Inspection on 11/07/05 for Memory House Care Centre

This inspection was carried out on 11th July 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

Memory House Care Centre 24/06/09

Memory House Care Centre 29/04/08

Memory House Care Centre 30/04/07

Memory House Care Centre 08/08/06

Memory House Care Centre 16/12/05

Memory House Care Centre 09/03/05

Memory House Care Centre 05/08/04

Memory House Care Centre 22/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Memory House 6-9 Marine Parade Leigh on Sea Essex SS9 2NA Lead Inspector Carolyn Delaney Unannounced 11th July 2005 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. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Memory House Care Centre Address 6-9 Marine Parade Leigh on Sea Essex SS9 2NA 01702 478245 01702 711168 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) Ashbourne (Eton) Limited Mrs Judith McGugan CRH Care Home 45 Category(ies) of DE (E) Dementia - over 65 (45) registration, with number OP Old Age (45) of places Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Personal care to be provided for older people aged of 65 years 2 Personal care to be provifed to no more than forty-five service users who have dementia and are over 65 years of age 3 The number of persons for whom personal care is to be provided shall not exceed forty-five Date of last inspection 9th March 2005 Brief Description of the Service: Memory House provides accommodation for up to forty-five older people, over the age of sixty-five years who have a diagnosis of dementia or Alzheimers disease. Accommodation is provided in a beautiful large older style which over looks the Thames estuary and is situated within a short walk of Leigh Broadway and Old Leigh Town. Memory House has thirty-three single bedrooms and six shared bedrooms. There are three dining areas and two lounge areas. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on 11th July 2005 between the hours of 12.00 and 19.00 by Carolyn Delaney, Lead Inspector for the home. A number of records for residents who live at the home including assessment documents and care plans were examined and five residents and three relatives were spoken with. A number of documents in respect of staff working at the home including recruitment and training records were examined and four members of staff were spoken with. The serving of the lunchtime and evening meals was observed. The environment was not assessed on this occasion. What the service does well: What has improved since the last inspection? It was positive to note that the day-to-day management of the home had not been adversely affected in the absence of the registered manager and that staff continued to work well as a team in order to provide a good service to the people who live there. Staff working at the home ensure that so far as it is possible that residents living at the home have the medication, which has been prescribed ad that where residents persistently refuse medication that the implications of this is discussed with the individual and / or their relatives and that the persons condition is monitored. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 6 What they could do better: 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. Memory House I56 I06 S15512 Memory House V238570 110705 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 Memory House I56 I06 S15512 Memory House V238570 110705 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 People living at Memory House and / or their relatives are offered detailed information about the services, facilities and any rules in respect of living at the home. People’s health, safety and general needs are assessed in detail before they are offered a place at the home so as to ensure that the home can meet these needs before they make a decision about moving in. EVIDENCE: Assessments in respect of residents needs were detailed in respect of the individual’s healthcare, safety and general needs including preferences for daily routines. Residents and their relatives who were spoken with said that they happy with the care provided by the home. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8& 9 Staff working at the home plan and record care and treatment, which is reviewed regularly in respect of each person living there. Staff do not always act so as to minimise the risks of injury to people living at the home. People living at the home receive their medication at the appropriate times, assisted by suitably trained and skilled staff. EVIDENCE: Care plans for people living at the home were generally very detailed and updated according to changes in each individual’s general or medical condition. Where there were short term needs identified such as when residents developed chest or urinary tract infections the management of these conditions were clearly recorded so as to ensure that staff were aware of changes in treatment and care for these people. There were risk assessments in place to identify and manage risks to residents of sustaining injury or harm from for example falls. These plans were reviewed periodically however there was little evidence that they were reviewed and changed if necessary following incidents where residents did sustain injuries. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 10 For example where one resident had sustained an number of falls and subsequent injuries the risk management plan had not been updated and it was not clear that staff were considering if changes to care / supervision would be needed. Records in respect of medicines received into the home, administered to residents and disposed of when appropriate were well maintained up to date and accurate. Staff receive their medicines at the times for which they are prescribed. Two residents keep and take responsibility for their topical creams and bronchodilator inhalers. Staff support them to maintain this level of independence while regularly ensuring that each individuals medical and general condition does not affect their ability to continue to do so. Staff who administer medication receive regular training in respect of the safe handling and administration of medication. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 11 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 & 15 Activities provided by the home do not always meet the needs of the less able people living at the home. The home provides a variety of food for residents living at the home. However residents were not provided with details of the menu and staff could support residents who require assistance in a more positive manner, while promoting choice and independence for the more able people who live at the home. EVIDENCE: The Home employs an activities coordinator foe twenty-one hours per week who provides a variety of activities such as games quizzes and exercises to music for those residents who are capable of and wish to participate. Care staff also assist and escort residents who wish to go out to local shops etc. Outside entertainers come to the home and provide shows etc. Some residents particularly those who are less able or do not wish to participate in group activities are offered some one to one time with the activities coordinator, however there appeared to be little else in the way of meaningful occupational activities offered to these people and some said that there was little to do during the day. It was noted on the day that each of the clocks in communal areas such as lounge and dining rooms had stopped and none were displaying the correct Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 12 time, which could add to individual’s confusion. It was further noted that during the inspection that the same music was played repeatedly without any apparent consultation with the people sitting in the communal areas. The serving of both lunch and evening meals were observed. Residents and some staff who were asked were not aware of what foods were available from the menu, which was not displayed or available. The majority of people said that they food was good; some residents said that it was a ‘bit tasteless’ or ‘a bit monotonous. Those residents who require assistance with meals are served and assisted first and the more able people are then served their meals. This is noted as good practice, however those more able people were seated at the tables at the same time (12.30) and therefore were waiting for their meals. The meals were noted to be presented and served in an appealing way and looked quite appetising. Residents who require extra nutrition are provided with supplement drinks. At the evening meal residents had the choice of soup, sandwiches and fish salad. One other resident had cheese on toast. Some staff were noted to assist residents with their meals in a positive manner. However others were seen to stand at the table feeding residents whilst chatting amongst themselves. One member of staff was noted to put a tabard/ apron on a resident before her meal without explaining what she was about to do. Condiments such as sauces were not readily available for those more able people who would be able to choose and serve themselves. Residents were not offered a choice of cold drinks such as water or juices with their meal, only orange cordial. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 13 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 Staff working at the home deal with complaints in an appropriate manner. Not all staff working at the home are aware of the homes policies and appropriate actions to take so as to ensure the protection of people living at the home from abuse. EVIDENCE: The home has clear guidelines for receiving, investigating and responding to complaints received in respect of the services provided. Records in respect of complaints received by the home were up to date and showed that where residents and /or relatives made complaints that these were acted upon and actions taken to resolve the issues promptly. Records did not indicate whether complaints were substantiated or unsubstantiated. Staff working at the home receive Ashbourne’s ‘Resident Welfare’ training, which covers issues regarding the protection of vulnerable people from abuse. Two of the four members of staff who were spoken with could not demonstrate that they fully understood the principles in respect of the protection of vulnerable people and one member of staff when asked how they would act if verbal abuse of a resident (shouting) was observed, said that they would report it ‘ if it was a bad case’ but would not if the person had ‘just lost their temper’. It was explained to this staff member of staff that it is never acceptable to shout or lose ones temper with people who are living at the home. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 14 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 The home is generally well maintained but essential facilities including heating and hot water are not always available to meet the needs of people living at the home. EVIDENCE: At the time of this inspection it was reported that the home did not have heating due to a fault with the system, which had been identified during a routine maintenance check. The weather was good on the day of the inspection and residents were unaffected at this time. The acting manager said that she anticipated that the works would be completed by the end of this week, however at the time of writing this report this problem had not been rectified and the weather had deteriorated and the problem with the heating had not been resolved. The acting manager has put measures in place such as checking room temperatures and providing electric heaters for anyone who requires them. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 & 30 Residents living in Memory House are cared for by appropriate numbers of staff. However some staff work excessive hours, which over a sustained period could affect the level of care provided. Staff are not recruited in a consistently robust manner so as to protect the safety, interests and welfare of the people living at the home. Residents are cared for by staff who are provided with training in respect of the roles that they are to perform and the needs of those living at the home. EVIDENCE: The home employs six members of care staff in addition to the manager during the day and three members of staff at night. Staff working at the home are contracted to work between twenty and forty-nine hours per week, however two members of care staff work in excess of sixty hours per week. Some night staff pick up day duties to cover for absences due to holiday leave and sickness. One member of night staff was noted to work a late shift following a night duty, which is not good practice. The duty rota was clear in respect of the times that staff commence and finish shift and who is to take responsibility for each shift. Staff also have allocated tasks and duties so as to make the best use of staffing resources. Two members of care staff had been employed at the home since the last inspection and their recruitment files were examined. For both of these members of staff it was not clear that they were recruited in a consistent and robust manner. Appropriate checks were not made in respect of the Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 16 individual’s previous employment history. For one member of staff there was no evidence that a Criminal Records Bureau (CRB) disclosure or PoVA First had been carried prior to or since their employment at the home and there was no formal system for supervision of this member of staff. Where staff’s first language is not English there was no evidence that this was identified and a plan developed to deal with the problems that this posed. Staff working at the home receive regular training such as moving and handling, health and safety and fires safety etc. It was positive to note that assessments in respect of learning were carried out up to a week following each training session so as to determine staffs understanding. With the exception of issues in respect of the protection of vulnerable adults as identified elsewhere in this report, staff appeared to be well trained and aware of the needs of the people living at the home. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 17 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, 33 & 35 People living at the home are supported by staff who are well managed. The day-to-day management of the home is carried out so as to ensure that resident’s interests and welfare are protected EVIDENCE: It was positive to note that in the absence of the homes registered manager that the day to day running and management of the home had not been adversely affected and that staff continued in the main to act and carry out their duties so as to best serve the people who live in the home. Records in respect of the monies held by the home on behalf of the people living at the home were examined. As identified at the last inspection the receipts in respect of financial transactions were disorganised and did not seem to correspond with the records kept. However records and the monies held on behalf of residents did correspond. The acting manager was advised that the records and receipts would benefit from a reorganisation. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 18 Standard thirty-eight was not fully assessed on this occasion and the requirements in respect of the laundry facilities, which had been identified at previous inspections, will be carried forward. The acting manager said that the funding for this had been approved and that work was due to commence sometime later this year. Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 19 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 3 x 3 x 2 x x x Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 20 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. Standard OP8 Regulation 13(4) Requirement The registered persons must ensure that risks to people living at the home are identified and so far as it is practicable are managed and minimised. The registered persons must ensure that the facilities and services provided by the home in respect of meaningful activities, and the other issues identified in this section of the report, are suitable for and promote independence and a good quality of life for the people who live there. The registered persons must ensure that meals are provided with the support and assistance of staff so as to assist those people who require it, and promote the independence of those people who are more able The registered persons must ensure that all staff are aware of the correct action to take in order to protect the people living at the home from abuse. The registered persons must ensure that appropriate heating is provided for the people living at the home. Timescale for action 30/08/05 2. OP12 16(2)(n) 30/08/05 3. OP15 16(2)(i) 30/08/05 4. OP18 OP30 13(6) 30/08/05 5. OP19 4 16 10/08/05 Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 21 6. OP26 4 16 23(2)(j) 7. OP27 19 19 8. OP29 19 9. OP35 16(2)(l) 17 The registered persons must ensure that appropriate arrangements for hand washing are in place in the laundry. (This is outstanding from the previous two inspections) The registered perons must ensure so far as it is practicable that people living at the home are supported and cared for by staff who have appropriate rest time and do not work excessive hours. The registered persons must ensure that staff are recruited to work in the home according to a robust and consistent procedure so as to protect the people who live there. The registered persons must ensure that records maintained in respect of monies held by the home on behalf of service users living at the home must be up to date and accurate in order to minimise the risks of mishandling. (This is outstanding from the previous inspection. To be arranged. Immediate & ongoing Immediate & ongoing 30/08/05 10. 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 Good Practice Recommendations Memory House I56 I06 S15512 Memory House V238570 110705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea SS2 6BG 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 Memory House I56 I06 S15512 Memory House V238570 110705 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. 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!