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Inspection on 19/10/05 for Horncastle House

Also see our care home review for Horncastle House for more information

This inspection was carried out on 19th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is an activities programme in place and activities are posted on the notice board. The dining room and lounges are now more comfortable and efforts are made to get residents to the lounge and to sit in armchairs instead of wheelchairs.

What has improved since the last inspection?

What the care home could do better:

Door wedges are currently used to hold open doors. The use of these wedges should cease and following discussion with the fire authority alternative devices to be fitted to doors. This will be a requirement of this inspection Improvements could be made in the recording of medication, in particular reasons for not administering medication as prescribed to be recorded in care plans. More frequent review of medication may alleviate the necessity for such omissions.

CARE HOMES FOR OLDER PEOPLE Horncastle House Plawhatch Sharpethorne East Grinstead West Sussex, RH19 4JH Lead Inspector Sheila Gawley Announced Wednesday 19 October 2005, 09:30am th 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. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Horncastle House Address Plawhatch, Sharpethorne, East Grinstead, West Sussex, RH19 4JH 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) 01342 810219 Dr Shafik Hussien Sachedina Mrs. Linda Mountford Care Home 43 Category(ies) of Care Home with Nursing registration, with number of places Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/10/04 Brief Description of the Service: Horncastle House is a care establishment providing nursing, registered to accommodate up to 43 service users in the category OP (persons over 65 years), four of which can be in the PD category (physical disability under 65 years). A maximum of four persons over 50 years in the category PD may be accommodated. Horncastle House is a large detached property located in the village of Sharpethorne, near East Grinstead. The accommodation is arranged over two floors, which are served by a passenger lift. There is one shared bedroom. Horncastle House is part of the Sussex Health Care Group and is privately owned by Dr Sachedina and Mr Boghani. The newly registered manager is Mrs Linda Mountford. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was carried out on the 19/10/05. Residents and staff were spoken to. The majority of the comments about care and life in the home were positive. Observations made on the inspection, discussion with staff, residents and management, information from the pre inspection questionnaire and comment cards. Will be used in compiling this report. This report will also take into account information gathered on an additional visit on 20/05/05. 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. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 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 Horncastle House H60-H11 S24159 Horncastle House V240264 191005 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) 1-4 Prospective residents have the information they need to make an informed choice about where to live. Each resident has a written contract/ statement of terms and conditions with the home. No resident moves into the home without having had his/her needs assessed and been assured that these will be met. Residents and their representatives know that the home they enter will meet their needs. Prospective resident service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. EVIDENCE: The Statement of Purpose and Service User Guide was clear and comprehensive and had been made available to all service users. Terms and conditions are supplies top all residents at the point of moving in the home. Needs assessment is undertaken prior to, and upon admission, and these helped to generate the plan of care. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 8 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 The resident’s health, personal and social care needs are set out in an individual plan of care. Residents, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Car plans inspected were mostly up to date. The need to be more specific in care plan reporting was discussed with the manager, for example “cream applied” needs to state what cream and to what part of the body it is applied. Policies and procedures are in place to ensure the safe receipt, administration and disposal of medication. Medication withheld needs to be recorded correctly and this should prompt a review of medicines. This would ensure that residents are protected from harm due to drug omissions or errors. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 9 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) 12-15 Resident find the lifestyle experienced in the home matches expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Residents maintain contact with family/ friends/ representatives and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Residents able to express an opinion stated that they were happy in the home and that there was flexibility in routine. One resident was out to a weekly club that she likes to attend. Residents stated that they enjoy activities and one resident stated that she misses activities, as she cannot get out due to a broken leg. The food seen being prepared and served was sufficient and nutritious. Residents stated that they enjoyed the food. Pureed food was served appropriately and assistance was offered in an appropriate manner. The chef was spoken to who has up to date food and hygiene training, as do the two kitchen assistants. He stated that he can exercise freedom in menu planning. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 10 Up to date fridge, freezer and food temperatures were available. There was however food in the fridge unlabeled and also some sacks of food on the floor. These practices were discussed with the chef and again later with the manager. These practices to be discussed and reconsidered with the Environmental Health Officer so as not to risk the health and safety of residents. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon EVIDENCE: A significant component of the additional visit on 20/05/05 was related to the recording and management of complaints. The complaints book was available for inspection and showed that complaints were recorded and that they were followed up. There is a clear complaints procedure in place and this is included in the service user guide. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,22,23,24,26 Residents do not live in an entirely safe and well-maintained environment. Residents have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Residents live in safe, comfortable bedrooms with their own possessions around them. The home is clean, pleasant and hygienic EVIDENCE: The use of wedges to hold doors open was evident. This practice means that the resident’s health and safety is at risk in the incidence of fire. The need for suitable hold open devices that respond to the detection of fire by the fire alarm system to be installed and maintained to the correct standard by a competent person was discussed with the registered manager. The inspection of 28 10 04 stated that the fabric and the décor of the building was looking tired. The visit of 20/05/05 made a requirement that all parts of Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 13 the home to be clean and reasonably decorated. Significant improvement was seen today but the work is ongoing. Sever rooms have been or are in the process of being decorated. A lounge previously unused has been cleared and new curtains are on order. Some beds are still old and worn and the manager is unsure as to whether these are to be replaced at this time. Some bed tables are worn and as the water resistant covering is broken they present a risk to the health and safety of residents. Lighting fittings still need attention, such as new cords complete with grip on the ends. The maintenance man stated that he is doing this and the manager stated that she intends to replace some light shades. Some residents have been assessed for specialist chairs to allow them to sis in the lounge more safely, Resident’s bedrooms had their own furnishings and belongings. The home today was clean and free from offensive odours. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 The numbers and skill mix of staff meets resident’s needs. Staff are trained and competent to do their jobs. EVIDENCE: Staff rota were available for inspection and show adequate numbers of staff on duty. Staffing is assessed by using the residential Forum. A comprehensive training programme is in place and records are kept of those staff who have attended. This ensures that residents are protected by sufficient numbers and suitably trained staff. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,38 Residents 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. Resident’s benefit from the ethos, leadership and management approach of the home. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The newly registered manager is a Registered nurse level 2 and has completed the Registered Managers Award. She has recently taken over the management of this home but has several years management experience with the organisation. She undertakes training to retain the Post Registration Education and Practice requirement for continued registration with the Nursing and Midwifery Council. Staff spoken to stated that they are happy with the Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 16 management of the home. Several improvements are evident in the home since the visit to the home of 20/05/05. The manager has policies and procedures, staff training, health and safety checks and risk assessments in place to ensure the health, wellbeing and safety of residents and staff. The issues that pose a risk to the health and safety of residents have been discussed with the manager and are stated in the relevant sections of the report. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 x x 2 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x x 2 Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 23(d)(4) (5) 16 (j) Requirement The building complies with the requiremants of the local fire serviceand environmental health department. Timescale for action 31 12 05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 9 Good Practice Recommendations The registered person to ensure there is a policy and staff adhere to procedures for the administration and recording of medicines. Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Horncastle House H60-H11 S24159 Horncastle House V240264 191005 Stage 4.doc Version 1.40 Page 20 - 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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