Inspection on 30/07/09 for Marina Rest Home

This inspection was carried out on 30th July 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Marina Rest Home 06/08/08

Marina Rest Home 29/08/07

Marina Rest Home 01/08/06

Marina Rest Home 31/10/05

Marina Rest Home 27/06/05

Marina Rest Home 17/02/05

Marina Rest Home 22/09/04

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Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Marina Rest Home Cuthbert Street Hebburn Tyne And Wear NE31 1DJ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Eileen Hulse     Date: 3 0 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Marina Rest Home Cuthbert Street Hebburn Tyne And Wear NE31 1DJ 01914835588 NOFAX Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Dr Inder Paul Vinayak,Dr Veena Vinayak care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is : 37 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 10 Dementia - Code DE, maximum number of places: 5 Mental disorder- Code MD, excluding learning disability or dementia, maximum number of places: 22 Date of last inspection Brief description of the care home Marina Rest Home is a converted property to its present use as a care home. It comprises of two units, one caring for up to twenty-seven older persons and a separate seventeen-bed unit for people with dementia. The home is currently working Care Homes for Older People Page 4 of 28 Over 65 0 0 10 5 22 0 Brief description of the care home with the Care Quality Commission Registration Team to change the catagories of service users it currently admits into the home. The home does not provide nursing care. The older persons unit is two-storey, the first floor being accessed by a passenger lift or stairs. The Dementia Care Unit is a one storey newer extension. Each unit has lounges dining rooms bathrooms, bedrooms and toilets. Senior care staff and care staff, staff the home throughout the 24-hour period. The home is situated in a residential area close to the town centre. It is within walking distance of local amenities and accessible by local transport services. There is ample car parking space to the front of the building. The home charges #397:00 to #460.00p per week. Personal items such as clothing, toiletries, hairdressing and outings are not included in the fee rates. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was completed on 6 August 2008 This is an overview of what the inspector found during this inspection The quality rating for this service is 1 STAR. This means that people who use this service experience Adequate quality outcomes. How the inspection was carried out. Before the visit we looked at:information we have received since the last visit on 6 August 2008 and how the service dealt with any complaints and concerns since the last visit; Care Homes for Older People Page 6 of 28 any changes to how the home is run; the providers view of how well they care for people; the views of people who use the service their relatives and staff. During the visit we observed staff practice and talked with people who use the service and looked at how well their needs are met. We looked at other records which must be kept and checked that staff had the knowledge skills and training to meet the needs of the people they care for. We looked around the building to make sure it was safe clean and comfortable and checked if any improvements had been made. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are included within the plans of care for all service users which help to form the basis of the individual care plan. This ensures that before admission takes place the home is able to know if the care needs can be met by them. Evidence: All service users currently living in the home have had pre admission needs assessments carried out by a care manager and the deputy or manager of the home. When a vacancy occurs, a care manager makes a referral to the home and the prospective service user spends some time in the home meeting other service users and having a meal with the people who live there. In some instances one to two overnights stay are offered. This gives the person the time to decide if they would like to move in and ensures the correct equipment and care plans are in place prior to their admission. The homes admission and assessment procedure ensures that people have an informed choice about moving in. They are Care Homes for Older People Page 11 of 28 Evidence: given information about the home, such as the service user guide and the homes brochure which is currently being reviewed and updated with new information and this tells people what they can expect from the service. Following admission, each service user has a care plan developed from information gathered during the assessment so that when followed by staff it helps the care needs to be met on a daily basis. The person lives in the home for six weeks to see if they want to live there permanently and to ensure the home can meet their needs. This period is followed with a review meeting held between the service user and their representatives, the home staff and the care manager. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users living in the home have individual plans of care, however, they do not explain in detail how the care needs are to be met by staff and therefore the home cannot be sure that care needs are being met on a daily basis. Service users have access to all NHS facilities and services and this ensures healthcare needs are met and good medication administration procedures ensure that medicines are administered safely. Evidence: All service users have an individual care plan that is completed by staff and gives the staff guidance on how the care needs of people living in the home will be met. During the visit three care plans were looked at. The care plans were organised with an index to find information easily and they included areas such as pre admission assesments, personal information and photograph, admissions sheet that includes healthcare needs, a life history and other healthcare information that should be kept. Care Homes for Older People Page 13 of 28 Evidence: However, the day to day care plans did not include sufficient information to guide staff to ensure that the care needs are met on a daily basis. One care plan stated that (name) needs assistance when dressing and bathing but gave no guidance to staff on how this should be carried out. It also stated that the service user should assist in tasks to maintain some level of independance but again did not state how this need could be achieved or what the service user was able to do to maintain a level of independance. Another area of a care plan stated that the service user finds it difficult to participate in activities but there was no written record to say how or if this need had been addressed. On the 31/07/09 the care plan stated that the service user had visited the optician and that the person could be registered as being partially sighted but there was no information recorded to state if the home had done anything about this. One care plan stated If necessary assist (name) using a wheelchair but the daily notes had several entries stating (name) shouting for a wheelchair and it is not known if staff are clear about when wheelchair assistance is necessary. One service user regularly goes out alone but there was no risk assesment in place to ensure this person is kept safe. The risk assesments looked at were all written in the same format and repeatedly stated to be offered support and guidance but did not state how staff were to do this. Although the care plans are evaluated they are repetative and give no clear indication that the care needs are being met and the care plans are being followed. All service users have a choice of GP and there are regular visits from all local GPs and other healthcare professionals such as chiropodists, dental service and opticians. Service users needing to attend hospital out patient appointments are escorted by a member of staff or if the person prefers a family member. The home uses a monitored dosage medication system that is delivered to the home on a monthly basis by a local pharmacy and only senior staff administer medications to service users. Medicine administration records were signed, up to date and well maintained with photo identity of the service users, however, the home do not keep copies of prescriptions that are requested from the GP and therefore cannot check what has been ordered when the medications are delivered from the pharmacy. Care Homes for Older People Page 14 of 28 Evidence: A medication audit of drugs held by the home confirmed medication was stored and recorded correctly and followed the guidelines of the homes medication procedures. Staff responsible for administering medication have completed Safer Handling of Medication training. Staff stated that the drugs fridge temperatures are taken on a daily basis but records could not be found to confirm that this happens. In talking with service users and relatives about the general care, comments they made included, This is a good place to be You get well looked after The dinner today was very nice . Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities are available and service users are supported to join in activities of their choosing and ability which helps to contibute to fulfilling days. Furthermore, service users are offered and receive a varied, wholesome and nutritious diet and this helps to promote the well being of people. Evidence: The activity co-ordinator is currently on maternity leave and in her absence staff on duty are organising activities on a daily basis. There was no evidence of activities taking place during the inspection and the activity records could not be located on the day but the Manager stated that one service user visits the local shops and likes to attend a church service every Sunday and entertainers are brought into the home regularly. One service user in the younger adult unit within the home commented, Its brilliant living here, I go to bed when I like and go out on my own. We get brill meals and sometimes I get a takeaway. During the visit, a lunchtime meal was taken with service users. Tables were well set with tablecloths, condiments, sugar bowls and milk jugs and every table had an individual teapot. However, there were no serviettes on the tables and people used Care Homes for Older People Page 16 of 28 Evidence: tablecloths to wipe their hands. Service users were all offered a choice of meals, whilst seated at the dining room tables. The meals were pleasantly served with a main choice of meat loaf or chicken, with potatoes, green beans and sweetcorn and cold drinks were also offered to everyone. The lunchtime meal was pleasant, staff were courteous and respectful to people and anyone requiring staff support to eat their meal was given help in a sensitive and dignified manner. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and their families have the information they need should they have a concern or complaint about the service and good safeguarding policies and procedures are available and this helps to protect service users from abuse. Evidence: The home has a complaints procedure that is given to service users and their representatives following admission into the home and tells people how to make a complaint and the length of time it will take before a response is received. It also explains to the complainant how the service will deal with the complaint. As well as people being given this information, it is also on the back of bedroom doors. Only one complaint has been received in the last twelve months and this was documented and dealt with efficiently. Some service users spoken with during the visit made the following comments, There is nothing to complain about in here If I was worried about something I would tell the manager I have been given information telling me what to do if I want to complain The care staff have received safeguarding training and in discussions with some staff it Care Homes for Older People Page 18 of 28 Evidence: was clear they would know what to do should an abusive situation be suspected or a complaint be received whilst they were on duty. Safeguarding procedures are made available to all staff. There have been no issues regarding abuse in the last twelve months. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained and a number of improvements have been made since the last inspection. This provides people who live there with a comfortable and safe place to live. Evidence: Marina Rest Home is a converted property and is divided into two units. The Southview unit is for people with dementia type illness and since the last inspection has undergone an extensive refurbishment programme. Corridors, bedrooms, lounges and the dining room have all been redecorated and new carpets have been laid in the bedrooms with new lighting in the communal areas and double glazing put into place throughout the building. In the Marina unit for people with a mental health need aged 18 - 65yrs all bedroom furniture and soft furnishings have been replaced and a sensory room and hairdressing salon have been created. The salon has had a hair washing sink installed with cupboards and mirrors put into place. A new kitchen is now available that can be used by service users and their families for the preparation of snacks and hot drinks. This area was a former bedroom and now has a table and chairs, fitted furniture and a sink unit. Care Homes for Older People Page 20 of 28 Evidence: The open plan lounge has been adapted into a games room with a pool table, flat screen tv and a service user information area with information leaflets available including nutriction, advocacy, selfcare and mental health. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well trained and competant staff are in post and there are good recruitment procedures which help to ensure that suitable staff are employed and that service users are kept safe and receive a good quality of care. Evidence: The duty rota reflected the numbers of staff on duty on the day of the visit and the staffing levels were adequate to meet the current needs of service users. Over seventy five percent of the care staff currently employed in the home have achieved an NVQ qualification in care and all members of staff complete mandatory training. The training matrix identifies the training needs and shows training that has taken place. All the necessary mandatory training had been completed and was up to date. The manager was able to discuss in detail the recruitment process the service uses whenever they have a staff vacancy. It is satisfactory and robust. The induction and probationary period for all new staff lasts twelve weeks. The personal staff files for two members of staff, one of whom was recently recruited, were looked at. Both files were organised and kept up to date and the information Care Homes for Older People Page 22 of 28 Evidence: included all of the necessary documentation that the home is required to keep such as job application, references, photocopies of completed training, personal identity and criminal record bureau checks. Although a checklist used in the interview process is kept within the personal files, the interview notes taken during the interview are not kept and therefore cannot be used in the future if they need to be. In discussions with staff on duty they were positive about the service and made the following comments:I get very good support from the manager We do lots of training to help us in our jobs I enjoy working here and we work great as a team. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently well managed by a person who is appropriately qualified. Health and safety procedures are maintained and therefore this helps to enure the smooth running of the service and that service users are kept safe. Evidence: The manager has been in this role for over nine years and her qualifications include the Registered Managers Award and NVQ Level four in care. Recently she has completed the following courses to update her knowledge and skills, palliative care course, understanding bi-polar disorder, nutrition and Mental Health induction. Staff individual supervision sessions are in place and records of this are held on staff personal files and observation showed that all staff follow safe working practices at all times. The introduction of a quality assurance system has been maintained and continues to be updated regularly. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 37 26 The registered provider must 30/09/2008 complete a report on the conduct of the care home and supply a copy to the registered manager and CSCI on request. Care Homes for Older People Page 25 of 28 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 7 15 The care plan must explain the care needs of service users in detail This will ensure that peoples needs are met on a daily basis 27/11/2009 2 7 15 The care plans must be evaluated with the correct information This will make sure the care needs remain unchanged and relevant 27/11/2009 3 9 13 Temperatures of the medical 30/10/2009 fridge must be taken and recorded daily This ensures medication needing to be refridgerated is stored at correct temperatures 4 12 16 Records must be kept of all activities that take place 27/11/2009 Care Homes for Older People Page 26 of 28 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 This will ensure that activities will be appropriate to people living in the service 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!