have a dispensing label. Records of receipt, administration were maintained, although the recorded reasons, for non- administration of medicines prescribed to be taken regularly, were not always clear. One medicine was being administered at the incorrect time, Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 10 without consideration of the additional instructions on the dispensing label. There was a list of staff authorised to administer medicines, which had not all attended a medication training held in August 2005. A requirement is made in this report for them to do so. Homelands DS0000014577.V252344.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): These standards were not assessed on this occasion. EVIDENCE: Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 12 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 Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: Prior to the previous inspection the Commission for Social Care Inspection had received a letter of complaint from someone who wished to remain anonymous. At the previous inspection the Inspector raised the concerns with the Manager who stated that where the issues raised were founded she would take action to rectify matters. It was seen at this inspection that the Manager had taken the appropriate action with regard to this standard. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 13 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 and 26 The residents have access to a communal lounge, plus a dining room, which are reasonably furnished and overlook a secure rear garden. There is a passenger lift for those residents whose rooms are upstairs. There are enough toilets and assisted baths to meet the needs of residents. A large gazebo has been erected in the garden for residents to sit out in should they wish. Some maintenance to the home is required, together with some decoration and renewal of furnishings. EVIDENCE: At the previous inspection of Homelands all the rooms were visited, to ensure that the environment was safe and comfortable for people who live there. Resident’s rooms, in the main, were homely and comfortably furnished, although some furniture was in need of replacing. It was noticed at this inspection that although some carpet has been replaced, the home is still in need of extensive redecorating and refurbishment. At this inspection, Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 14 Homelands was seen to be cleaner than at the previous inspection, and virtually free from offensive odours. It was seen that building work with regard to the office downstairs was finished, although there were still areas in need of minor attention. The Manager informed the Inspector that this work was in hand. Bed linen is still in the process of being replaced, however there was no evidence found of torn or soiled linen at this inspection. Wheelchairs, previously left in the hall, are now housed elsewhere. Residents told the inspector that they were very happy with their bedrooms. There were still no locks on resident’s bedroom doors, which respect the privacy of residents, but the home has until the end of the year to address this matter. The fire exits were clear, and a window in a resident’s bedroom, considered dangerous at the previous inspection, has been replaced. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 15 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 and 30 Homelands was found to be adequately staffed with employees who, in the main appear competent to care for older people who are mentally frail, however not all staff members had received the required training. Staff training, including NVQ, is ongoing and all training undertaken is recorded on staff member’s files. The Manager informed the Inspector that where necessary, agency staff is used. EVIDENCE: The duty rotas indicated that enough staff members are on duty over the 24 hours period to meet the needs of the residents, including two waking staff members at night. There was evidence of some staff members having received some training, however some staff members still have not received training in medication, and there was no evidence that all staff members had received the required fire training, despite there having been a requirement made for these matters to be addressed, following the previous inspection. Requirements are made, again, in this report with regard to these issues. The Manager informed the Inspector that the job description of a care worker has been reviewed, and now accurately reflects the duties expected of them. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 16 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, 33, 34, 35, 37 and 38 Residents 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. The Manager has recently been registered with the Commission for Social Care Inspection. The home is run in the best interests of residents, and the health, safety and welfare of residents and staff are promoted and protected, in the main. EVIDENCE: The inspector saw that insurance cover is in place to meet the National Minimum Standards. The Manager informed the Inspector that there is a business and financial plan for the home, which would be made available upon request. Records of accidents, injuries and incidents, involving staff members and residents are recorded and reported appropriately. At the previous inspection Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 17 the Manager informed the Inspector that she was going to approach Personnel Solutions with regard to appointing an administrator to undertake some of the paperwork, which would include ensuring that all staff members undertake the necessary training. A recommendation is made in this report for this to occur as several of the records, (mentioned previously in the body of this report) required to be kept by the Commission for Social Care Inspection, were not available to the Inspector on the day of inspection. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 18 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 2 x 4 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 2 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 3 3 x 2 2 Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 19 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 2 3 Standard 9.7 & 30.1 30 2 Regulation 18(c)(1) 18(a) 5(c) Requirement That all members of staff, administering medication, receive appropriate training. That all staff members receive the required fire training. That each resident is provided with a statement of terms and conditions at the point of moving into the home (or contract if purchasing privately) Photographs of residents are to be included in their file, each resident’s weight is to be recorded regularly, and residents or their representatives are to sign their care plans. Timescale for action 31/10/05 31/10/05 31/10/05 4 7 17 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 37 and 38 Good Practice Recommendations That someone be employed who would take responsibility DS0000014577.V252344.R01.S.doc Version 5.0 Page 20 Homelands for ensuring that all the records required by the Commission for Social Care Inspection are kept up to date. Homelands DS0000014577.V252344.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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