Inspection on 10/05/05 for Le Brun House

This inspection was carried out on 10th May 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

Le Brun House 11/03/09

Le Brun House 28/03/08

Le Brun House 15/05/07

Le Brun House 28/06/06

Le Brun House 13/02/06

Le Brun House 29/10/04

Le Brun House 01/06/04

Le Brun House 07/07/03

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

CARE HOMES FOR OLDER PEOPLE Le Brun House 9 Prideaux Road Eastbourne East Sussex BN21 2NW Lead Inspector Angela Gunning Unannounced 10 May 2005 09:00 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. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Le Brun House Address 9 Prideaux Road Eastbourne East Sussex BN21 2NW 01323 734447 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) Mrs Iiona Austen Hellen Spicer Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (OP) 15 of places Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is fifteen (15). 2. That service users are aged sixty-five (65) years or over on admission. Date of last inspection 29 October 2004 Brief Description of the Service: Le Brun House is a care home registered to provide accomodation and care for fifteen (15) older people. The home is a detached house situated approxiamately one mile from Eastbourmne town centre, with a main bus route within easy walking distance. Currently there are thirteen (13) single bedrooms and one (1) double bedroom. There is a passenger lift to access the first and second floor accomodation. The home provides a large lounge at the front of the house and a seperate dining room. Buiding work has begun to add a further five (5) single bedrooms and a conservatory. The provider is planning to apply to the CSCI for a change to the homes registration category to care for people with a dementia type illness. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which was undertaken over seven hours during the day. Several people were spoken to, including the manager, three members of staff on duty, seven residents and two visitors. Parts of the environment were inspected, including the kitchen, communal areas and three bedrooms. Two care plans and two staff records were examined and a meal was sampled. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that their emergency call bell system is in working order and accessible to service users. The manager needs to ensure that all the required recruitment information is obtained and induction is given before new care staff begin to work in the home. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 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 Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 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) 2, 4 A contract adequately informs people of the terms and conditions of residency at Le Brun House. Some residents are presenting with dementia-type symptoms since moving into the home and this has implications regarding the mix and compatibility of residents, which will need to be addressed. EVIDENCE: Each resident and/or their representative has been a copy of the terms and conditions of residency, outlining the fees charged, additional costs of services above the fees, period of notice required and who is liable if there is a breach of contract. Some residents living at Le Brun House are presenting with dementia-type symptoms and the provider is planning to apply to the CSCI for a change to its’ registration category to care for people with a dementia type illness. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 9 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, 8, 10 There is an effective care planning system in place, which assists staff in monitoring and meeting service users’ health and welfare needs. Privacy and dignity is respected. EVIDENCE: The home operates a keyworker system and care plans are monitored and reviewed by keyworkers on a monthly basis. Staff spoken to during the inspection were aware of service users’ care needs and one considered that the staff team ‘really look after people’ at Le Brun House. A relative confirmed that she was ‘satisfied with the care given’ to her mother. Healthcare professionals, such as General Practitioners and District Nurses are contacted for advice and assistance as and when necessary. The manager and staff were observed to interact and speak to people in a friendly, respectful manner and were conscious of respecting their privacy. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 10 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) 12, 13, 14, 15 There are good arrangements in place for enabling staff to support service users’ in social and leisure activities. The home encourages and supports service users to maintain links with the community and contact with family and friends. Autonomy and choice is respected. EVIDENCE: A programme of both in-house and external activities is provided and staff were observed engaging service users in a variety of social and leisure activities throughout the day, such as playing dominos, going for a walk, reading and painting nails. One service user is currently assisted to attend a weekly social gathering in the community and another attends a weekly church service. One service user spoken to said she ‘appreciates the daily walks’ she has with the support of staff. There are two communal areas for service users to meet with visitors, otherwise in private in their bedrooms and one relative confirmed that she is ‘welcome in the home at any time’. A choice of nutritionally balanced lunchtime and suppertime meals are offered and service users can choose to eat their meals in the dining room or their bedroom. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 11 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, 18 The complaints procedure is clear and accessible to all those who live in the home and their relatives or representatives. The home has satisfactory arrangements that ensure staff have the knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The arrangements for dealing with complaints is included in the home’s Statement of Purpose and Service User Guide and is displayed in the hallway and a number of relatives have confirmed that ‘they are aware of the home’s complaint procedure’. There is a book to record complaints and no complaints have been logged since the last inspection. All staff are given the homes’ policy on protection of vulnerable adults and prevention of abuse and they receive in-house training as part of their induction training. However, two new members of staff have yet to receive this training. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 12 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, 26 There are currently major building works going on to extend the home and this is being managed in planned and safe way, ensuring minimum disruption to residents and staff. A satisfactory standard of hygiene and cleanliness is maintained. EVIDENCE: Building work has begun to add a further five bedrooms and a conservatory to the home. The builders are aware of the safety needs of the residents and staff and the provider and manager have a planned strategy for the management of this project. Service users spoken to during the inspection confirmed that ‘they and their relatives had been consulted about this building work and the probable inconvenience to them’. There is an emergency call system, however it is out of date and was not functional in one residents bedroom. The provider said that ‘it going to be replaced within-in the next six months’ and this will be checked as part of the re-registration process. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 13 The home was seen to be clean and hygienic. However, the arrangements for dealing with the laundry needs to be improved, such as transporting soiled laundry appropriately, providing hand washing facilities in the laundry room, ensuring the floor is not left wet and that residents are given their own clothes. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 14 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, 29, 30 The home is developing a stable staff team and there are sufficient staff employed to meet service users’ needs. The procedures for recruitment and induction of all new staff needs to be more robust to protect the people living at the home. EVIDENCE: At the time of the inspection there were nine residents at Le Brun House and the staff rota indicated that there are always two carers and either the manager or provider working in the home. One member of staff spoken to said that ‘we have a good team and we work well together’. The home also employ a cook and a cleaner. Staffing arrangements will need to be reviewed before the extension and the proposed change of registration category is accepted by the CSCI. Two recruitment files were checked and these were seen to contain most of the relevant information, although, it was noted that POVA or CRB checks had not been carried out prior to them working in the home. The manager has developed an induction programme that meets the required standards and all staff are currently working through this. However, the staff rota indicated that one new member of staff had worked a shift before receiving the homes’ initial induction training. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 15 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) 32, 36, 37, 38 Le Brun House is successfully and competently managed, enabling staff to be supported to provide quality care to residents. EVIDENCE: The manager has worked hard to resource and manage the improvements that were needed at Le Brun House. There has been improvement in various record keeping systems and a system has been implemented to ensure that staff are familiar with the home’s policies and procedures, with staff confirming that ‘rereading the policy of the month is helpful’. Staff receive regular one-to-one supervision sessions and it was noted that these sessions also assist them in their learning and development needs. The staff spoken to said the manager is ‘understanding and approachable’. A satisfactory programme of mandatory training is provide and there is a system in place for recording the training they have received and when it is due to be redone. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 2 x x x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 x x x 3 3 3 Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 17 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. 2. Standard 18 22 Regulation 13(6) 16(2)(c) Requirement All staff receive training in the protection of vulnerable adults and prevention of abuse. That the call bell system functions throughout the home and is accessible to service users. Soap and towels are for hand washing are provided in the laundry room. Appropriate bags are used to transport soiled laundry and that soiled laundry is not carried through the kitchen. That the required recruitments checks are carried out before new straff beging to work in the home. That new staff receive adequate induction before they begin to work in the home. Timescale for action 31/8/05 10/5/05 3. 4. 26 26 13(3) 13(3) 0/5/05 10/5/05 5. 29 7, 9, 19 10/5/05 6. 30 13(4)(c) 10/5/05 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 H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 18 Le Brun House 1. 2. 26 Additional staff are employed to assist with laundry tasks. Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection 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 Le Brun House H59-H10 S21154 Le Brun House V217129 100505 Stage 4.doc Version 1.20 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!