Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Lea House Lea House Rest Home 40 Terminus Avenue Bexhill on Sea East Sussex TN39 3LZ The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sally Gill Date: 1 6 0 9 2 0 0 8 Information about the care home
Name of care home: Address: Lea House Lea House Rest Home 40 Terminus Avenue Bexhill on Sea East Sussex TN39 3LZ 01424220968 01424848907 shona2@onetel.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sadna Seesarun Type of registration: Number of places registered: Mrs Sadna Seesarun,Mr Baldeo Seesarun care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 15 Conditions of registration: Service users must be older people aged sixty five (65) years or over on admission. The maximum number of service users to be accommodated is fifteen (15). Date of last inspection Brief description of the care home Lea House is a detached property situated in a quiet residential area of Bexhill-on-Sea. The town centre with its shops and access to bus and rail services is approximately one mile away and local amenities are a short walk away. Resident accommodation is provided in one double and thirteen single bedrooms, all of which have en-suite toilet and wash basin facilities. Communal areas include a range of lounge and dining spaces Care Homes for Older People
Page 2 of 10 and an adapted bathroom. A shaft lift provides level access to the first floor accommodation. The home has large front and rear gardens and parking is available at the front of the home. The home is registered to provide residential care to fifteen older people. The fee range for Lea House is 315 - 400 per week. More detailed information about the services provided at Lea House can be found in the homes Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the Provider. Latest CSCI inspection reports are kept in the homes office. Care Homes for Older People Page 3 of 10 What we found:
The reason for this inspection was to check the compliance of the requirements made at the previous key inspection on the 31st July 2007 and also to look at areas of concern raised anonymously with the Commission the outcome is as follows: Three residents contracts were examined. This highlighted there are two types of contracts in use. Neither type contains all the information recommended in the National Minimum Standards (NMS) for Older People. The latest version does not contain details of the room number or period of notice. The owner had not signed the contracts. The manager advised that letters advise of increases in fees annually. Copies of these are not held on file. Three care plans were examined briefly one was signed and two were not. The manager advised that where appropriate residents have signed their care plans. One resident was spoken to who said they are very happy living at the home and happy with the care they receive. The care of two residents was discussed in detail and a third briefly. The accident book highlighted that two of these residents had had several falls since July 2008. One resident had lost considerable weight according to appearance. The manager advised this had been during a hospital stay earlier this year. However the care plan showed that the resident had not been weighed since 25/09/07. The manager advised that she felt the resident had been weighed since then but not recorded and that the resident did have a good appetite. The manager advised this resident has been referred via their GP to the falls team and a psychiatrist. The manager was asked to confirm a timescale for the appointments. The other resident discussed in detail has also been referred to the falls team and community matron although the manager was not sure why they had been referred to the community matron. She was asked to investigate and confirm timescales for both appointments. When a resident continues to display behaviour of verbal aggression this should be monitored and recorded in detail and then re-referred to the GP. Medication arriving at the home and disposal was discussed. The manager advised that medication can arrive mid cycle and this can be left in the kitchen until the next staff change over. This is not a safe system. The manager also advised that not all medication that is not administered is returned to the pharmacist. Again this is not good practice. The manager advised that a new chart had been developed for medication prescribed as required. However this could not be found during the visit. The storage of the medication cupboard key was discussed. Storage is not in line with good practice guidance. Two residents rooms were viewed and one resident spoken to. During this time it was noted that the dignity of one resident could be greatly enhanced. The resident had a cardigan on which was badly stained although the manager advised later staff had managed to persuade the person to change. They were also sitting in an armchair on a sheet of polythene although partly covered by a waterproof sheet. This does not enhance their dignity and action must be taken. See also later comments regarding Care Homes for Older People Page 4 of 10 environment. If the resident refuses to change their cardigan this should be recorded. Two bedrooms, the dining room and quiet lounge were viewed. Generally the home appeared well maintained, clean and tidy although there were areas where better storage could enhance the home. The manager advised that some new furniture had recently arrived. One bedroom was not well maintained and had an unpleasant odour. The carpet was badly stained, curtains were not well hung, a towel rail was broken and also a toilet roll holder. These areas must be addressed. The manager advised there is a small staff team and she herself is also very hands on. In addition to the manager there are three staff on duty Monday to Friday morning and two staff other mornings and in the afternoons. Staff’ are also responsible for the cooking and cleaning. There is one member of staff on wake night duty. The manager is on call when not in the home. Since the last inspection the manager has obtained a copy of the Skills for Care induction, which will be used, when a new employee starts. Staff’ have also attended moving and handling and first aid awareness training. The procedure for storage of residents’ monies was discussed. This is not currently held in secure storage which would be good practice. The home has obtained a new accident book. This was viewed and although showed a high level of falls appropriate action is being taken. The storage of accident reports does not maintain confidentiality and must. A fireguard has now been fitted to a door highlighted as wedged open at a previous inspection. However this door did not close shut when the guard is release and this could compromise fire safety. Action must be taken. What the care home does well: What they could do better:
The contacts need to be reviewed again against the NMS and then a completed version agreed with each resident. The owner should also sign each contract. Copies of letters advising of increases in fees should be retained on file. Care Homes for Older People Page 5 of 10 Residents should be weighed regularly which should be recorded including any losses or gains and appropriate action taken. Medication must be logged directly onto the Medication Administration Record (MAR) chart and stored securely in the medication cupboard at all times. All medication not administered must be returned to the pharmacist with a record maintained so a clear audit trail of medicines entering the home is evidenced. The safekeeping of the key to the medication cupboard should be reviewed taking account of professional guidance. Practices and the environment should be reviewed to ensure resident’s dignity is respected and enhanced at all times. Residents must live in a well-maintained environment. Residents’ monies must be held securely. Information relating to people must be held to ensure confidentiality. Fire doors must close shut when released. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 2 5(1)(c) The Registered Manager 16/10/2008 must ensure that all residents have contracts that contain all the information stipulated in the National Minimum Standards. [This must include fees and bedroom occupied] Previous timescale of 31/12/06 not met. Care Homes for Older People Page 7 of 10 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 The registered manager 29/10/2008 must ensure that medicines brought into the home are recorded directly, are stored securely at all times and that all medicines that are not administered are returned to the chemist with a record maintained. The key to the medication cupboard must be held securely in line with guidance. The registered person must make suitable arrangements for the recording, handling, safekeeping, safe administration, and disposal of medicines received into the care home. 2 10 12 The registered manager 29/10/2008 must review practices and take action to address shortfalls in the enviroment to ensure residents dignity is promoted at all times. The registered manager shall make suitable arrangements to ensure that the care home is conducted in a manner which rspects the privacy Care Homes for Older People Page 8 of 10 and dignity of service users 3 35 16 The registered manager 29/10/2008 must ensure any residents monies given for safekeeping are kept in secure storage The registered manager shall provide a place where money and valuables of services users may be deposited for safe keeping. 4 38 23 The registered manager must ensure that all fire doors close shut on release of the fire guards fitted. The registered manager shall make adequate arrangements for the containing of fires. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 29/10/2008 1 8 The registered manager should ensure that residents are weighed regularly which is recorded in their care plan. Appropirate action is taken for any loss or gain. The registered manager should ensure that information regarding the administration of prescribed as required necessary medication (PRN) is adequately recorded. The registered manager should ensure that completed accident records are stored to ensure peoples confidentiality is upheld. 2 9 3 37 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
