Inspection on 26/01/06 for Inver House

This inspection was carried out on 26th January 2006.

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 12/07/05

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 Inspection 26th 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 Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Inver House Address Foreland Road Bembridge Isle Of Wight PO35 5UB 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) 01983 872312 01983 875814 Islecare `97 Limited Mrs Joanne Debora Bennett Care Home 35 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (35), of places Physical disability over 65 years of age (12) Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 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 DS0000012502.V283180.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two inspections for the year at Inver House and took place unannounced over 6 hours. The inspector toured the building and looked at a selection of records. Two carers and four residents were spoken with individually and in private. Other residents were spoken with as a group in the lounge. Since the last inspection enforcement action in the form of a statutory requirement notice had been taken to ensure that at all times suitably qualified, competent and experienced persons worked in the home in such numbers as are appropriate for the health and welfare of service users. The home submitted an action plan to demonstrate how the requirement would be met and there was evidence during this inspection that staffing levels were being appropriately maintained. Therefore, the notice is deemed as having been met. Views of the service were generally very positive. Key standards not assessed on this occasion had been assessed at the last inspection. What the service does well: What has improved since the last inspection? • • • • • A system in place to ensure that staffing levels are consistently met. An increase in the ratio of NVQ trained staff. New fridge and freezer for the kitchen. New chairs in the special care unit. A room dedicated as a quiet room for visits and consultations. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 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. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 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 Inver House DS0000012502.V283180.R01.S.doc Version 5.1 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): 4 and 6 This standard was assessed at the last inspection when the numbers and skills mix of staff on duty were not sufficient to meet the needs of the residents. This resulted in enforcement action being taken. Since that time the home has addressed the shortfalls identified in duty rotas, and the Islecare package of training has ensured that staff have the skills to deliver the services and care, which the home offers to provide. Inver House does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. EVIDENCE: The manager confirmed and records showed that significant progress had been made to ensure that staffing levels are maintained at a level, which meets the needs of the residents. Since the last inspection the staff group has been relatively stable and training has been ongoing. Currently 72 of care staff are qualified at NVQ level 2 with others undertaking the training. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 9 The home has a range of equipment to enable staff to transfer residents safely and records show that specialist healthcare professionals are called in as and when required. Most residents at Inver House are long term. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. The home’s Statement of Purpose includes the provision of respite care, which is offered when accommodation is available. There was no evidence that the provision of this service has a negative impact on the resident group. One short stay resident making arrangements with the manager to be collected the next day was heard to speak about the home and the service in glowing terms. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10 The practice in the home ensures that residents’ health care needs are met according to their assessed needs. The home ensures that staff respect residents’ privacy and dignity at all times, especially with regard to the arrangements for health and personal care. EVIDENCE: The home has equipment in place to enable appropriate pressure area management. The manager said that one resident had a pressure sore that was almost healed with regular dressing by the District Nurse and management by staff. On the day of the inspection a visiting District Nurse made very positive comments about the home’s response to healthcare issues. All residents have access to opticians, dentists, chiropodists, etc., and the GP’s practice is conveniently sited next to the home. Since the last inspection the manager has taken steps to improve the home’s response to some specific issues of dignity and respect, which were identified following a complaint. Residents’ clothes have been properly labelled and instructions given to staff, in order to minimise the risk of clothing being wrongly allocated during the laundry process. Residents are now assured that Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 11 their choice of staff gender for the provision of personal care is respected and care plans clearly state preferences. Issues of rights, dignity and respect are covered in the home’s induction programme for staff. Medical examinations are carried out in the resident’s own room and it was noted that staff knock before entering rooms. The home provides a pay phone in the hall for residents’ use and some have installations in their rooms. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 Residents are supported to maintain their independence and to exercise choice with a range of activities provided. They are encouraged to pursue interests inside and outside the home. Visitors are welcome at any time and are able to meet with residents in private. EVIDENCE: Daily routines are as flexible as possible within the constraints of group living. Most residents take the main meal of the day in the dining room while a few prefer meals to be taken to their rooms. Details of residents’ interests and hobbies are recorded in their care plans. The home has a member of staff who coordinates activities. The manager said this has brought about an increase in the range of activities on offer. Details can be found on the notice board in the dining room. On the day of the inspection it was noted that the visiting musician was met with a good response from residents, so much so that one resident was seen to be enjoying a dance with staff in time to the music. The inspector spoke with one resident who regularly visits the local shops and places of interest in the village. The home will endeavour to meet residents’ spiritual needs with visiting clergy from local churches. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 13 Details of visiting arrangements can be found in the service user’s guide. Generally there are no restrictions. Residents can receive visitors in their own rooms, any of the communal areas, or if privacy is required a quiet room is available. While there are no volunteers visiting the home at present an application from one such person is currently being considered. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has a one-page adult protection summary guidance conspicuously displayed for staff, to ensure responses to suspicion or evidence of abuse are robust. The Company’s policy and procedure is under review and not currently being used. EVIDENCE: The inspector has looked at Islecare’s adult abuse policy and procedure, updated in May 2005. It was noted that the policy did not adequately reflect the Social Services role as the lead agency in adult protection. A representative of the Company has withdrawn the policy and staff rely on the one page summary guidance that is conspicuously displayed in the office. Care staff are fully aware of local reporting procedures and confident about reporting issues of concern without delay. Issues arising in the home during 2005 have demonstrated the robustness of the home’s procedures. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 While the location and layout of the home is generally suitable/adequate for its stated purpose in providing a safe and comfortable environment for those who live and work there, the company recognises that major development will substantially upgrade the environment and meet future needs. Several improvements since the last inspection were noted. All areas of the home are kept clean and tidy and free from unpleasant odours. Issues relating to the potential for cross infection identified at the last inspection had been addressed. EVIDENCE: The inspector toured the building with the manager. All areas were seen generally to be clean, hygienic and free from unpleasant odours. It was noted that since the last inspection the following improvements had been made: • • A new fridge and freezer installed in the kitchen. In a first floor bathroom the toilet waste pipe had been repainted. DS0000012502.V283180.R01.S.doc Version 5.1 Page 16 Inver House • • • Infection control procedures had been reinforced with staff to ensure safe practices. No shortfalls were identified during the tour of the building. New chairs had been purchased for the special care unit. A room had been dedicated for use as a quiet lounge for visitors/consultations etc. The planned major refurbishment of the home has reached the consultation stage and subject to the appropriate planning permission being granted work is expected to commence during 2006. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Staff at Inver House are now deployed in adequate numbers to meet the needs of the people who live there and have the necessary training, skills and experience to meet residents’ needs and ensure they are in safe hands. EVIDENCE: The manager said and duty rotas confirmed that with various shift patterns during the day a minimum of two care staff work in the special care unit with three in the main part of the building. Numbers are boosted by an additional carer during the morning. There are two wakeful night staff with one sleeping in on call. These levels are considered adequate for the current needs of residents. The home employs additional domestic, catering and activities staff. Residents made very favourable comments about staff and raised no concerns about staffing levels. At the time of the inspection there were 72 of care staff qualified at NVQ level 2 or above. Five further care staff are currently working towards achieving the award. The home has three NVQ assessors among the staff group. In contrast to the position at previous inspections the home now uses minimal agency staff. Islecare provides an accredited induction/foundation training programme for new staff, which follows the requirements of the Sector Skills Council. A staff training matrix shows dates of scheduled statutory training, which is refreshed at appropriate intervals. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 18 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 and 33 The manager has been in post for eighteen months and is currently working towards achieving the recommended management qualifications. Islecare has an annual development plan and a process of establishing residents’ views about the service. EVIDENCE: The manager Mrs Bennett has been in post for the past eighteen months and is undertaking the training to achieve the NVQ at level 4 in care. She has registered for the Registered Managers Award, which will follow on. She is a representative on the Older Persons Services Forum organised by social services and attends liaison meetings. There was evidence that she keeps up to date with statutory training and service related subjects. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 19 The manager said that residents are regularly asked about the quality of the service and views are sought via questionnaires. The questionnaires are given to relatives/representatives of those in the special care unit. The inspector saw evidence of the home’s response to some of the issues raised. A representative of the Company visits from the mainland to carry out a periodic audit of the service and monthly visits take place to monitor the conduct of the home. The Company has recently published its review of the service. Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 20 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 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x x x x x Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Inver House DS0000012502.V283180.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW 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. 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