Inspection on 25/01/06 for Homeleigh

This inspection was carried out on 25th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Homeleigh 21/09/09

Homeleigh 04/11/08

Homeleigh 07/11/07

Homeleigh 10/01/07

Homeleigh 18/10/05

Homeleigh 17/03/05

Homeleigh 27/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Homeleigh Avenue Road Erith Kent DA8 3AU Lead Inspector Lorraine Pumford Unannounced Inspection 25th January 2006 13.00p 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 Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 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. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Homeleigh Address Avenue Road Erith Kent DA8 3AU 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) 01322 339691 01322 350291 Kent Community Housing Trust Mrs Claire Helen Evans Care Home 48 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (32) of places Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Homeleigh is a large detached building situated in a pleasant residential area of Erith. It is near to local shops and facilities, and has bus routes and train stations within easy travelling distance. It is owned and managed by Kent Community Housing Trust (KCHT), which is a charitable (not for profit) Trust, and who have other care homes for older people within the region. The home is set into a hillside, and has four floors, of which 3 are for accommodation. The top (3rd) floor is used as the premises for KCHT’s Bexley Regional Office. The ground and first floors include bedrooms and communal areas for older people (not in any other category of registration), and includes up to 4 beds for respite or short term care. There are also 4 rooms kept on the ground floor for older people with a high level of visual impairment. The 2nd floor has bedrooms and a communal lounge/dining room, and is used specifically for older people with dementia. There are additional safeguards in place for their safety. All levels can be reached via a passenger lift. As the home is on a hillside, the gardens are accessed from the first floor at the rear of the building, and there is a spacious patio area, walkways, a lawn and mature shrubs. The home provides day care for several Service Users each day additional staffing is provided. Day care services are not required to be inspected by CSCI, and so does not form a part of this inspection. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by one inspector who spent the afternoon in the home, during this time some service users, manager and administrator were spoken to and a relative was spoken with in private. Parts of the premises were inspected and some records examined. The manager stated that discussion continues to take place regarding the future of Homeleigh, it is acknowledged by all parties that the building is very old, and a decision has yet to be made either to undertake a major refurbishment of the existing home, or the option of moving to alternative premises. The majority of key standards were inspected during the course of the previous inspection. A minimum of two inspections generally takes place within a 12 months period to all Registered Care Homes. As this inspection may not have covered all the “National Minimum Standards” it is recommended that if further information is required a copy of the last inspection report also be obtained. What the service does well: Service users are cared for by suitably qualified and competent staff. Although the external appearance of the building is large and impersonal, staff have created a friendly and relaxed atmosphere within the home. Service users can be assured that their privacy and dignity will be respected at all times. Service users are able to be participate in a range of activities both in the home and in the local community. It is apparent that staff endeavoured to maximise service users independence, personal autonomy and choice. Procedures are in place to protect service users financial interests. Service users who are able are supported to manage their own financial affairs. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 6 Service users and their representatives can be confidant that any concerns raised with the management of the home will be investigated and action taken to address the matter. The home has provided additional staff to support a service user on a one to one basis, until a more appropriate placement can be found which can meet this service users additional needs. What has improved since the last inspection? What they could do better: Staff responsible for writing care plans need to ensure that care tasks are clearly documented and provide clear guidance on the action required to meet the service users assessed need. Care staff must be provided with appropriate support and guidance from suitably qualified health and social care professionals to enable them to manage the challenging behaviour and aggression currently being exhibited by a service user. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 7 Sluice rooms must be kept clean and tidy to reduce the possible risk of infection being spread. 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. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 8 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 Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 9 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): 6, Homeleigh does not provide intermediate care. EVIDENCE: The key Standard 3 was inspected during the course of the previous inspection and therefore not inspected again on this occasion. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,10, Staff respect service users privacy and dignity at all times. EVIDENCE: As service users care plans were inspected in detail at the time of the previous inspection, on this occasion only two care plans were inspected in relation to specific concerns raised during the course of this inspection. The first was examined in relation to the challenging behaviour being exhibited by one service user. The manager stated and records indicated that additional staffing had been provided to enable the service user to be supported on a one-to-one basis, support and guidance was also being provided by a community psychiatric nurse whilst a more appropriate placement was being sought by the social services care management team. It was evident from records seen that some members of care staff were able to manage the behaviour exhibited more successfully than others, discussion took place around the need for care staff to be provided with specialised training to enable them to support this service user with additional needs. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 11 Further staff and the service user would benefit from specialist psychiatric involvement in formulating a care plan to help manage his currant behaviour, to enable staff to feel confident in their approach to handling the situation and ensure a continuity of approach by all staff towards the service user concerned. The second care plan examined was in relation to the assistance a service user requires with personal care. At present it is not possible for the service user to have either a bath or shower, information regarding this aspect of the service users personal care is referred to in the care plan in general as to assist with a wash. Discussion took place with the manager regarding the need for this term to be clearly defined into tasks i.e. service user is able to wash hands and face with minimal assistance, however requires full assistance with body wash etc, staff should then record on a daily basis the aspects of the task that have been undertaken. The manager agreed to follow-up with staff the issues discussed regarding care plans. During the course of this inspection the inspector observed and the relative spoken with confirmed that service users requiring assistance with personal care were assisted in a calm and dignified manner by care staff, who respected their privacy. Staff were seen to knock on service users bedroom doors before entering. Due to a change in the use of rooms the telephone for service users to use has been relocated to a corridor, the manager stated a privacy hood is due to be fitted to the wall shortly which will enhance privacy for service users using the telephone. Staff have positioned a bell by the phone so service users can call for staff assistance when they have finished making a telephone call. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 12 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): 13,14 Service users are able to maintain regular contact with relatives and friends and participate in local community life. Service users are helped to exercise choice and control over their lives. EVIDENCE: From talking to service users, staff and a relative it is apparent that service users are able to maintain links with family, friends and the local community. A relative spoken with stated that she is always made to feel welcome by staff working in the home and is offered refreshments; she has found this to be the case regardless of the time or day that she visits. The home has a number of lounges (including a quiet lounge without TV) and small seating areas around the home, as well as a visitors room and a designated smoking room. Service users were seen to move around the home freely, choosing where they wished to sit and were assisted by staff if required. Bedrooms seen were individually personalised with service users personal effects, photos and mementos. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 13 When service users are able they are encouraged to manage their own financial affairs, the administrator stated that she provides practical assistance for these service users. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 14 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 Service users can be confident that any concerns they raise will be addressed thoroughly. EVIDENCE: The CSCI have received no complaints regarding Homeleigh during the course of this year. A relative spoken with stated that when a family member had raised concerns regarding the quality of food, action had been taken promptly by the manager to address the matter raised. A service user spoken with stated she had nothing to complain about and stated, Its very nice here . Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 Service users are provided with a clean comfortable environment with sufficient communal space. EVIDENCE: On the day of the inspection all areas used by service users and seen by the inspector were clean, warm and free from unpleasant odour and appropriately furnished to meet the needs of the current service user group. Service users spoken with stated they found the home comfortable. A sluice room on the upper floor was being used as a storeroom for various items such as garden furniture and items no longer in use by service users. Discussion took place around the need for the room to be clean and tidy and used solely as a sluice room to reduce the risk of any possible infection being spread around the home. The manager stated this issue would be addressed There is an emergency call system in all areas used by service users. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 16 The home provides grab rails in corridors. Bathrooms and toilets are provided with appropriate aids to assist physically frail service users. The manager has provided information to the CSCI regarding the number of falls sustained by service users in the home. She has taken appropriate action to monitor these and to ascertain any apparent reasons, i.e. service users wearing inappropriate footwear, the layout of room, service users medication, etc. as this appears to be a long term issue. Discussion took place regarding the possibility of arranging for an assessment of the premises and facilities to be undertaken by a suitably qualified person. The manager stated that the trust has a designated responsible person to assess the health and safety of the buildings. The manager also stated that service users are able to access support and advice from a qualified community physiotherapist, the inspector suggested that this person may be able to provide additional assistance with an assessment of the premises. Records seen indicated that all hoists used in the home have received an appropriate maintenance check. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 17 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 Service users can be assured that they are cared for by suitably qualified and competent staff. EVIDENCE: A relative spoken with stated she had been concerned at the number of agency staff who had been working in the home, although she acknowledged that more recently she had seen the same faces more often. The manager stated she has an arrangement with the agency, to as far as possible have the same temporary carers and therefore provide service users with continuity of care. The manager stated that a temporary imbalance in staffing in the home has occurred as another home run by the trust is closing. She had therefore been unable to recruit new staff on a long-term basis instead holding open possible vacancies to give staff from the other home the opportunity of transferring. This process is now nearing completion and the home will be operating with a full complement of permanent staff in the near future. The shift pattern facilitates good communication with a staff handover period between the morning, afternoon and night shift. Good interaction was observed between staff and service users throughout the inspection, staff addressed service users by their preferred names and Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 18 provided care in a calm unrushed manner. Service users spoken with spoke highly of staff and the care provided. The number of service users attending the home for day care has increased due to the closure of another care home. Additional hours have been provided by the designated activity staff to cover the increase in numbers. The manager stated that a sufficient number of staff hold first aid certificates to ensure that a suitably qualified person is on duty for each shift. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 19 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): 35, Procedures are in place, which protect service users financial interests. EVIDENCE: A random sample of records in relation to service users personal allowance were examined. The record of service users personal allowance tallied with the amount of money held by the home for safekeeping. Record seen indicated that whenever possible service users sign to say they have received money being held for them by the home. Staff issues receipts to relatives depositing money for service users in the home for safekeeping. Receipts are kept for any items purchased by staff on a service users behalf. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 20 The home has appropriate facilities to keep safe small amounts of money and personal possessions on a short-term basis. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 21 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 X X X n/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X 3 X X X 2 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 X X X X 3 X X X Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP30 Regulation 18(1)(c) Requirement Staff must to be provided with appropriate training, to manage service users with challenging and complex needs. Timescale for action 30/03/06 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 OP7 OP26 Good Practice Recommendations Ensure that care plans clearly indicate tasks to be performed and action to be taken by staff to Complete these tasks. Sluice areas need to be kept clean and tidy and fit for the purpose at all times. Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Homeleigh DS0000006793.V275247.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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