Inspection on 12/07/05 for Inver House

This inspection was carried out on 12th July 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.

Other inspections for this house

Inver House 15/04/09

Inver House 28/04/08

Inver House 15/09/06

Inver House 26/01/06

Inver House 03/03/05

Inver House 17/08/04

Inver House 11/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Inver House Foreland Road Bembridge Isle of Wight PO35 5UB Lead Inspector Neil Kingman Unannounced 12th July 2005 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. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Inver House Address Foreland Road, Bembridge, Isle of Wight PO35 5UB 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) 01983 872312 01983 875814 Islecare 97 Limited Mrs Joanne Bennett Care Home only 35 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (8), Old age not falling within any other of places catergory (35), Physical disability over 65 years of age (12) Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 3rd March 2005 Brief Description of the Service: Inver House is a care home providing personal care and accommodation for 35 older people. The home offers a day care service for up to four service users per weekday. An area of the home has been developed to accommodate and meet the needs of those individuals with mental frailty, and illness associated with dementia. The home is a large three storey detached property set in its own grounds and situated in a residential road in Bembridge village, a few minutes walk from a range of local shops and the nearby beach. There is a large car park to the front of the building from which there is level access into the home. The accommodation offers a range of single rooms on all three levels, accessible to residents via a passenger lift. There is a large enclosed garden, which is mainly laid to lawn with flowers, shrubs and seating for service users. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Inver House took place unannounced over 6¼ hours. The deputy manager helped the inspector initially, before the manager arrived mid morning. A tour of the premises took place and a selection of records was inspected. Due to cognitive impairments it was difficult to fully engage with service users. However, the inspector had an opportunity to speak with eight (day care and residents). Comments were quite positive and no concerns were raised. Four members of staff were spoken with. Two comment cards were received from relatives of residents, both raising concerns about the service, which are outlined in the report. What the service does well: What has improved since the last inspection? What they could do better: The following issues of concern were identified during the inspection or from comments received from relatives: Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 6 • A freezer and two fridges in the home’s kitchen were in need of repair or replacement. The Company has confirmed that arrangements are in hand to replace the appliances with new ones. A toilet waste pipe in a first floor bathroom was in need of repainting. Chairs in the special care unit lounge/dining room are old and stained. The home must bring forward its planned renewal programme to ensure they are upgraded by 30/9/05. The home has since confirmed that arrangements are in hand to replace all chairs. The manager recognises that the home lacks facilities for providing a storage area for wheelchairs and equipment, and a communal facility for private visits other than in residents’ rooms. It has been an issue at previous inspections. However, a major development of the home has been planned for some time, when such facilities would be catered for. In light of the comments received by a relative of a resident the manager confirmed that with some thought arrangements could be made to provide a dedicated equipment free room for private visits. Some infection control practices were seen to be unacceptable. The manager has since confirmed that measures to improve infection control procedures have been reinforced with staff to ensure safe practices. It was evident from duty rotas and staff comments that the home has difficulty in responding appropriately to unplanned staff absences. This has the potential to compromise the health and welfare of service users. This issue has been dealt with by way of separate correspondence with the Company. • • • • • 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. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 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 standard(s) 3 and 4 The manager ensures that the care needs of the people who live at Inver House will be met by undertaking a proper assessment prior them moving into the home. Although Islecare provides a package of training for staff to develop their skills to deliver the services and care which the home offers to provide, at the time of the inspection shortfalls were identified in duty rotas, where the numbers and skills mix of staff on duty were not sufficient to meet the needs of the residents. EVIDENCE: The newest resident in the home had been admitted some two weeks prior to the inspection. The manager confirmed that she and her deputy had carried out a pre-admission assessment at the hospital before this person moved into Inver House. The assessment was completed in full and was available with the resident’s care plan. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 9 The manager confirmed and records showed that statutory and refresher training is scheduled for all staff. Additionally, the Company has introduced training packages that are linked to the NVQ programme, including the promotion of continence and dementia awareness. The home has a range of equipment to enable staff to transfer people safely and it accesses services to assist people with sensory impairment. In addition to ten permanent care staff employed at the home there were six new staff recruited together about five weeks before the inspection. The home also relies on bank staff to make up for shortfalls where possible. Records showed that only four members of the care staff were qualified at NVQ level 2. From conversations with staff and records seen it would appear that the home’s response to unplanned absences was inadequate on certain shifts. This has been covered in standard 27 of the report and addressed by way of separate correspondence with Islecare. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 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 standard(s) 7 and 9 The home has a system of care planning with an individual plan for each resident. They demonstrate that residents’ health care needs are identified and met. Medication is securely held and appropriate records are maintained. EVIDENCE: Each resident has an individual care plan. The inspector looked at a sample of three plans, which included a resident with high care needs, a resident who was largely self caring and had been in the home for several years and the newest admission to the home. Plans follow the Company format where care needs are identified and details recorded of care to be given and when. The deputy manager confirmed that a comprehensive review of all care plans was in progress. This was in evidence in two of the plans recently reviewed, which showed information to be clear and detailed. Risks were noted to be identified and assessments were in place. Due to some cognitive impairment residents spoken with showed little knowledge of the existence of their care plan. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 11 Records showed that medication is administered only by staff deemed competent by the manager. Medication was stored securely and administration records were found to be in good order. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 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 standard(s) 14 and 15 While residents are supported to manage their own financial affairs for as long as they are able, in reality most have family to assist. The promotion of choice extends to all aspects of daily living including personalisation of rooms, and meals. Residents receive varied, wholesome and good quality food in a pleasant dining room. EVIDENCE: The manager was very clear about accessing the advocacy service for residents where it was appropriate to do so. She confirmed that currently all but two had family to support them. This was confirmed in conversations with some residents. One resident manages his own affairs and the manager acts as appointee for another. Service users are entitled to bring personal possessions with them into the home and some rooms were seen to have been personalised. As at previous inspections from discussions with service users and the cook, and sampling food at lunch-time the inspector considered the standard of meals was being maintained. Again there was unanimous praise for the choice, quality and presentation of food served. A five-week menu showed that residents’ meals were varied, wholesome and nutritious. The inspector had an opportunity to sit with two day-care users and a resident over lunch. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 13 The atmosphere was relaxed and congenial and staff were attentive throughout. In addition to three meals a day, service users are offered early morning tea and a regular supply of drinks with biscuits and sometimes cakes during the day. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 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 standard(s) 16 The home treats residents’ complaints seriously and responds appropriately. EVIDENCE: The home has a complaints policy and procedure, details of which are included in the service users’ guide. The inspector looked at the home’s complaints register, which gave details of two complaints this year and the action taken by the home. The system was seen to be appropriate. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 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 standard(s) 19, 22 and 26 While the location and layout of the home was seen generally to be suitable for its stated purpose, on the day of the inspection shortfalls were identified with some furnishings, and the decoration and upkeep of the premises. The home provides level access to all areas including the rear garden and access to resident accommodation is via and eight person passenger lift. A range of equipment is available to assist in moving people safely but a lack of a storage area compromises communal space. While the home employs staff to keep the building clean and hygienic on the day of the inspection one area smelled strongly of urine and shortfalls were identified in the home’s infection control procedures. EVIDENCE: Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 16 The building is set in quite spacious grounds with ample off-road parking to the front. There is level access into the home and the good sized gardens at the rear provide a safe environment for both able and confused residents to walk and sit. The inspector toured the building with the manager. The following issues of concern were noted: • An offensive smell in the special care unit was traced to a bathroom where a urine soiled rug was soaking in the residents’ bath. This clearly had the potential for cross infection. The manager dealt with the issue immediately. In another bathroom there were several tubs of cream and a bar of soap left lying around. This had the potential for cross infection. The manager dealt with it immediately. In the home’s kitchen it was noted that seals around the doors of two fridges were split, causing them to leak water. A broken shelf in an old freezer was held in place by string. In a first floor bathroom the toilet waste pipe was in need of repainting. At the last inspection the home was required to address the issue of badly peeling ceiling paint in a first floor ladies toilet. The standard of work carried out to address this issue was noted to be poor. • • • • • At the time of producing this report the manager has confirmed that infection control procedures have been reinforced with staff to ensure safe practices. The manager pointed out that the Company’s programme of maintenance and redecoration was ongoing and that chairs in the special care unit lounge/dining room were due for replacement during this financial year. However, a comment card received from a relative of a resident highlighted the fact that the chairs were badly stained and unhygienic. The inspector returned to Inver House at a later date, met with the relative, inspected the chairs and confirmed that her concerns were justified. The manager gave an assurance that the chairs in question would be replaced at the earliest opportunity. The manager said that the home had recently experienced a difficulty in retaining a gardener. As a consequence attention was not being paid to regular maintenance of the grounds. This also was highlighted in comments received from the relative of a resident. The manager confirmed that a new gardener was due to commence work on 8 August 2005 when the matter would be fully addressed. Two relatives of residents commented on the fact that the home lacked suitable facilities for residents to meet with visitors in private other than in their rooms. One pointed out that a room on the ground floor suitable for the purpose was used for the storage of wheelchairs. This has been an ongoing Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 17 problem identified at previous inspections. A representative of the Company had confirmed that plans were in place for a major development of the site, which would enhance facilities for service users. Meantime, the manager has put forward an arrangement whereby the room in question would be made suitable for visitors and the wheelchairs removed. It was also said that an unpleasant smell was occasionally present in this particular room. The smell was not in evidence during the inspection or at a later visit that the inspector made to the home. However, it was noted that an inspection hatch to a waste flow was situated in a corner of the room. The manager gave an assurance that it would be inspected to ensure it was operating properly. The manager confirmed that as part of the ongoing programme of maintenance and development during this financial year two of the home’s three lounges would be redecorated and toilet floors on the ground floor would be upgraded. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 18 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 and 29 The skill mix and numbers of staff are not maintained to ensure the needs of service users are consistently met. A robust recruitment procedure ensures residents are protected. EVIDENCE: The home had recently recruited six people from Slovakia to fill vacancies in care staff. All recruitment records were in order. However, evidence of CRB/POVA checks had to be faxed through to the home from the Company’s administrative office. Arrangements have now been made for this evidence to be readily available for inspection by persons authorised. There were three Slovakian carers on duty during the inspection. The inspector spoke with only one in private as there were perceived communication difficulties with the other two. This carer expressed concern about staff shortages on specific shifts. A long standing experienced carer also raised concerns about the home’s ability to cope with unplanned absences e.g., staff sickness. The inspector looked at the duty rota, which confirmed that on two days the skills mix and numbers of staff fell below a level that was acceptable for the health and welfare of service users. While there were two staff in the special care unit, the rest of the building was covered by a senior and a new care assistant. Given the numbers and assessed needs of the service users at Inver House the numbers of staff on duty must not fall below two in the special care unit and three in the main part of the building. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 19 Staff spoken with were very clear that residents received very good care from staff who were on duty. Due to cognitive impairments only one resident was able to fully engage with the inspector. This resident was full of praise for all of the staff but did comment that there were not enough staff to assist her first thing in the morning, a situation that suited her as she was happy to wait. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 20 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) 35 and 38 The home provides a sound system to ensure residents’ finances are safeguarded. With the exception of issues identified as requirements, policies, procedures and staff training are in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: The integrity of the system for administering residents’ monies was examined by way of dip-sampling. Receipts were kept of transactions and records and monies balanced The home has a health and safety policy in place and all care staff undertake statutory training, which includes health and safety, food hygiene and manual handling. A selection of records was inspected including accidents, complaints, Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 21 fire alarm tests and public liability insurance, all of which were in good order. Other issues identified as requirements have been highlighted earlier in the report. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 22 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 x x 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 4 COMPLAINTS AND PROTECTION 2 x x 2 x x x 2 STAFFING Standard No Score 27 2 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x 3 x x 2 Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 23 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 Requirement To arrange for repair/replacement of a freezer and 2 fridges in the homes kitchen To repaint the WC waste pipe in the first floor bathroom. Timescale for action 12/8/05 Immediate requiremen t notice served. 12/8/05 immediate requiremen t notice served. 30/9/05 12/8/05 12/8/05 Immediate requiremen t notice served. 2. 19 23 3. 4. 5. 19 26 27 23 13 18 To replace old and stained chairs in the special care unit lounge/dining room. To make suitable arrangements to prevent the spread of infection in the home To ensure that at all times suitably qualified, competent and experienced persons are working in such numbers as are appropriate for the health and welfare of the service users, i.e., 2 staff in the special care unit, and 4 in the other part of the building at peak times, 3 at off peak times. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 24 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 19 Good Practice Recommendations To provide a dedicated room for private visits. Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Mill Court Newport Isle of Wight PO30 2AA 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 Inver House H55-H04 S12502 Inver House V218041 280605 Stage 4.doc Version 1.40 Page 26 - 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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