Inspection on 27/05/05 for Homelands

This inspection was carried out on 27th May 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Homelands 14/10/08

Homelands 09/10/07

Homelands 19/04/06

Homelands 26/09/05

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 Jennifer Wright Announced 27 May 2005, 09:00 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 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 H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 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 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 Position vacant Care Home (CRH) 20 Category(ies) of Dementia-over 65 years of age (DE(E)), (20) registration, with number Mental Disorder, excluding learning disability or of places dementia-over 65 years of age (MD(E)), (20) Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. 20 in the registration category MP/E (persons with past or present mental disorder-over 65 years). Date of last inspection 7 December 2004 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, and the position of Manager is currently vacant. Mrs Liz Hawkins is in the process of making an application to the Commission for Social Care Inspection (CSCI) to become the Registered Manager of the Home. A Management Company, Personnel Solutions, is over seeing the running of the business. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, the first of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. A second inspection, which will be unannounced, will be undertaken later in the year. During the inspection the Inspector toured the building, visited every room, and examined care, and staff records. The inspector met many service users, but due to their mental frailty, they were not able to tell the Inspector what it was like living at Homelands, however they were seen to be comfortable and well cared for, and appeared happy. A visitor spoken to on the day of inspection told the Inspector that they were very pleased with the care that their relative was receiving. Three staff members were also spoken to on the day of inspection, about how they find working at Homelands. The Inspector examined records about care being provided to residents; as well as records of any accidents, or concerns or complaints, to make sure that the residents at Homelands were being taken care of. All of the four requirements identified in the last report dated 7th December 2004 have been complied with and assessed as met at this inspection. Eight of the ten recommendations made at that time have also been addressed. At this inspection Homelands was audited against the National Minimum Standards for Older Persons. The majority of elements in each of the standards were met, however five requirements one recommendation were made following the inspection. The Inspector would like to thank everyone who cooperated with her on the day of this inspection. What the service does well: There was a happy atmosphere at Homelands on the day of inspection, and a visitor spoken to said that whenever she visits she is always pleased to see how well the staff members get on with the people who live in the home. The Inspector shared a meal with the residents, that was very nicely cooked, and the residents told the Inspector that the food was “just like home cooking”. Residents are encouraged to help out in the garden, and are in the process of planting hanging baskets. There is a secure garden to the rear of the property Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 6 for residents to walk and sit out in. There was evidence that residents have their own “bits and bobs “ around them in their bedrooms, and residents told the Inspector how much they liked their room. Prior to the inspection relatives and visitors were offered the opportunity to complete a short questionnaire. Three people responded, and they were all complementary of the home. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 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 standard(s) 1 3 5 6 The Manager informed the Inspector that prior to moving into Homelands, prospective residents and their representatives are given sufficient information about what the home offers, to enable them to make a choice as to whether or not they want to live there. In addition before moving into the home, people are assessed, by a member of staff, in their own home whenever possible, to make sure they are suitable, and invited for a trial period. In that way people know exactly what they can expect from Homelands. EVIDENCE: Due to their mental frailty the residents spoken to on the day of inspection were not able to tell the Inspector whether or not they had been given any information about Homelands prior to their moving in, but a visitor confirmed to the Inspector that she had been given information all about the home, enabling her to make a choice. A visitor spoken to on the day of inspection told the Inspector that they would go to the Manager or any staff member if they had any queries, and had no complaints whatsoever about the way the person they were visiting was being looked after. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 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 standard(s) 7 8 9 10 11 Where possible residents are involved with the drawing up of their care plans. All residents are informed of all services available under the National Health Service, and the Inspector was assured by the Manager that specialist equipment is provided where necessary. The District Nurse is involved with the care of the residents whenever appropriate. From the comments made by some residents and a visitor, it would appear that the staff members respect the privacy and dignity of the people living there. EVIDENCE: Where resident are not able to be involved with the drawing up of their care plans, then the residents relatives or advocates are involved. A visitor told the Inspector on the day of inspection that the staff “always update her” as to what is happening with regard to the person they visit. It was observed that not all staff members administering medication had received accredited training, and a requirement is made in this report for this to take place. Records of drug administration are maintained. Care plans past, and present were examined as part of this inspection to ensure that the correct procedures were being followed. It was noted that detailed records of meetings, where procedures were apparently discussed, were not kept. The Manager assured the Inspector that records of all meetings/discussions would be kept in future. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 10 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 standard(s) 12 13 14 15 People living at Homelands are not always able to make the day-to-day decisions about how they want to live their life. Where this is so, then their relatives or representatives are consulted. Activities are suited to the conditions and dependency of the residents at present. Visiting is positively encouraged. Residents are served meals that are nutritious and appetising. EVIDENCE: There are activities for those who wish to participate which include “music for health”, monthly “sing-a-longs”, and games involving newly purchased beanbags. Staff members manicure resident’s nails, and assist them with make-up. Some residents showed off their newly painted fingernails, to tins, on the day of inspection. The Manager informed the Inspector that she is hoping to introduce some more activities that will involve reminiscing. Several of the residents assist staff members in making up hanging baskets for the garden. A visitor told the Inspector that she was always well received when she visited the home. The inspector shared a meal with the residents, which was very tasty and enjoyed by all. The meal was been served in an appetising manner to encourage appetite and nutrition. The Inspector observed that the mealtime appeared to be unhurried with residents being afforded sufficient time to eat their meal. Staff members were seen to help residents in a sensitive and unobtrusive way, during the course of the meal, where necessary. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 11 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 standard(s) 16 17 18 Regular training sessions for staff, a complaints book, plus policies and procedures regarding abuse, ensure that, as far as is possible, the people who live at Homelands are protected from bad practice. EVIDENCE: The home has a complaint’s procedure in place. A visitor spoken with said they knew who to complain to, and that should they have any concerns at all, then they would have no hesitation in going to the Manager, and that they felt certain that they would be listened to. The Manager informed the Inspector that everyone is aware that they can always come to her whenever they want to. Prior to this inspection The Commission for Social Care Inspection had received a letter of complaint from someone who wished to remain anonymous to the home. As agreed by the complainant, the Inspector raised the concerns contained within the letter with the Manager, on the day of inspection, and was satisfied with her response. Where the issues raised were founded, the Manager agreed to take action to rectify matters. These will be looked at, at the next inspection. The Manager assured the Inspector that training on Adult Protection was in place. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 12 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 standard(s) 19 20 22 24 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 when the sun is too hot. Some urgent maintenance is required, together with some decoration and renewal of furnishings. EVIDENCE: During the course of the 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 noted that many residents had brought personal possessions into the home, including small ornaments, pictures and photographs. On the day of inspection, Homelands was seen to be clean, and reasonably free from offensive odours. The Manager informed the Inspector that policies and procedures were available for staff members to access, regarding control of infection, and the safe disposal Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 13 of clinical waste. The decor is looking tired, and although this is not currently a regulation requirement, consideration should be given to improving the decor in order that it does not become a legislative requirement at the next inspection / in the future. Some carpets were in need of replacing, and it was seen that building work with regard to the office downstairs was unfinished. The Manager informed the Inspector that she would contact a builder immediately with a view to their completing the work, as a matter of urgency, in order to ensure the safety of her, and other staff members who have access to the office. Bed linen is in the process of being replaced, however there was evidence of torn, soiled linen on some of the beds on the day of inspection. The Inspector was assured by the Manager that all bed linen would be replaced immediately. A recommendation is made in this report that wheelchairs, currently left in the hall, are to be housed elsewhere. Residents told the inspection that they “liked their bedrooms”, and visitors spoken to on the day of inspection also appeared satisfied with them. There were no locks on resident’s bedroom doors, which respects the privacy of residents. A requirement is made in this report for this matter to be addressed. All obstacles are to be removed from areas around the fire exits, and a requirement is made for all fire exits to be kept clear at all times. A requirement is also made for a window, in a resident’s bedroom, which the Inspector, and staff members, considered dangerous, to be attended to as a matter of urgency. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 29 30 Homelands is adequately staffed with employees who, in the main appear competent to care for older people who are mentally frail. The Manager informed the Inspector that all staff members who administer medication are to receive the appropriate training, and a requirement is made in this report for this to be actioned. Staff training, including NVQ, is ongoing and all training undertaken is recorded on staff member’s files. 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. The Manager informed the Inspector that where necessary agency staff are used. EVIDENCE: The Manager informed the Inspector that training is ongoing. A member of staff spoken to on the day of inspection told the Inspector that they felt supported by the Manager and another staff member said that she has “enjoyed the opportunities that she’s had whilst at Homelands”. A visitor told the Inspector that there always appeared to be enough people on duty to assist the residents when they needed it. The Manager informed the Inspector that the job description of the care workers is to be reviewed, to accurately reflect their duties. There was no evidence that all staff members have had the required fire training, and a requirement is made in this report for this matter to be addressed as a matter of urgency. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 36 37 38 Mrs. Hawkins, the Manager, has yet to be registered with the Commission for Social Care Inspection. Records needed for the safe running of a care home were available for inspection. These records were not kept in a satisfactory manner, and the Manager confirmed that she is going to approach Personnel Solutions with regard to appointing an administrator to undertake some of the paperwork. Policies and procedures are available for staff members to refer to, to ensure the safety of the people who live and work at Homelands. EVIDENCE: Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 16 Visitors confirmed to the Inspector, that the Manager and staff members are approachable and offer assistance when needed. Staff members told the Inspector that they “liked the way Homelands was run now”. The Manager informed the Inspector that all staff members attend food handling training, first aid training, and moving and handling. In addition she confirmed that risk assessments, regarding the safety of all residents, and staff members are undertaken. Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 2 2 x 2 x 2 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 x x x 3 3 2 Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 18 no Are there any outstanding requirements from the last inspection? 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. Standard 9.7 & 30.1 24.1 Regulation 18.(c)(1) 12(4)(a) Requirement That all members of staff, administering medication, receive appropriate training That the registered person shall make suitable arrangements to ensure that the establishment is conducted in a manner, which respects the privacy of service users That all fire exits be kept clear That the window identified, at the inspection as being in a dangerous state,be replaced as a matter of urgency. That all staff members receive the required fire training, Timescale for action 31.07.05 31.12.05 3. 4. 19 19 23 23 27.05.05 30.06.05 5. 30 18(a) 30,06.05 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. 2. Refer to Standard 9 Good Practice Recommendations A recommendation is made in this report that wheelchairs, currently left in the hall, are to be housed elsewhere Homelands H60-H11 S14577 Homelands V221374 270505 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection 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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