Inspection on 10/08/05 for Homelea Residential Care Home

This inspection was carried out on 10th August 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

Homelea Residential Care Home 25/04/07

Homelea Residential Care Home 09/01/06

Homelea Residential Care Home 01/02/05

Homelea Residential Care Home 02/08/04

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

CARE HOMES FOR OLDER PEOPLE Homelea 15-17 Lewes Road Eastbourne East Sussex BN21 2BY Lead Inspector James Houston Unannounced 10 August 2005 11:30 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. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Homelea Address 15-17 Lewes Road Eastbourne East Sussex BN21 2BY 01323 722046 01323 764342 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) Nifinara Limited Dr Nina Patel Care Home 27 Category(ies) of Dementia (DE), 27 registration, with number of places Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is twenty seven (27) Date of last inspection 1 February 2005 Brief Description of the Service: Homelea is registered to provide care and accomodation for up to twenty-seven people with a dementia -type illness. The home is close to Eastbourne town centre and a short car journey from the seafront. It is comprised of three buildings combined into a large detached house with a small front garden and a large rear garden and car park. There is level access to all parts of the garden and seating is provided for residents. The home is owned by two medical doctors, one of whom is also the registered manager. They are experienced and committed to providing a high level of care to their residents. The home aims to provide a safe homely environment in which residents are able to lead satisfying lives, retain dignity, privacy and exercise choice. Regular social activities within the home and outings are arranged. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the later morning and afternoon of the eighth of August 2005. Before the inspection papers held by the Commission for Social Care Inspection were read and those standards to be assessed were prepared. The inspection in the home took 5.7 hours. A tour was made of the premises. A variety of records including three care plans and policies and procedures were read. The inspector spoke with eight residents, four relatives, four staff, the assistant manager and the owners. There were twenty-six residents accommodated on the day of the inspection. What the service does well: 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. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 6 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 Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 7 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 and 6. The home’s statement of purpose and service users’ guide give full information to prospective residents, residents and their representatives. The home fully assesses prospective new residents. Residents and/or their representatives are encouraged to visit the home before admission to assist them in the decision about whether or not to enter the home. EVIDENCE: The home has a comprehensive statement of Purpose and Service Users’ Guide. These are made available to residents and/or their representatives. The home has also developed a document setting out how they meet National Minimum Standards in respect of documents and procedures, which is made available to residents and their representatives. Records inspected showed that the home undertakes full pre-assessments for prospective residents, visiting them in their present setting. The manager and a senior carer undertake these assessments. They were seen to include all the elements listed under this standard. Records showed care management assessments are obtained where available. Staff said that residents or their families are invited to visit the home prior to coming in, and all residents are invited for a trial stay before their stay becomes permanent. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 8 A relative confirmed that this had happened when their family member had been admitted to the home. The owner/manager said that emergency admissions are avoided where possible and that one has not happened for some time. The home’s Statement of Purpose details the admission procedure. The home does not provide intermediate care. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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) 7,9 and 10. Care plans are well drawn up and managed. Medication systems are thorough. The privacy and dignity of residents are respected. EVIDENCE: The pre-admission and initial assessments form the basis of residents’ care plans. Three care plans were examined in detail. They are comprehensive and include risk assessments in respect of residents. The home has developed a care audit trail, and a range of recordings contribute to the monthly review of care plans. The recordings and monthly reports read were up to date and well written. Staff said that they have had input as to how to write in records. The home has a key worker system to ensure continuity of care for residents. The home has full policies and procedures for the administration of medication. No residents self medicate. Some drugs held are signed for by two staff in accordance with this standard. The medication administration records were inspected and found to be fully recorded. The home will put an appropriate security device on the small drugs fridge. Evidence was seen that the staff have had relevant training. Residents and relatives said that residents are well treated by staff. Staff said that they knock before entering rooms, and ensure that residents are assisted as necessary in dealing with their mail. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 10 The home uses portable screens in its two double rooms, to ensure privacy when personal care is being given, but has installed the tracking for permanent screening. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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 standard(s) 12 and 13. Social activities are well managed and provide variation and interest for people living in the home. Visitors are made welcome. EVIDENCE: Staff said that residents are able to get up and go to bed at times of their choosing, and eat in their rooms if they wish. Records inspected showed that residents’ leisure and other interests are recorded. Residents are enabled to follow religious observance as desired and a resident said that a friend takes her out to church regularly. The home offers in-house sessions morning and afternoon with reminiscence, word games, puzzles and craft. Outside staff lead singing and dancing and a resident said that they enjoy these. There are regular monthly outings in a minibus to local places of interest, when residents are accompanied by staff and a volunteer from a local voluntary body. Residents said that they enjoy these outings. A relative said that their family member enjoyed the outings but did not always choose to go as they liked being in the home. Residents said that visitors are made welcome in the home, and visitors to the home confirmed this, one noting that staff provide, unasked, beverages exactly to their liking as soon as they arrive. Staff said that they understand the importance of links with family and see making visitors welcome and offering refreshment as an important part of their task. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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 standard(s) 18. The home’s procedures, processes and training for staff are designed to protect residents in the event of any abuse or allegation of abuse. EVIDENCE: The home has detailed policies and procedures on adult protection in line with local guidance and all care staff have been trained in adult protection. Evidence of this was produced for inspection. The procedures have not had to be invoked in respect of any resident. There was evidence that staff have received training in dementia care and in how to deal with challenging behaviour. Staff are aware of the home’s policy on not receiving gifts, and sign on appointment to acknowledge receipt of this. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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 standard(s) 19,20,22,24 and 26. The home provides accommodation to a good standard. Some maintenance items need attention. Communal areas and bedrooms are well presented. Appropriate adaptations and equipment are provided. Laundry facilities are suitable. EVIDENCE: The home is generally well maintained. Some external and internal paintwork requires some attention and the owners have already contracted for this work to be done shortly. A small area of tiling in one bathroom and a door handle in another require attention. One fire door needs adjustment. Provision of stair lifts provides access to all floors. There are in places two or three steps where installation of stair lifts is not feasible. The home has two lounges and a dining area. The lighting is domestic in character. Furnishings are of good quality. The home has a large rear garden which is accessible to residents via the provision of ramps. The home has two fixed bath hoists and two lightweight portable ones for use in other bathrooms. A suitably qualified person has assessed the premises and all recommendations have been met. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 14 The owner/manager said that they had installed extra handrails throughout the home and that these have assisted residents in moving safely through the home. Call bells are provided in all areas to which residents have access. Floor pressure pads are provided for those residents who have a tendency to wander at night to ensure that staff are alerted. Residents said that they like their rooms. Rooms are well furnished and residents said that they are able to bring their own things into the home. Records inspected showed that an inventory of these items is kept. Where appropriate specified rooms have washable flooring. A resident told the inspector she has a key to her own room. The owner/manager confirmed that a small number of residents hold keys to their rooms on a risk assessed basis. The home’s laundry is well sited away from food preparation and serving areas. It is well equipped and there is an appropriate hot wash cycle. A relative said they are happy with the laundry service for their relative. The owner/manager said that bed sheets continue to be sent to a local laundry for cleaning. The home has suitable policies for the control of infection and disposal of clinical waste. On the day of the inspection the home was found to be clean and tidy. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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 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 and 28. A competent staff team meets residents’ needs. The staff team is appropriately qualified. EVIDENCE: The home has five carers on duty during the week and six at weekends, with a senior carer on duty as well. The assistant manager and both owners, one of whom is the registered manager also work full time at the home and are extra to the rota. The owner/manager said that they are also on call to the home. At night there are two waking staff on duty in the home. In addition the home has cooks, cleaners, a gardener and a maintenance person. Staff and a relative considered that there are enough staff on duty to enable them to meet the needs of residents. Turnover of care staff is low, and agency staff are not used. The home has eighteen care staff and eight of these hold NVQ in care at level 2, and one at level 3. Five more are doing NVQ level 2 and two have just enrolled. The assistant manager holds a postgraduate qualification in management and is doing NVQ level 4 in care. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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 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) 32,33,36 and 37. The home has an open and positive atmosphere. Quality assurance processes are well considered. The home has a commitment to supervising staff. Recording systems are good. EVIDENCE: Residents and relatives said that they find the staff and owners easy to talk to. Staff said that they find the owners very approachable and willing to consider ideas put forward. There are regular staff meetings and minutes of these were made available to the inspector. The home embarked upon and has achieved the “Investors in People “ award as a means of ensuring that a recognised quality assurance and quality monitoring system is in place. Surveys for residents’ families/representatives are carried out, and these were made available to the inspector. The home is in regular contact with its stakeholders and is aware of their views on how the home is achieving goals for residents. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 17 It is recommended that consideration be given approaching stakeholders formally from time to time. The home also has its own tool for internal auditing and reviews progress regularly. Records inspected confirmed that care staff receive recorded supervision at least six times a year. The owner/manager said that ancillary staff receive supervision twice a year. Records inspected were found to be well kept. Policies and procedures are comprehensive and reviewed regularly. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 3 x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 3 x 3 3 x x 3 3 x Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 19 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. Standard Regulation Requirement Timescale for action 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. 3. Refer to Standard 9 19 33 Good Practice Recommendations Review the security of the drugs fridge. Address maintenance issues identified. Consider approaching stakeholders formally from time to time as part of quality assurance processes. Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex 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 Homelea H59-H10 S21142 Homelea V230755 100805 Stage 4.doc Version 1.40 Page 21 - 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!