Inspection on 06/03/07 for Irene House

This inspection was carried out on 6th March 2007.

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

Irene House 16/10/07

Irene House 18/10/06

Irene House 05/01/06

Irene House 03/08/05

Irene House 23/02/05

Irene House 13/09/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Irene House 1 Parkfield Road Worthing West Sussex BN13 1EN Lead Inspector Ms J Hartley Unannounced Inspection 6th March 2007 10.40 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 Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Irene House Address 1 Parkfield Road Worthing West Sussex BN13 1EN 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) 01903 529060 01903 529058 www.guildcare.org Guild Care Position Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2006 Brief Description of the Service: Irene House is a care home registered to accommodate forty residents over the age of sixty-five years, some of who may have nursing needs. The home is situated in a residential area of Worthing. It is a detached, two-storey building with a central courtyard area and private parking facilities at the front entrance. Residents are accommodated in single rooms with a wash hand basin. Two bedrooms have en-suite toilet facilities. There is a passenger lift for access from the ground floor to the first floor. There are three lounge areas and two dining rooms. Irene House is owned by Guild Care, an organisation which has three other care homes in the area. The current level of fees range from £436 to £538. Items not covered by the fee include hairdresser, chiropodist, aromatherapy, daily papers and toiletries. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit for this key unannounced inspection took place over six hours. The manager Mr Duffadar was present throughout the inspection and provided the information required. The inspector examined information held on the service file since the last inspection in October 2006, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. Evidence was also gathered from the pre-inspection questionnaire completed by Mr Duffadar, the results of a survey, completed prior to the inspection by ten residents and comments received from seven relatives/visitors. During the inspection the inspector spoke to many of the residents, and nine members of staff. The inspector undertook a tour of the premises and looked at six residents’ files and three staff files. Various record books, policies and procedures were also examined. Following the last inspection five requirements were made. At this inspection all of these had been met. What the service does well: What has improved since the last inspection? Since the last inspection a new manager has been employed. He is in the process of applying to be registered. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 6 There have been a number of improvements made in the home. A new management structure has been put into place, which clarifies roles and responsibilities of staff within the home. Staffing levels have been increased, including an extra registered Nurse on duty in the mornings and increased hours for domestic staff. A new chef manager has been employed to oversee the menus and nutritional content of the meals. Pre admission assessments and care plans now contain more detail about residents’ needs. Care plans and risk assessments are being reviewed regularly. Activities are now available to residents four days a week, these are arranged by two Activities Coordinators. A new medication room has been added to the home. The fridge that stores medication that needs to be kept cool is now located in this room rather than in the dining room where it was at the last inspection. There has been an on-going maintenance programme. Many bedrooms and communal areas in the home have been redecorated and recarpeted. A courtyard garden has been improved and now includes a water feature and raised flowerbeds. 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. The summary of this inspection report can be made available in other formats on request. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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 Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed prior to admission into the home. There has been an improvement in the information gathered in pre-admission assessments, which are now clear and detailed. EVIDENCE: At the previous inspection it was found that assessments were being carried out prior to residents being admitted to the home but no information about the residents’ physical, social or emotional needs was being documented. During this site visit the inspector case tracked six residents’ files and found that assessments now include clear, detailed information on residents’ needs. Assessments were signed and dated and included information about where and when they were carried out. Irene House does not provide Intermediate Care, therefore Standard Six does not apply to the home. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 9 Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are plans of care in place that set out individual personal, health and social needs. Residents have access to health services to meet their assessed needs. Medication policies are in place. Residents are able to take responsibility for their own medication if they wish, within a risk management framework. Residents feel that they are treated with resprect and their right to privacy is upheld. EVIDENCE: Six residents’ files were case tracked. Each resident has a plan of care that details the action that needs to be taken by staff to ensure that all aspects of their health, personal and social care needs are met. Since the last inspection a lot of progress has been made in the quality of information contained in care plans, the regular reviewing of care plans and the involvement of residents. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 11 Most care plans seen were signed by residents. All had been reviewed and updated, where applicable, on a monthly basis. Residents’ files showed that community health resources, including doctor, dentist, optician, chiropodist and hospital are accessed to meet residents’ health needs. Risk assessments for pressure sores, nutrition, pain and falls were seen to be in place and up to date. During the visit staff were seen providing residents with drinks and assisting them when needed. Daily records of key events are kept and health appointments are clearly recorded. The manager said that he is going to undertake an audit of the accident forms that have recorded falls by residents to enable the home to take preventative measures if required. Policies and procedures regarding the receipt, recording, storage, handling, administration and disposal of medication were seen and found to be adequate for their purpose. Following a risk assessment service users are able to administer their own medication if they wish. Risk assessments for those residents who self medicate were seen. The fridge that contains medication is now kept in the locked medication room that has been added to the home, instead of the dining room where it was located at the last inspection. The medicine cabinets were well organised with no evidence of over-stocking. Changes in medication are now clearly recorded. Records were seen of all medication received, administered and leaving the home. These were accurately recorded and signed. The receipt, administration and disposal of controlled drugs were clearly and accurately recorded in a Controlled Drugs Register. Medication is only administered by qualified nurses. Residents said that their personal care needs are addressed in private and that staff are sensitive and treat them with dignity. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines of daily living are flexible. Residents are able to maintain contact with family, friends, representatives and the local community. They are also able to exercise control over their lives. The food provided is wholesome and appealing and enjoyed by the majority of the residents. EVIDENCE: Since the last inspection the home has arranged for two members of staff to organise activities. A wide choice including music and movement, manicures, entertainers, trips out and quizzes are now available to residents four days a week. Residents’ attendance to activities is recorded to enable the home to analyse which residents are taking part and find out if the residents who take part infrequently would like other activities offered to them. A record is also kept of each resident’s preferences, for example whether they prefer one to one or group activities. Key topics of interest and conversation are also recorded for each resident to enable them to be picked up by the next activities organiser or the residents’ keyworker. Residents spoken with said Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 13 they enjoy the activities provided. One resident said that when the lift was broken the activity organiser came up to her room and played dominoes with her as she was unable to go downstairs. Another resident said that lots of outings are organised. All the relatives/visitors who replied to the survey said that they are made welcome in the home and that they are able to visit their friends/relatives in private. This was confirmed by residents. One resident said that he is visited by his daughter, family and friends and that all are made very welcome. Residents manage their own financial affairs for as long as they are able to. Residents said they are able to exercise choice in their lives. The menu for the home was seen and contained a varied, wholesome diet. There are two main choices for dinner each day, and omelettes are available for people who do not want either. There are also several sweet options. Residents are able to have a cooked breakfast every day if they wish. All the residents spoken with on the day of the visit said they enjoyed the food. One resident said it was “beautiful”. In the residents survey eight respondents said they always or usually like the food and two said they sometimes do. One resident said that the food was not always soft enough for her to eat comfortably. This was reported to the manager who said he would follow it up with the resident and the chef. A chef manager has recently been employed. He is overseeing changes to the menu, liaising with residents about their likes and dislikes and modernising the kitchen. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel that their complaints will be listened to, taken seriously and acted upon. Residents are protected, as far as possible, from abuse by the homes policies, procedures and staff training. EVIDENCE: The complaints procedure was seen and found to be clear and accessible. The procedure is contained in the service user guide. There have been no complaints since the last inspection. Residents said that if they had any complaints they would discuss them with senior staff or the manager. They were confident that the home would take the complaint seriously and address it. Eight out of ten respondents to the service user survey said they know how to make a complaint. Four out of seven relatives/ visitors said they were aware of the home’s complaints procedure. The homes’ adult protection and whistle blowing policies were seen and found to be robust. Staff records show that they have received training in Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 15 recognising and responding to abuse during their induction. The staff training programme includes Abuse and Neglect training. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Irene House provides a safe, well-maintained environment that is clean, comfortable, pleasant and hygienic. EVIDENCE: Irene House is clean, homely and free from offensive odours. Decoration is in good condition and of a high standard. Furnishings are comfortable and domestic in character. In the last year thirteen bedrooms have had new carpets fitted and the servery area has had new vinyl flooring laid. Since the last inspection fifteen bedrooms, the hallways, stairs, staff room, offices and through lounge have been redecorated. The gardens are attractive, well-kept and accessible to residents. There are areas for seating in the sun and shade. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 17 A courtyard garden has recently been improved. It now has a patio, water feature and raised flowerbeds. Laundry facilities are sited appropriately, away from food preparation and storage areas. Floor and wall surfaces are easily cleanable. The floor surface is impermeable. The home has access to a maintenance team that is employed by the company. Bedrooms are well decorated, comfortably furnished and have evidence of residents’ private possessions in them. Residents said that they were able to bring their own furniture and possessions with them when they moved in. Rooms are centrally heated and individually and naturally ventilated. Radiators and pipe work are covered, and windows have restrictors in place. There is emergency lighting throughout the home. Water temperatures are restricted to within the required limits by thermostatic valves. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels have recently been increased in the home. Both staff and residents feel that this has improved the ability of staff to meet the resident’s health care needs. Thorough training and Induction programmes are in place. Residents are protected and supported by the homes’ recruitment policies and procedures. EVIDENCE: Following the last inspection a requirement was made that the number and skill mix of staff on duty must be appropriate to meet the needs of the residents accommodated. This requirement was made as the number of nursing staff on duty at the time was not sufficient to meet all the resident’s health care needs, complete the documentation and provide direction to other staff. Several comments from residents were made in the service users survey that staff are not always available, staff are sometimes too busy to stop and listen to requests made by a person who communicates slowly, and it takes a long time for help to come when called for. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 19 However, there has recently been an increase in hours of Registered Nurses to enable two to be on duty each morning. There has also been an increase in domestic hours by 50 hours per week. There are now two Registered Nurses and seven care assistants on duty in the mornings; one Registered Nurse and seven care assistants in the afternoons and one Registered Nurse and three care assistants on duty at night. Some residents spoken with felt there had been an improvement in staffing levels. One resident said, “they always come quickly when I ring my bell”. The manager said that there is now a call monitoring system in place. He is going to monitor call waiting times and set a minimum time for staff to respond to residents’ calls. Staff breaks are now staggered to ensure there is adequate cover. Staff spoken with said that staffing levels have been increased and the introduction of a second Registered Nurse in the mornings has improved the situation. Currently thirty care assistants have, or are working towards, an NVQ Level 2 or 3. This is an improvement since the last inspection. The home has a thorough recruitment procedure in place. Staff records show that two written references, CRB and POVA checks are obtained before appointing a member of staff. The company has a comprehensive training programme in place. Training available includes Health and Safety training and courses relevant to the needs of the residents, for example Communication, Dementia, Sensory Loss and Person Centred Care. A new induction programme has recently been introduced which is very thorough and includes the Skills For Care Induction Standards. An anonymous concern was received by the Commission saying that staff have not received adequate fire safety training. Training records seen during the visit show that staff have received Fire Safety Training provided by an outside company. The manager said that night staff have to attend the training four times a year and day staff twice a year. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is no registered manager in post at Irene House. The current manager is in the process of applying to be registered. Thorough quality assurance measures are in place to measure the homes’ success in meeting the aims, objectives and statement of purpose of the home. The home’s policies, procedures and record keeping safeguard the health, safety, welfare and financial interests of service users. EVIDENCE: Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 21 At present there is no registered manager in post at Irene House. The current manager is in the process of applying to be registered. A new management structure has been put into place, which clarifies roles and responsibilities of staff within the home. The Guild Care organisation has a number of measures in place to review the quality of care and service provided at the home. These include audits and spot checks, surveying the residents and relatives, trustees unannounced visits to the home and various committees with resident representatives. Residents spoken with said they felt staff and management were approachable. Residents’ main finances are looked after by themselves, relatives or Power of Attorney. Residents’ “pocket money” is deposited at Head Office in a pooled account and sent to the home when requested. The Commission has agreed that safeguards are in place within this system, which, as far as possible, protects the residents’ money. The organisation has an accounting system set up on the computer. Records are kept of the individual residents’ money and receipts are produced. The home has clear and comprehensive Health and Safety policies in place. There have been recent checks on the central heating and electrical systems. The home has also had a recent test for Legionella. There is no specific Infection Control training available to staff. The manager said that the home has an Infection Control Nurse and she will organise training. Staff have received training in health and safety. Clearly recorded accident records are kept. Follow up forms are also completed to enable the home to put measures and risk assessments in place to reduce the risk of accidents. Irene House DS0000024160.V329940.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 23 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 Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Irene House DS0000024160.V329940.R01.S.doc Version 5.2 Page 25 - 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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