CARE HOMES FOR OLDER PEOPLE
Homeleigh 24-28 Stocker Road Bognor Regis West Sussex P021 2QF Lead Inspector
Mrs D Peel Unannounced Inspection 6th December 2005 11:30 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 DS0000024156.V270949.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Homeleigh Address 24-28 Stocker Road Bognor Regis West Sussex P021 2QF Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 863373 01243 863056 Homebeech Limited Mrs Roma Wood Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th June 2005 Brief Description of the Service: Homeleigh is a care home able to provide personal care and nursing care for up to 40 older people. The home is situated close to the sea on the outskirts of Bognor Regis and it is easily accessible by public transport. Shops and other local facilities are close by. Communal space consists of two lounges, a conservatory, dining room and additional sitting areas by the main entrance to the home. Private accommodation consists of 36 single bedrooms and 2 double bedrooms. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 2.5 hours on the 6th December 2005 and was carried out by two inspectors. This was the second visit to the home this year and it was carried out to complete Homeleigh Nursing Homes annual inspection programme for the year 2005 required by the Care Standards Act 2000. The inspectors arrived at 11.30 am and were welcomed by the manager of the home. A tour of the home took place, residents’ care records and staff records were inspected along with other documentation, which showed how care needs are to be met and how the home is being managed. Staff were spoken with informally during the visit and residents were encouraged to talk about living at the home with the inspectors. What the service does well: What has improved since the last inspection?
Residents say that the activities programme has improved since the new manager took over. There has been a new boiler installed to provide a better heating system and supply of hot water although on the day of the visit the providers were waiting for the supplier to visit and replace a faulty part to the boiler. The home is well managed and the present manger is effective in her role as registered manager. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 6 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. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, 5,6 Prospective residents and their families are provided with the information they need to make an informed choice about the home. Residents and their relatives/advocates have a contract so that they know the terms and conditions for living at the home. Residents are assessed prior to moving into the home to make sure that the home can provide a care plan which residents or their families know will meet their needs. EVIDENCE: Homeleigh Nursing Home has a Statement of Purpose and Service User Guide, which sets out the aims and objectives of the home and describes the facilities available. This document is provided to prospective residents and their relatives/advocates to help them make a choice about where the prospective resident wants to live. A contract/statement of terms and conditions of residency is provided for each resident. Residents spoken with during the visit had usually had a relative visit the home on their behalf before they had moved to the home. One person felt that they
Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 9 had had little choice about the home or which room they had. This matter was discussed with the manager who provided an explanation of the circumstances. Homeleigh Nursing Home does not offer intermediate care but can offer periods of respite care. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 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): 7,8,9,10 Care planning systems give clear information to assist with all aspects of health, personal and social care needs. Records are in place to monitor the health care needs of residents to make sure that any signs of residents being unwell are recognised. The home can demonstrate good medication handling. Privacy and dignity is not always upheld and so residents may sometimes feel that staff do not fully respect their dignity. EVIDENCE: Copies of care plans are kept in residents’ rooms so that residents have ownership and staff have the plans at hand to record daily care notes. These plans were sampled during the tour of the home and were found to be regularly reviewed and very informative. Care plans recorded monthly weight, pulse and blood pressure monitoring. It was observed that staff keep regular checks on those residents ill in bed. Medication records viewed at this visit were clear and fully completed. Two lockable trolleys are used to store and transport medication around the home. The manager is in the process of reviewing the homes medication policy. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 11 During the visit it was observed that a resident using the toilet facilities near to the lounge had left the door wide open. Two staff were seen to walk past the door and did not suggest that the door might be closed to provide privacy and dignity in a public area. This matter was brought to the attention of the manager. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 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): 12 Activities are varied to suit residents preferences and abilities. EVIDENCE: Residents say that there are more opportunities to take part in activities. Monthly reports to the CSCI show that in the past few months there have been seasonal activities such as a barbeque and a halloween party. Staff and the home have introduced cookery afternoons. On the day of this visit a clothes party was going to take place in the afternoon. One resident spoken with confirmed that they had continued their hobby of needlework and had been making seasonal greeting cards. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No standards were assessed EVIDENCE: Standards 16 and 18 were assessed at the last visit and scored 3 Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Homeleigh is clean and residents have a comfortable, homely environment to live in. Comfortable bedrooms are provided which residents have personalised. EVIDENCE: The inspectors carried out a partial tour of the home. It was observed to be clean and the décor was of a good standard. Residents spoken with in the privacy of their bedrooms were satisfied with the quality of the décor in their rooms. Most residents have brought personal items to the home, which they have on display in their rooms. During the tour of the home it was observed that the window restrictors on two windows sampled on the upper floor were broken. This was brought to the attention of the manager as a health and safety risk to residents. The floor surface in the upstairs sluice does not have an impermeable floor surface. A recommendation has been made that the carpet is replaced with a suitable surface, which can be washed to promote infection control. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 The staffing levels are set at a level, which allows residents needs to be met. Recruitment procedures have improved but the protection of residents cannot be assured when individual staff have not provided evidence of CRB and POVA clearance. Staff are provided with training to do their jobs so that residents needs can be met and that they are in safe hands. EVIDENCE: Qualified nursing staff are on duty at all times of the day and night, supported by a team of care assistants and ancillary staff. During this unannounced inspection it was evident that there were plenty of staff on duty allowing for care staff to spend quality time with residents. The home encourages staff to take part in the NVQ programme and continues to aim to achieve the target of a ratio of 50 trained care staff (NVQ 2 or equivalent) by the end of December 2005. Residents spoken had many positive comments to make about the staff at Homeleigh. One resident said “the staff are incredible, they can’t do anything else for me to make me feel at home”. The recruitment procedures at the home have improved but there was still one missing CRB/POVA clearance for a member of staff who had been employed since 2002. This matter is of concern and the providers should consider why this evidence has not been supplied and action taken to ensure that residents are not at risk. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35,38 The home is well managed providing leadership and guidance for staff. Some practices do not promote and safeguard the health and safety of residents living at the home. EVIDENCE: An external accountant is monitoring the system being used to deal with service users monies. This system works for the home. However it does not fully meet Regulation 20.1 of the Care Homes Regulations in that the monies are being paid into a bank account which is not in the name of the individual service users for which it belongs. Procedures for protecting residents against the spread of a fire are not being adhered to. During the tour of the home three bedroom doors were being wedged open. One resident confirmed that they have their door wedged open both day and night. This matter was brought to the attention of the manager as a concern for the safety of residents.
Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 17 COSHH procedures are not being adhered to. Domestic staff were using COSHH products, which had been decanted, into unlabeled bottles. This matter was brought to the attention of the manager. Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 3 3 3 3 3 1 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 2 x x 1 Homeleigh DS0000024156.V270949.R01.S.doc Version 5.0 Page 19 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 OP38OP25 Regulation 13.4 (a,c) Requirement Working window restrictors should be in place for all windows above ground floor level. Staff who do not provide evidence of CRB and POVA clearance should not work at the home The Fire Officer must be consulted about the practice of wedging beroom doors open.(the provider should inform the CSCI of what action has been taken within 28 days of the inspection) Timescale for action 16/01/06 2 OP29 19 16/01/06 2 OP38 23.4 16/01/06 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. 3. Refer to Standard 10 26 35 Good Practice Recommendations Staff should be reminded to encourage residents to maintain their privacy and dignity. The floor surface in the upstairs sluice should be rmeable. It is recommended that the organisation can demonstrate how individual residents will receive any interest applicable from the resident’s bank account.
DS0000024156.V270949.R01.S.doc Version 5.0 Page 20 Homeleigh Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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