Inspection on 20/09/05 for Lea House

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Lea House 16/09/08

Lea House 27/07/07

Lea House 25/05/06

Lea House 19/04/05

Lea House 12/10/04

Lea House 10/06/04

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 Lea House Lea House Rest Home 40 Terminus Avenue Bexhill on Sea East Sussex TN39 3LZ Lead Inspector Andy Denness Announced Inspection 20th September 2005 14:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lea House DS0000047969.V252011.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. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Lea House Address Lea House Rest Home 40 Terminus Avenue Bexhill on Sea East Sussex TN39 3LZ 01424 309580 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) Mrs Sadna Seesarun Mr Baldeo Seesarun Mrs Sadna Seesarun Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is fifteen (15) Date of last inspection 19 April 2005 Brief Description of the Service: 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 shops are a short level walk. Accommodation is provided in 13 single and one double bedrooms and a shaft lift is fitted to assist service users to access first floor accommodation. The home is registered to accommodate up to fifteen older people and the owners are Mr and Mrs Seesarun. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over an afternoon and evening in September and lasted five hours. To help gather evidence on how the home is performing the Inspector sat and ate an evening meal with service users, met with staff and the home’s manager, examined a range of records and written information and undertook a tour of the premises. In depth discussions took place with eight service users. Also written feedback regarding the home was received from several service users and some health professionals. What the service does well: What has improved since the last inspection? What they could do better: Following recent serious concerns raised with Social Services regarding the protection and safety of service users the Commission for Social Care Inspection has issued a three ‘Legal Notices’ requiring that action is taken to address matters relating to the safety of service users, a failure to comply with this notice could lead to the proprietors being prosecuted. Following this inspection requirements for improvements have been made regarding the quality of the plans of care and recruitment procedures. The manager has also been required to ensure that suitable activities and entertainments are provided for service users and that she informs the Commission for Social Care Inspection of any occurrences that affect the wellbeing of service users. Recommendations have been made regarding staff training, the recording of complaints and management support for staff. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 6 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. Lea House DS0000047969.V252011.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 Lea House DS0000047969.V252011.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. Pre assessment procedures are satisfactory and ensure that service users are admitted to a home that is suitable to meet their needs. EVIDENCE: A statement of purpose has been produced for the home, this document provides guidance for prospective service users about Lea House and the service provided; this document was examined, it was of satisfactory quality. Assessments of service users’ needs are undertaken by the manager prior to admission to the home; a selection of these were examined, they were of a satisfactory quality and covered required areas of daily living. All service users are issued with a contract detailing the terms and conditions of their stay at Lea House, this document contained all required information. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9 & 10 The poor quality and lack of consistency of the plans which provide guidance to staff on how to meet service users’ needs, could result in health, personal care and social care needs being overlooked. EVIDENCE: Using the initial assessment of need as a starting point individual plans of care are compiled for each service user; these identify amongst other things what support service users require from staff to meet their day to day needs in relation to health, personal and social care needs. A selection of these plans was examined; they were of a poor quality and contained little detailed information. In one instance a plan did not contain information regarding a service users’ mental health needs or of the regular medication they were taking to combat this. Care plans do not contain an assessment of risk regarding falls or the risk of developing pressures sores, it has been required that these are introduced for all service users. Because of repeated concerns over the poor quality of the plans of care it has been required that the manager undertakes training in the subject as a matter of urgency. A monitored dosage medication system is used records and storage were examined and found to be in order. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14 & 15. Minimal social opportunities are available to service users. Arrangements regarding visitors, choice and meals are satisfactory. EVIDENCE: From the examination of records and discussions with service users it was evident that there are limited opportunities for them to participate in activities in the home. It has been required that the manager consults with service users and introduces a range of activities and entertainment suited to their needs. The Inspector was told that visitors are welcome at any reasonable time. Service users said that they have choices in all areas of daily living including what time to get and go to bed and how to spend their day. The Inspector sat and ate a meal with service users; the meal was well prepared and enjoyed by service users. Records examined confirmed that a varied and wholesome menu is provided. Service users spoke positively of the meals provided for them, comments included “ the food is very good” and “the food is excellent”. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 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 the following standard(s): 16 & 17. Service users are confident that their complaints will be listened to and acted on. The home has recently failed to ensure the protection and safety of one service user. EVIDENCE: The home has a written complaints procedure in place for service users or their representatives to follow should they be unhappy with any aspect of the care provided in the home, this was of a satisfactory standard. Service users said that they are confident that their complaints would be listened to and acted on by the manager. It has been recommended that the manager introduces a central complaints record. The home has a written adult protection policy in place. As previously mentioned in this report an adult protection alert was recently raised by Social Services regarding a failure of the home to ensure the safety of one service user. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 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 the following standard(s): 19,20,21,22,23,24,25 & 26 Physical standards throughout the home are good ensuring that service users live in a comfortable an homely environment that is suitable to meet their assessed needs. EVIDENCE: An inspection of most areas of the premises took place; accommodation is on two floors and a shaft lift is fitted to assist those service users who may have mobility problems. The gardens are well maintained and the front garden especially is used by service users to sit and socialise. The home has a pleasant dining room and lounge for use by service users; these were furnished in a comfortable and homely style. Bedrooms are decorated and furnished to a good standard and service users said that they were able to bring their own furniture with them if they so wished; all bedrooms have ensuite facilities. Sufficient other communal bathrooms and WCs are available to meet service users needs. The main bathroom is fitted with a bath seat to assist those service users who may have mobility problems. Emergency call points are fitted in areas used by service users. The home was clean and Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 13 hygienic throughout. Hot water outlets are fitted with thermostatic controls to ensure that service users do not scald themselves; records examined confirmed that these are working properly and are regularly tested. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 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 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 & 30. Staffing arrangements were generally good although improvements are needed to staff recruitment practices and some staff training is required to ensure the safety and well being of service users. EVIDENCE: From records examined and discussions with service users it appears that sufficient numbers of staff are on duty to meet the needs of service users. The rota indicated that only two staff are on duty at the weekends, however the manager said that she and her husband worked some hours, it has been required that the manager ensures that this shown of the rota. Service users spoke very positively of the manager and her staff, their comments included, “staff are very good” and “staff are very kind”. Currently 50 of staff are not trained to the required national level, however the manager said that several staff were due to start their training in the near future. It has also been required that the manager ensures that all staff are trained in first aid, moving and handling, fire safety and infection control. An examination of recruitment records confirmed that generally satisfactory procedures are followed when new staff are employed, however it was noted that the manager had accepted old Criminal Record Bureau checks on two staff recently employed, when new ones should have been completed. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 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 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): 31,32,33,34,35,36,37 & 38 The manager is a trained nurse and is currently undertaking her required management training; the requirements made following this inspection and the recent adult protection alert raised by Social Services have highlighted the need for her to undertake further training as a matter of urgency. EVIDENCE: Both service users and staff spoke well of the manager. She is a trained nurse but has had no experience of managing a care home for older people until purchasing Lea House two years ago. This has caused some problems highlighted at a previous inspection and by the recent adult protection matter. She is undertaking the required management course and it has been required that as a matter of urgency she undertakes training regarding the compilation of care plans and risk assessments. The manager did earlier in the year undertake some quality assurance work by distributing questionnaires to service users, it has been required that she now does this again, ensuring that questionnaires are dated and that the information gained is collated and any Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 16 issues identified addressed. The manager holds some money on behalf of one service user; records and balances regarding this were examined and found to be in order. Since the last inspection the manager has introduced close monitoring of staff practices including how they bathe a service user etc. Written records regarding this were good, it has been required that the manager now expands her supervision to provided regular one to one meetings for staff. A selection of records and procedures required by regulation was examined, these were generally in order although it was noted that the manager had failed to inform CSCI of some serious incidents that had befallen one service user; the failure to report significant occurrences was raised at the last inspection, because of this and the repercussions of failing to report matters, this matter has been included in the recently issued legal notices. A selection of health and safety matters was examined, these were found to be in order, although it has been required that the risk assessments regarding the environment are reviewed. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 17 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 3 2 3 3 2 1 1 Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP8OP7 Regulation 15 Requirement That care plans are expanded to include detailed information and guidance for staff regarding all areas of daily living; included should be individual pressure sore risk assessments and falls risk assessments; these assessments must be reviewed regularly and when needs change. That following consultation with service users a programme of activities and entertainments are introduced. That a central record of complaints is kept. That the hours worked by the proprietors at weekends are included on the rota. That new Criminal Record Bureau checks are obtained for newly employed staff. That the manager undertakes training in the compilation of care planning and the risk assessment process. That quality assurance questionnaires are again distributed to service users, the DS0000047969.V252011.R01.S.doc Timescale for action 30/10/05 2 OP12 16(2)(m) 30/12/05 3 4 5 6 OP16 OP27 OP29 OP31 22 18(1)(a) 19(1)(c) 18(1)(a) 30/10/05 30/10/05 30/10/05 30/12/05 7 OP33 24 30/12/05 Lea House Version 5.0 Page 19 8 OP36 18(2) 9 OP37 37 10 OP38 13(4)(a) completed questionnaires should be dated, the information collated and a record kept of action taken as a result of matters raised in the questionnaires. That formal staff supervision is expanded to included regular one to one meetings with the manager. That in line with Regulation 37 of the Care Standards Act, the manager informs CSCI of any significant occurrences that may affect the wellbeing of service users. This requirement was also made at the last inspection. That the risk assessments of health and safety matters and the environment are regularly reviewed. 30/12/05 20/09/05 30/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP28 OP31 Good Practice Recommendations That 50 of staff are trained to NVQ level 2 by the end of 2005. That the manager completes her management training to NVQ level 4 or its equivalent by the end of 2005. Lea House DS0000047969.V252011.R01.S.doc Version 5.0 Page 20 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. 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