Inspection on 25/04/07 for Homelea Residential Care Home

This inspection was carried out on 25th April 2007.

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 09/01/06

Homelea Residential Care Home 10/08/05

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 Residential Care Home 15-17 Lewes Road Eastbourne East Sussex BN21 2BY Lead Inspector Gwyneth Bryant Key Unannounced Inspection 25 April 2007 09:00 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 Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homelea Residential Care Home Address 15-17 Lewes Road Eastbourne East Sussex BN21 2BY 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 722046 01323 722046 homelea96@hotmail.co.uk Nifinara Limited Dr Nina Patel Care Home 27 Category(ies) of Dementia - over 65 years of age (27) registration, with number of places Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is twenty seven (27). Service users must be older people aged sixty-five (65) years or over on admission. Service users with a dementia type illness only to be accommodated. Date of last inspection 9th January 2006 Brief Description of the Service: Homelea is registered to provide care and accommodation for up to twentyseven 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. Two medical doctors own the home, one of which 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. Information about the service, including the Statement of Purpose is made available to prospective service users or their representatives, on request, as part of the admission process. Intermediate care is not provided. The range of weekly fees is currently from £366 - £550; the fees do not include hairdressing, chiropody, aromatherapy, toiletries and newspapers. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over 7.25 hours and its purpose was to check compliance with both key standards and other minimum standards. There were 26 people in residence on the day of which four were spoken with. Discussion also took place with two carers, two relatives, the registered providers and two healthcare professionals. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. The registered provider provided a preinspection questionnaire and the information given is included in relevant parts of this report. Prior to the site visit the registered providers sent copies of surveys sent to relatives and healthcare professionals as part of the quality monitoring process and comments included: ‘we cannot fault the treatment and care given to my sister and they do an incredible job maintaining dignity’. ‘high standard of care always’ ‘all staff and management always caring and helpful’. ‘very caring and thoughtful staff – keep up the good work’. ‘(name) always makes a point of telling me how good the food is’ ‘at visiting they are always welcoming, sociable, friendly and give time to discuss my sister’. ‘we are always greeted by the staff who are welcoming and friendly’. ‘the staff are very kind to mum – thanks to all’ ‘I am delighted to see how happy all the staff are’. ‘I have always found (registered providers names) most helpful’. ‘no concerns but my grateful thanks to management and staff for the superb job they do’. ‘everyone doing a difficult job extremely well’. ‘all staff are very friendly and helpful’ What the service does well: The home is well managed with comprehensive staff training programmes and detailed quality monitoring systems in place. People living in the home are encouraged to be independent and all aspects of their health and welfare identified and planned for. Those people living in the home, who were able to express an opinion, said they were happy; the food was good and the staff very kind. Relatives spoken with also commented on the welcome they received from staff and how much they appreciated the management ensuring they were included in care planning processes. Healthcare professionals spoken with also felt the home provided a good quality of life to those living in the home. Record keeping remains good, providing an opportunity to track all Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 6 aspects of the service and in particular to the working practices. Staff felt well supported and welcomed the wide range of training provided. 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. The summary of this inspection report can be made available in other formats on request. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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 Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4. Standard 6 is not applicable. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are carried out at the time of admission to ensure the home can meet the needs of people living in the home. EVIDENCE: Comments from the homes’ surveys included: ‘it is early days yet but we are very happy with everything so far’. Pre-admission documents for recent admissions were viewed and it is clear that they are used effectively to demonstrate that the home is be able to meet the assessed needs of those people who are to be admitted to the home. Intermediate care is not provided. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care planning systems ensure that the health, medical and personal needs of those living in the home are identified and planned for in a consistent and comprehensive manner. EVIDENCE: Four care plans were viewed and found to contain detailed information on all aspects of the care required by those living in the home. The plans included clear direction to staff in meeting identified needs, on a daily basis if necessary. The home maintains continuation sheets which are used to monitor the personal and healthcare needs of the people living in the home. During the site visit one person indicated that she would like a key to the internal doors. This was discussed with her relative and the management and a key was immediately provided on a trial basis and subject to satisfactory risk assessments. People living in the home, who were able to do so, said that the ‘girls’ are lovely and they are all very kind and that they felt all looked after. One Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 10 commented ‘the girls are very good – they do all they can and (name); nothing is too big for her’. Staff spoken with were knowledgeable about the needs of those living in the home and what action was required to meet those needs. Surveys provided by the home that had been sent to healthcare professionals and other stakeholders included comments such as: ‘it (care) has always seemed of a good standard’ ‘when I visit I have always felt staff to be kind and caring’ ‘caring environment’ ‘every effort is made to meet the care needed’. ‘very good care seems to be given to all patients’. ‘the staff are respectful, kind and gentle. ‘the quality of care is excellent and efficient’. Healthcare professionals spoken with during the site visit also believed the care given to be of good quality. This was the first visit to the home by one but she already felt the management approach to be open and she believed this would form the basis for good working relationships in the future. One relative spoken with said how much better her mother was since moving into the home in that her mobility had improved and she had put on weight. She commented that ‘the staff are marvellous, can’t fault any of them’. On touring the premises a number of rooms contained creams that were not prescribed for the occupant. This was discussed with the management and a senior carer. As the home has a policy of maintaining skin integrity by applying generic cream to all those living in the home staff do not always check the name on the label. One of the registered providers dealt with the issue immediately and none of the creams were of a type that put people at risk, therefore no requirement was made. The Registered Providers agreed to ensure that in future staff use creams only for the person it is prescribed for to eliminate all risks. Policies and procedures for the receipt, storage and administration of medicines are in place and medication records were accurate and up-to-date.. All staff who administer medication have received satisfactory training. Staff were observed to treat those people living in the home with care and respect and it was that staff had built comfortable relationships built on trust. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The lifestyle of people living in the home matches their expectations in respect of activities, choice and meals. EVIDENCE: Pre-inspection information from provider indicated that activities included outings, reflexology, aromatherapy, hand/feet massage, musical entertainment, Extend exercises and pet visits. This document included copies of the menus and demonstrated that menus are varied, nutritious and well balanced. The home provides activities every day during both the morning and afternoon periods and staff spoken with demonstrated a good understanding of how best to provide activities. Some people living in the home preferred to wander throughout the home during the day and this was facilitated by the provision of keys to internal doors. One person asked to go for a walk and a member of staff responded immediately and took her to the garden. One lady living in the home expressed a preference to only receive personal care from female carers. This request is clearly documented in her care plans and is observed in practice. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 12 Alternatives are offered at each meal times, snacks, drinks are provided throughout the day and supplements supplied for those service users who need them. People spoken with on the day all said that the food was good and one relative joined her mother for the lunchtime meal. The home continues to maintain daily charts to record the meals consumed by each person living in the home. This ensures that each person has a well balanced and nutritious diet, supplemented as required. Comments about meals from those living in the home included: ‘the food is lovely and plenty of it’. ‘the food is good and they give lots of it’. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that those living in the home and their representatives feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. EVIDENCE: Copies of questionnaires sent to relatives were provided prior to the site visit; these questionnaires asked relatives to comment on care given and if they had any concerns. One questionnaire raised some issues in respect of food, staff turnover and a healthcare need. There was evidence to show that the management had dealt with these issues and met with the relatives to reassure them their comments had been read and addressed. Comments in other questionnaires included: ‘we are made aware of any concerns’ The CSCI have not received any complaints and the home has received 3 complaints of which only one was partially substantiated and the others were unsubstantiated. Pre-inspection questionnaire from the provider indicated that staff have been trained in Protection of Vulnerable Adults. One person living in the home presents challenging behaviour at mealtimes so an interim arrangement of using a safety gate to limit her access to others during meals is in place. This person’s family are happy with the arrangement. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 14 This matter was discussed with the manager who said she intends to try alternative measures after taking advice from an appropriate healthcare professional. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home are provided with a homely, comfortable, pleasingly decorated and safe environment. EVIDENCE: A tour of the premises was carried out and all parts of the home are well maintained and décor is good. Individual bedrooms were attractively decorated and it was evident that many of the people living in the home had taken the opportunity to personalise their rooms with pictures and ornaments. The home has an on-going maintenance and refurbishment programme and some of the lounge armchairs have recently been replaced. Floor pressure pads are provided for those people who have a tendency to wander at night to ensure that staff are rapidly alerted and reduce risk. Staff spoken with were aware of procedures to reduce the risk of cross infection and were observed to be wearing gloves and aprons as required and all have been trained in infection control procedures Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff with appropriate skills to meet the needs of those people living in the home and the recruitment practice is also sufficiently robust to safeguard those living in the home. EVIDENCE: Information supplied by the providers indicated that of the 20 care staff, 12 have National Vocational Qualifications level 2 in care and 4 are in the process of gaining this qualification. Staff rotas showed that there are four carers and one senior carer on duty during each daytime shift and two night waking staff. Additional staff training has been provided for food hygiene, falls prevention, infection control, dementia care, medication and prevention of tissue breakdown. Staff training is supplied both in-house and by outside trainers. In addition to care staff, domestics, cooks and ancillary staff are employed. Relatives and a healthcare professional spoken with said there are usually plenty of staff around to properly supervise those living in the home. Recruitment records were viewed and it was found that all staff had provided the required information prior to appointment except one who had not provided a reference from his employer. This was discussed with the manager who explained that the referee was the persons direct line manager who had a good knowledge of their day-to-day working practice. The manager agreed to get a reference from the employer without delay. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 17 All staff had provided a Protection of Vulnerable Adults and Criminal Record Bureau checks. Domestic staff did not have these checks as they do not have unsupervised access to those living in the home but the manager said she intends to introduce them for these staff as an additional safeguard. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home and staff benefit from clear leadership and direction and all aspects health, safety and welfare are protected and promoted. EVIDENCE: The Manager/Registered Provider has the required qualifications in care and management as does the other Registered Provider. In addition both are medical doctors and undertake regular training to update their skills and knowledge. The home does not handle monies of those people living in the home, if any items are bought the cost is added to the monthly invoice and receipts provided. Staff and relatives confirmed that she is open and approachable and both staff and relatives were seen to consult with her and the other registered provider throughout the site visit. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 19 The information in the pre-inspection document demonstrated that regular checks are made to ensure that all electrical and gas systems and appliances are safe and maintained in good working order. This document also showed that staff have been trained in fire safety and there is a detailed fire risk assessment in place for all parts of the premises. There is a range of health and safety checks including fire drills and checks on water delivery temperatures. Fire safety equipment is regularly serviced and all staff have been trained in fire safety procedures. Staff spoken with confirmed that fire safety is included in the induction process. The manager maintains a quality assurance system to check compliance with all of National Minimum Standards and regularly consults with those living in the home and their representatives via surveys and one-to-one discussions. Staff spoken with said that they feel supported by the management and demonstrated an understanding of how to maintain the safety of those living in the home. Accident records were viewed and found to be accurate and maintained in line with the Health and Safety Executive guidance. Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 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 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Homelea Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Residential Care Home DS0000021142.V334087.R01.S.doc Version 5.2 Page 23 - 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. 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