Inspection on 12/08/05 for Marjorie Cobby House

This inspection was carried out on 12th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Marjorie Cobby House 25/11/09

Marjorie Cobby House 03/12/08

Marjorie Cobby House 03/01/07

Marjorie Cobby House 07/02/06

Marjorie Cobby House 18/02/05

Marjorie Cobby House 16/08/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

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 Marjorie Cobby House St Peters Crescent Selsey West Sussex PO20 0NA Lead Inspector Kathy Allen Announced 12 August 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. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Marjorie Cobby House Address St Peters Crescent, Selsey, West Sussex, PO20 0NA 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) 01243 605334 West Sussex County Council Mrs June Lawrence Care Home (CRH) only (PC) 34 Category(ies) of Old age, not falling within any other category registration, with number (OP), (34) of places Physical disability (PD), (34) Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Two service users under 50 years of age may be admitted. 2 The total number of service users accommodated must not exceed 34. 3 The Commission for Social Care Inspection is notified in writting of the date on which both people are discharged from the home at which time the registration will revert to admissions of people over 50 years of age. Date of last inspection 18 February 2005 Brief Description of the Service: Marjorie Cobby House is registered to provide care and accommodation for up to 34 people over 50 years of age for short stays or rehabilitation. The home is located near to the centre of Selsey, West Sussex and the accommodation is on two floors served by a passenger lift. There is a courtyard garden which is well maintained. All residents have their own room although none have en-suite facilities and there is a range of communal space including a separate room for residents who smoke. Part of the premises are dedicated for the rehabilitation service and suitable kitchen facilities are provided. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection, which included an analysis of incident reports and those of other statutory bodies such as the fire service. Comment Cards were distributed via the home to residents, relatives and visitors and two were completed and returned. The inspection took place from 9am over eight and a half hours on August 12th 2005. During the inspection all of the residents were seen either privately in their room or in communal areas. One relative and one friend of a resident were also spoken with. A discussion was held with the manager and four staff was interviewed. In addition a number of records were seen. Residents said “they got me back on my feet”, “it’s lovely here” and that “you can’t better the place”. What the service does well: What has improved since the last inspection? What they could do better: The administration of medication must be made safer. The registered provider must replace the condemned boiler without further delay. All fire work identified in the providers risk assessment for the home must also be completed without further delay and the requirement for compliance has been re-stated in this report. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 6 A record of complaints should be kept and hazardous chemicals must be stored safely. 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. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 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 Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 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) 1, 3 & 6 Prospective residents have the information they need to make a choice about moving to the home. No service users move into the home without having his/her needs assessed. Residents assessed for intermediate care are helped to maximise their independence and return home. EVIDENCE: There is a statement of purpose, which is made available and contains the required information. There is also a guide to the home, which is left in each bedroom for new residents. One resident said that she had not seen this document although it was seen to be available and others confirmed that they had a copy in their room. A full assessment is made of each resident prior to them moving to the home. It is conducted by a qualified social worker that is attached to the local doctors surgery but assigned to the home to ensure appropriate and effective placements are made. Since the last inspection the assessment process has improved so that people do not move to the home inappropriately, for example in the last days of their life or without any prospect of rehabilitation. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 9 Dedicated accommodation is provided for residents coming to the home for rehabilitation, which includes a domestic kitchen. The period of stay is six weeks and this is made clear to people before they arrive. Specialist services are engaged and include an occupational therapist and physiotherapist. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9 & 10 Individual care plans were written up for each resident. Where appropriate, they are responsible for their own medication however the procedure for administration does not always protect service users. They feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Since the last inspection the manager has ensured that all residents have a written care plan and daily notes show how their needs are met. These notes include details of incidents when residents refused help in an attempt to regain their independence. In one case, however, it had been stated that the person required an eye test and there was no evidence that this had been followed up. The manager agreed to look into this after the inspection. The majority of care plans were signed by the resident concerned. There is a written policy regarding the safe management of medication. All medicines are safely stored and senior staff administers them. A record is kept of medicines received and disposed of as well as those administered. However, there were a small number of occasions when a signature was not entered on the records, by the person administering the medication. This was discussed with the manager who said that she would follow the matter up. Two people were currently looking after their own medication. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 11 Personal care is provided in people’s own rooms or in bathrooms/toilets, which provided sufficient privacy. One person said how much she enjoyed her bath because the staff was “reassuring and kind”. There is access to a pay-phone, which is situated in a corridor although it is enclosed for privacy. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Residents are satisfied with the lifestyle experienced at the home. They maintain contact with family, friends and representatives as they wish. They are helped to exercise choice and control over their lives and wholesome and appealing meals are provided in pleasant surroundings. EVIDENCE: Residents were provided with some activities including music sessions, walks to the town and quizzes. Some preferred to spend time in their room and this was respected. The majority considered that there was enough to do and staff said that there were enough people to take them out if they wished. One person described the home as “free and easy”. Residents can meet with their visitors in their room or in communal lounges. In addition, there is a comfortable lounge set aside for more formal meetings such as when a social worker comes to see a resident. Residents can see whom they choose and two visitors said that they were always welcomed at the home. Cups of tea are provided and they can join their relative for a meal if they wish. Residents handle their own affairs often supported by family or solicitor. They can bring their own possessions to the home although this is limited by the fact that they only live there for a short time. One person was very pleased to have a calendar with her, which showed pictures of a country she had visited and where a relative lived. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 13 Residents were complimentary about the food provided. They said they “have a choice” and “the food is lovely”. Meals are served in a large, bright dining room on small tables, which are laid nicely. A cook is employed and he is familiar with any special diets that are required. One person who is diabetic confirmed that her needs are catered for. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Residents and others understood how to make a complaint and their concerns were taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: There is a clear and simple complaints procedure the details of which are provided to all new residents. It includes how to refer a complaint to the Commission for Social Care Inspection (CSCI). There have been eight complaints in the last year, two of which were directly about the service at the home. Details have not been recorded although the information was available from the manager. A recommendation has been made that the way a complaint is investigated and the outcome is recorded in the complaints log. This should assist the provider in monitoring the handling of complaints and customer satisfaction. There are written procedures for reporting concerns about resident’s wellbeing and staff, including those working at the home on a temporary basis, understood these. Suitable procedures are in place for handling resident’s money, which is kept in a safe place, and all transactions are recorded. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 Residents live in a well-maintained environment although their safety could be improved by replacing the condemned boiler and ensuring all identified fire precaution works are completed. The home is clean, pleasant and hygienic. EVIDENCE: The home is situated close to the town and the décor is satisfactorily maintained. The heating and hot water system is old and one boiler has been condemned. Services to the home in the winter could therefore be disrupted and this could put residents at risk. The grounds are private apart from a public path, which runs by the side of the property. Work is currently being carried out to ensure that the home meets all of the recommendations from the fire service. This includes renewing smoke seals, installing new fire doors around the lift area and fitting automatic doorstops. However the manager stated that not all of the work recommended in the homes risk assessment is scheduled to take place. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 16 The home is clean and free from offensive odours. Laundry facilities are situated away from food preparation areas and there is a separate sluicing area. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 There is sufficient staff to meet the needs of the residents and the homes recruitment procedure safeguards their well being. EVIDENCE: There is a written record showing which staff is on duty at any time. The number of residents at the home varies a great deal and staffing is adjusted accordingly. Staff told the inspector that there was “on the whole” enough staff and that there were enough “to get the work done”. Domestic staff is employed to keep the house clean and a team of kitchen staff prepare the meals. Two written references are obtained on staff before they are employed at the home. A number of staff that works at the home is from an agency and the home relies on the agency to have completed thorough checks on them. A Criminal Records Bureau (CRB) check is also carried out on permanent staff. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31, 32, 35, 36, 37 & 38 Residents live in a home, which is managed competently and benefits from good leadership and a sound management approach. Residents’ financial interests are safeguarded. Staff is appropriately supervised and the required records are kept. Health and safety measures do not always protect residents, as hazardous chemicals are not always stored safely. EVIDENCE: The registered manager has considerable experience and is qualified. There are clear lines of accountability although at times, the manager is unable to progress matters in a timely manner, particularly those involving the upkeep of the building, due to procedural and financial constraints. Staff said that the manager gives them confidence, supports them and that the home is a welcoming one for all staff members including those working there Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 19 temporarily and from ethnic minority groups. One person stated that the manager “would not ask you to do anything that she wouldn’t do”. Residents look after their own affairs although a number deposit money at the home for day-to-day expenses. The money is safely stored and accounted for. The manager ensures that staff is well supervised. They meet together at least every other month, although senior staff meets as a team more often. Time is also set-aside for a senior member of staff to meet with care staff individually every two months. Staff who work at the home via an agency also receive supervision if they frequently work there. Records are kept as required by regulation and they are safely stored. The manager ensures safe working practises through staff training in such areas as lifting and handling, infection control, fire safety and first aid. Risk assessments are also conducted. The premises are made safe by covered radiators and signs to alert people to hot water. However, as previously stated there is a risk that the supply of both hot water and heating could be affected by the poor state of the homes boilers. In addition, hazardous chemicals had been moved to a different storage cupboard due to building works and this cupboard was not locked. Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 3 x x 3 3 3 2 Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 9 19 Regulation 13 23 Requirement Staff must always sign to record the adminsitration of medication The manager must submit details of dates when work identified under the homes Fire Risk Assessement will be carried out The manager must confirm in writing when the heating and hot water system will be repaired/replaced All hazardous substances must be safely stored. Timescale for action August 12 2005 Sep 30 2005 3. 38 23 Sep 30 2005 4. 38 13 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. Refer to Standard 16 Good Practice Recommendations A record of complaints should be kept Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House, Liverpool Gardens Worthing West Sussex BN11 1RY 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 Marjorie Cobby House H60-H11 S37445 Marjorie Cobby House V235940 120805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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