Inspection on 16/01/06 for Ingleside

This inspection was carried out on 16th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Ingleside 06/05/08

Ingleside 12/07/07

Ingleside 08/05/06

Ingleside 14/07/05

Ingleside 09/03/05

Ingleside 02/08/04

Ingleside 10/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Ingleside 648 Dorchester Road Upwey Weymouth Dorset DT3 5LG Lead Inspector Val Hope Unannounced Inspection 16th January 2006 10:00 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 Ingleside DS0000026824.V278265.R02.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. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Ingleside Address 648 Dorchester Road Upwey Weymouth Dorset DT3 5LG 01305 812667 01305 813383 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) Mr Christopher James Webb Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two rooms may be used as doubles. Date of last inspection 14th July 2005 Brief Description of the Service: Ingleside Residential Care Home is established in a large semi-detached house set back from the main Dorchester to Weymouth road in the village of Upwey. The home is registered to accommodate 17 elderly people and has been owned and managed by Christopher Webb for the past 20 years. In total there are fifteen bedrooms available in a combination of 13 single and 2 double rooms. Bedrooms are situated on the ground and first floor of the house. The first floor is accessed by chairlift on the main staircase or by a back staircase. The communal facilities include two lounges, a separate dining room and a conservatory that overlooks the front garden. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by Val Hope, Regulation Inspector on Monday 16th January 2006 commencing at 13:10 hours. The inspection took approximately 3 hours. The purpose of this inspection was to review the requirements and recommendations made as a result of the previous inspection, assess key standards not assessed at the previous inspection and ascertain the views of residents accommodated about their life within the home. Mr Christopher Webb the Registered Person was away on holiday the home was being managed in his absence by Mrs Audrey Moore, one of three Senior Carers employed within the home. There were 15 elderly persons accommodated within the home on the day of the inspection. This report should be read in conjunction with the previous inspection report of 14th July 2005 to gain a comprehensive view of this home’s performance in relation to compliance with legislation and meeting National Minimum Standards. What the service does well: Ingleside continues to provide a good standard of care in very clean, wellmaintained comfortable surroundings to its client group of elderly people with low to moderate care needs. Residents said that they are treated with respect and due regard is paid to privacy, dignity and autonomy and choice. A high level of satisfaction with the accommodation, care and services provided by the home was evident. Comments received from residents included:“It really is lovely here I am quite content, the food is good and the staff are very kind”; “It is fine here but I do have to wait quite often when I ring the bell”; “Nice people live here and nice people work here too, the food is good home cooking and they know what I like” and “There is always someone around to help if you need it and I don’t have to worry about the upkeep of a house of my own anymore”. The location and layout of the home are suitable for the service user group. The décor is comfortable and very pleasant and the home was warm and well lit. For the most part, all furnishings are of a very good standard and present a homely and comfortable environment for service users. The home is well ventilated and warm. The gardens are well maintained. There is a stair lift, which is only used with staff in attendance. This only reaches the first small landing and there are a further three steps to access some of the bedrooms; Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 6 this therefore does have an effect upon the level of mobility of prospective service users who may be accommodated within these rooms. This is taken into consideration when assessing service users needs prior to offering accommodation in the home. There is a stable staff group and staffing levels meet with residents, satisfaction. What has improved since the last inspection? What they could do better: Shortfalls identified relating to medication and infection control matters need to be rectified. Fire doors must not be held open by inappropriate means. Comments received included: “Is it your fault I have to have my door closed? I always like it open” and “Why do I have to have my door closed just because you are here? I don’t like it, I want it open”. The provision of door closers in accordance with advice previously supplied in 2000 and 2003 to Mr Webb by Dorset Fire and Rescue Service will be necessary in order to ensure that residents are able to retain autonomy and choice, at the same time ensuring their safety in the event of fire. All staff must receive training relating to the Protection of Vulnerable Adults. Management processes need to be more robust. For example the recruitment process must be rigorous, staff should receive formal sessions of individual supervision periodically to support care workers strengthen and develop their skills and knowledge, and the draft staffing structure should define all management roles and responsibilities prior to implementation, to provide improved clarity for staff and residents. Additionally, a formal quality assurance system has yet to be fully completed and records required by regulation must be available for inspection at all times to any person authorised by the Commission for Social Care Inspection to enter and inspect. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 7 Mr Webb is aware that in order to meet the National Minimum Standard, he or a delegated manager must undertake formal up to date management training to achieve an NVQ level 4 in Management and Care [or equivalent]. 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. Ingleside DS0000026824.V278265.R02.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 Ingleside DS0000026824.V278265.R02.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): None of these standards were assessed. EVIDENCE: Ingleside DS0000026824.V278265.R02.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, 9 and 10 Care plans are of a satisfactory standard providing detailed instruction to social care workers to ensure residents assessed care needs are met. The medication administration records were unable to demonstrate that every resident had received their medication as prescribed, potentially putting a resident at risk. Residents are treated with respect and their privacy and dignity is promoted, enhancing their quality of life. EVIDENCE: The content of care plans has been improved to provide sufficient information to enable social care workers to deliver care to meet assessed needs. Care plan reviews have been conducted on a regular monthly basis and updated where necessary. A weekly monitored dosage system is used. Examination of the medication administration records found that one resident had not had one medicine administered as prescribed since from the 8th January to the day of the inspection [8 days]. Satisfactory procedures for the ordering, storage, administration and disposal of medicines were in place. A good rapport was Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 11 observed between staff and residents. Residents said they feel respected and that their dignity is protected when personal care tasks are undertaken Ingleside DS0000026824.V278265.R02.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): 14 Residents are helped to exercise choice and control over their lives promoting independence. EVIDENCE: Residents clearly have autonomy and choice in day-to-day aspects of their life; a fact demonstrated by their vehemence in complaining to the inspector that they “had to have” their bedroom door closed whilst the inspector was in the home. In order for home to continue to honour residents preferences in this respect, the provision of appropriate door closers will be necessary if fire precautionary measures are not to be compromised [see standard 19]. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 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): 18 Protection of Vulnerable Adults training is yet to be provided to all social care workers employed to safeguard residents from any form of abuse. EVIDENCE: The inspector was advised that there are two social care workers who have not yet received training relating to the Protection of Vulnerable Adults. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 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 and 26 The holding open of fire doors by inappropriate means compromises fire safety in the home and puts residents at risk. Shortfalls identified in infection control measures potentially places residents at risk from cross infection. EVIDENCE: Residents who have higher mobility needs are, where and when possible, accommodated on the ground floor. They experience difficulties when entering and leaving their rooms due to the lack of appropriate means of holding bedroom doors open. Residents told the inspector that bedroom doors had been closed by staff upon the inspector’s arrival at the home. They said they were very unhappy about this and that it was routine for doors to be held/wedged open [standard 14]. Residents confirmed that open doors were their particular preference and to meet their needs. This situation gives rise to some conflict in that by meeting standard 14, affording residents autonomy and choice by holding doors open by inappropriate means, fire precautionary measures have routinely been compromised [standard 19]. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 15 A satisfactory solution enabling the home to meet both standards 14 & 19 [and the regulations] would be the provision of appropriate door closers. An immediate requirement relating fire precautionary issues was made and additional information has been provided under separate cover for resident confidentiality purposes. Whilst there was a good standard of cleanliness generally throughout the home infection control was compromised by a dirty nailbrush left in the first floor bathroom wash hand basin and a bath body sponge and net body cleanser left in the ground floor bathroom posing the potential for communal use. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 and 30 There has been no recruitment to the staff team since the last inspection. EVIDENCE: Mr Webb attends the home each day there are a total of 11 social care workers on the staff team. No ancillary staff are employed other than a part time gardener and part time handyman. Carers also undertake domestic duties and some kitchen/cooking duties. There are a minimum of two care staff on duty at all times. One resident commented that it was ‘often’ the case the call bell took an unreasonably long time to answer, others said that said they did not routinely wait a long time for assistance also commenting that when it did, it was appreciated that staff were already busy with other residents. Overall, this did not appear to be a routine or widespread problem. With no new recruits to the staff team since the last inspection it was not possible to assess the requirement relating to recruitment [first made 9/3/05], which will be carried forward. With no new members of staff for over a year, the home has not had the opportunity to introduce a full induction and foundation training programme which meets National Training Organisation Standards. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 17 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): 31, 32, 33, 35 and 36 No one in a senior role in this home has undertaken any up to date formal management training to National Vocational Qualification Level 4 in Management and Care [or equivalent], designed to equip managers with up to date knowledge and management skills to ensure best practice methods are deployed for the benefit of residents. Quality assurance and performance monitoring has not been fully implemented to assist with future development of services benefiting residents. The home was unable to demonstrate that the financial interests of residents are safeguarded. A programme of formal individual staff supervision has not been implemented to support care workers strengthen and develop their skills and knowledge to ensure consistency of appropriate care to residents accommodated. EVIDENCE: Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 18 Mr Webb is aware that in order to meet standard 31, he or a delegated manager must have achieved an NVQ level 4 in Management and Care by 2005. However, he stands by the written statement made in response to previous inspection reports, which said: “Please note: Proprietor is not going to achieve NVQ in Management nor is he appointing a manager by 2005”. Mr Webb manages the home on a day-to-day basis and has overall responsibility for planning and financial management of the business in addition to chef and shopping duties. There are three senior carers who undertake management of care duties e.g assessment and care planning and review and risk assessment. Staffing arrangements currently remain the same although it is intended to make some changes to the staffing structure in the near future. A requirement was made at the previous inspection that a clear staffing structure be devised by 30/09/05 to accurately demonstrate roles and responsibilities within the home. A draft management structure with associated job descriptions was received by the Commission on 21/12/05 for comment; as Mr Webb was on holiday when this inspection took place discussion regarding the drafts had not been possible. Comments will now be made under separate cover. A formal system of quality monitoring and performance review has not been fully implemented. A questionnaire had been issued to residents and relatives several months prior to the last inspection. Since the last inspection the results of that survey have been collated and analysed however, the findings have not been utilised as part of an annual development plan for the home. The inspector was shown a policy relating to the home’s quality assurance process which appeared to be in draft form as it was undated and unsigned. The inspector was advised that the home does handle sums of money for a number of residents. However, the person managing the home in the absence of the proprietor had not been given keys to access these financial records and cash as another senior carer had been given this responsibility. The keys are routinely taken off the premises at the end of the staff members shift, therefore it was not possible for the inspector to assess whether the home handles residents money appropriately in accordance with National Minimum Standards. There was no evidence that staff have received formal individual supervision. Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 19 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 1 X X X X X x 2 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 x 1 1 x x Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 20 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 OP9 Regulation 13[2] Requirement The registered person must ensure that the home is able to demonstrate that medication has been administered in accordance with the prescriber’s instructions. The registered person must begin a programme of fitting appropriate fire equipment [door closers] to ground floor bedroom doors in accordance with advice provided by Dorset Fire and Rescue Service in letters dated 6/11/2000 and 7/1/2003. Prior to this report being finalised evidence that 5 door closers were fitted within the timescale was provided. The registered person must ensure that all members of staff receive training relating to the Protection of Vulnerable Adults This requirement is repeated from the previous inspection of 14/7/05. The registered person must ensure that bedroom doors are never held open by inappropriate means. The registered person must DS0000026824.V278265.R02.S.doc Timescale for action 16/01/06 2 OP14 12[3] 28/02/06 3 OP18 13[6] 30/05/06 4 OP19 23 16/01/06 5 Ingleside OP26 13[3] 16/01/06 Page 21 Version 5.1 6 OP29 19 7 OP31 10[3] 8 OP33 24[1] 9 OP35 17 10 OP36 18 ensure that infection control measures are comprehensively practised; items, which if used communally, have the potential to spread infection must be removed from bathrooms. The registered person must operate a robust recruitment process designed to protect residents. [There has been no recruitment since 9/3/05 therefore this requirement is repeated]. The registered person must undertake training to NVQ Level 4 in Management and Care or appoint a Registered Manager who has the appropriate training. This requirement is repeated from the previous inspection of 14/7/05. The registered person must ensure that an effective quality assurance and monitoring system is fully implemented, completed and a report of the review of the quality of care supplied to the Commission. The registered person must ensure that at all times records required to be kept by regulation are available for inspection by any person authorised by the Commission to enter and inspect. The registered person must ensure that a programme of regular formal supervision is implemented. This requirement is repeated from the previous inspection of 14/7/05. 30/05/06 30/05/06 30/06/06 30/01/06 30/05/06 Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 22 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 OP31 Good Practice Recommendations A review of the draft job descriptions provided to the Commission should be undertaken in accordance with correspondence made under separate cover, to provide clarity for social care workers employed. A job description defining the role of the Registered Person should be devised, a copy of which should be provided to the Commission. Policies and procedures demonstrating how the home actually operates should demonstrate their adoption and implementation by being signed and dated by the registered provider. These should be subject to annual review [if they have not been amended in the meantime according to any changes in practice]. 2 3 OP31 OP31 Ingleside DS0000026824.V278265.R02.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Ingleside DS0000026824.V278265.R02.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. 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