Inspection on 06/12/05 for Keller House

This inspection was carried out on 6th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Keller House 04/10/07

Keller House 29/08/06

Keller House 12/05/05

Keller House 11/01/05

Keller House 15/06/04

Keller House 03/06/03

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

CARE HOMES FOR OLDER PEOPLE Keller House 52 Carew Road Eastbourne East Sussex BN21 2JN Lead Inspector Debbie Calveley Unannounced Inspection 6th December 2005 07:45 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 Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Keller House Address 52 Carew Road Eastbourne East Sussex BN21 2JN 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) 01323 722052 01323 722052 Mr Twalebuddeen Durgahee Mrs Erlinda Durgahee Mr Twalebuddeen Durgahee Care Home 15 Category(ies) of Dementia - over 65 years of age (15) registration, with number of places Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fifteen (15). That only service users with a dementia type illness may be accommodated. That service users must be aged sixty-five (65) years and over on admission. 12th May 2005 Date of last inspection Brief Description of the Service: Keller House is registered to provide care and accommodation for fifteen service users that meet the registration category of older people with dementia. It is a large detached house situated approximately ¾ of a mile from Eastbourne town centre and the train station. The home comprises of eleven single bedrooms and two double bedrooms. There is a large lounge area, a separate dining room, which is situated next to a compact kitchen. On the lower floor there is a conservatory, which leads out to a natural well-tended garden. To the front of the house there is a patio area. There is a passenger lift and a stair lift that allows level access to all areas of the home. The home aims to provide a comfortable and homely environment for older people with dementia on a long-term basis and to care for them with dignity and to respect their rights as individuals. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 6 December 2005, from 0745 hrs until 1300 hrs. One inspector inspected the home and conducted informal interviews with five residents, two relatives and three members of day staff and two members of night staff. The inspection process consisted of a tour of the building, inspection of documentation and records, observation of the breakfast and lunchtime meal and looked at the delivery of care for eight residents. Mrs Durgahee has the main responsibility for managing Keller House. It was found to be a positive inspection and that many standards have been met and maintained. The inspector would like to take this opportunity to thank the staff and residents for their welcome and for their views of life in Keller House. What the service does well: What has improved since the last inspection? The presentation of food has improved, and the records indicate a well balanced diet and choice of food. The care plans have improved and the daily log is more informative, which demonstrate that residents have choice and control in their daily lives. The training programme demonstrates a wide variety of training, which enables staff to perform their jobs competently. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 6 The maintenance and cleanliness of the home has improved and been maintained to a suitable standard. Residents were seen to enjoy a more relaxed approach to getting up and having breakfast. 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. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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 Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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): 1, 2, 3, 4 and 5. The Statement of Purpose and Service Users Guide give prospective residents and/ or their representatives the information required enabling them to make an informed choice about where they live. A contract/statement of terms and conditions is given to all residents on admission, which confirms the facilities offered and care agreed. A pre-admission assessment is undertaken on all prospective residents before admission to ensure the home can offer them the care they require. The home welcome and encourage prospective residents and their representatives to visit the home prior to admission to enable them to assess the suitability of the home and meet the staff and fellow residents. EVIDENCE: A Statement of Purpose and Service Users guide, which conforms to the Care Homes Regulations and National Minimum standards, is in place. It is available Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 9 to all residents and their relatives and is written in a clear and user-friendly format. There is a statement of terms and conditions, which includes the services covered by the fees and the room to be occupied. It was confirmed from viewing the residents’ files that a pre-admission assessment is completed on all prospective residents. The assessment takes place at the residents’ place of residence, and input from other relevant professionals is sought when required. It is said that the residents’ representatives are involved if possible. Four pre-admission assessments were viewed. Two of the residents spoken with were able to confirm that they were visited before admission whilst three could not remember being involved. The pre-admission assessment identifies any specific needs of the prospective resident and this informs the admission process. The home provides supportive care for elderly people with dementia, and the documentation available demonstrates that a full assessment of the resident’s specific needs is completed following admission to the home, and then reviewed on a regular basis. The manager confirmed that trial visits can be arranged and residents and their representative can spend a day in the home prior to admission. This enables them to meet the staff and other residents, and sample the food and activities. There is a month’s trial either way to ensure that the home is suitable and the home can meet the needs of the resident. Unplanned/ emergency admissions are rare, but if they do occur, assessment and care planning takes place within twenty-four hours. Two residents confirmed that they had visited the home prior to their admission; one resident said her son had visited and chosen the home for her and another said that she had no idea how she came to be admitted to the home. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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, 8, 9 and 10. Residents benefit from a comprehensive care planning system that guides staff in all aspects of personal and health care and that all risks are identified and planned for. Residents are protected by satisfactory systems for the recording, handling and storing of medication. EVIDENCE: Eight care plans were viewed and were seen to be of an improved standard. Work has been done to update and extend the documentation to ensure there are clear directions for the staff to follow. The staff have recently attended risk assessment training and the risk assessments were also seen to be more detailed. As discussed at the time of the inspection, there are some areas that still need to be extended for certain residents. Care staff and the Manager spoken with were aware of residents individual care needs. Two residents spoken with said they believed staff were aware of their care needs and felt that they are properly looked after. Two visitors also said that their relatives were looked after well. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 11 The Medication Administration Record (MAR) chart was viewed and found to be satisfactory. The staff have received training in the administration, recording, ordering and storage of medication. Policies and procedures for staff to follow are in place. The medicines that have a short life when opened need to have the date opened clearly written, this includes eye drops, calogon and antibiotics. Staff were seen to be courteous and respectful to the residents throughout the inspection. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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, 13, 14 and 15. There are planned activities throughout the week; residents’ experience a lifestyle in the home that matches their expectations and preferences. There is an open door policy in the home and family and friends are welcomed in to home. The home provides a varied menu of well-presented food; residents are able to exercise choice and control over their diet and what they eat. EVIDENCE: There are activities in place, and these occur on a daily basis, outings are planned and enjoyed by the residents. Two residents were able to chat about the different outings that they had been on and the party they were going on next week. There was positive interaction seen between staff and residents and staff were seen having coffee whilst playing dominos and ball games with some residents during the visit. However as discussed, there is a need to develop social care plans with reference to past hobbies and interests and record the activities participated in as way of monitoring their mental and social health. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 13 The morning routine was seen to be more relaxed and informal, with a later breakfast time than previously seen. Care plans now include preferred times of rising and going to bed. Visitors were seen arriving at various times during the day and confirmed that they were welcomed in to the home at any time. All residents spoken with said that the food was good and that they are given a choice of meals. They also said that they are encouraged to eat in the dining room but may take meals in their rooms if they wish. Menus showed that balanced and varied meals are offered. Records are held detailing daily food choices for each resident. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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): 16. Satisfactory systems are in place to deal with complaints. EVIDENCE: The complaint procedure and policy was viewed and is available to all residents and their families. The complaint book was available for inspection. There have been no complaints received since the last inspection. One relative said that they would approach the manager with any concerns and feel confident that the issues would be addressed. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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, 20, 21, 22, 23, 24, 25 and 26. The standard of the environment within this home is good providing residents with an attractive and homely place to live in. Resident’s bedrooms are comfortable and they are able to bring in their own possessions. EVIDENCE: The home was found to provide a well-maintained, safe and comfortable environment for residents to live in. Resident’s bedrooms were warm and homely with personal photographs and ornaments evident. There is a paved area to the front and a large garden to the rear of the property, which is used in the summer months. The home has a large lounge and comfortable seats, and was pleasantly decorated with Christmas decorations. The home has a lift that provides access to three floors of the home, and a stair lift has recently been purchased for the upper floor. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 16 The call bell system was found appropriately placed for residents to access when required. There are adequate bathing facilities available for the needs of the residents. Random hot water temperatures were tested and were found to be of the recommended temperature. The cleanliness of the home was of an improved standard and was clean and tidy with no offensive odours. The laundry room needs some work to ensure the floor has appropriate flooring and pipe work is safe. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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, 29 and 30. The deployment and number of staff at key times is sufficient to meet residents care needs. The recruitment practice is robust and does provide sufficient safeguards for the protection of residents. Staff receive training to ensure they are competent to perform their jobs. EVIDENCE: The staff rota evidenced that there are two carers on duty continuously throughout the 24 hours. The night shift has one carer awake and one sleeping. Mrs Durgahee is supernumery to these numbers and is on call at all times. The recruitment process was found to be robust; staff files of employees were examined and were found to contain all the necessary documentation and Criminal Record Checks. Staff training is on-going and the recording of staff training evidenced that all staff are receiving the necessary training to perform their jobs. The manager has been pro-active in accessing appropriate training courses and staff were complimentary regarding the support and training they receive. All new staff complete an induction programme in line with the National Training Organisation. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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, 35 and 38. Resident’s benefit from an experienced Manager whom runs the home efficiently and effectively, including providing support to staff. The ethos of the home is open and some improvements to staff and resident’s consultation have been made. All aspects of resident’s health, safety and welfare were seen to be protected and promoted. EVIDENCE: Mrs Durgahee is suitably qualified and experienced to run the home. She takes responsibility for the day-to-day running of the home and is supernumery to the care staff; she is also on call for any emergencies. There are systems in place to safeguard residents financial interests; there are also policies and procedures in place for staff to follow in respect of gifts and rewards from residents and their families. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 19 Formal staff supervision is provided in accordance with the regulations and is recorded and kept in the staff files. Staff training in moving and handling, infection control, first aid, fire safety and food hygiene are undertaken and recorded, and all staff are receiving training in Caring for people suffering from Dementia, Nutrition, Risk Assessment Management and Prevention of Adult Abuse. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. Weekly testing of the call bell system and water delivery temperatures are undertaken and recorded to ensure residents health and safety are protected. A recommendation of good practice is to ensure that first aid boxes are accessible and fully stocked for immediate use. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 2 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 3 X X X 3 X X 3 Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 21 Yes 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 OP7OP12 Regulation 16 (2) (m) Requirement Timescale for action 01/04/06 2 OP26 13 (3) That an activity care plan and programme is developed taking in to account the wishes and preferences of individual service users.(Previous timescale of 14/06/05 not met) That the laundry floor is 01/04/06 impermeable and pipe work safe. 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 2 Refer to Standard OP9 OP38 Good Practice Recommendations Those medications with a short life are dated on opening. That first aid boxes are stocked with the appropriate items and easily accessible. Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Keller House DS0000021145.V254598.R01.S.doc Version 5.0 Page 23 - 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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