Inspection on 09/11/05 for North Corner

This inspection was carried out on 9th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

North Corner 07/11/06

North Corner 14/06/05

North Corner 03/02/05

North Corner 29/07/04

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 North Corner 1 Prince Edwards Road Lewes East Sussex BN7 1BJ Lead Inspector Elaine Green Announced Inspection 9th November 2005 10:00 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 North Corner DS0000055776.V249970.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. North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service North Corner Address 1 Prince Edwards Road Lewes East Sussex BN7 1BJ 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) 01273 474642 Mr Schoonraad Mrs Schoonraad Mrs Schoonraad Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. That service users are aged sixty five (65) years or over on admission. That the number of service users accommodated must not exceed sixteen (16). 14th June 2005 Date of last inspection Brief Description of the Service: North Corner is a large detached house situated in a quiet residential area of Lewes. It is a short walking distance to the town centre for those capable. There is access to local transport. Rooms are located over two floors. A stair lift is available to assist service users to the first floor. There is a lounge with a piano and T.V and a dining room both on the ground floor. The home is not suitable for wheelchair dependant service users. North Corner is registered for 16 service users, of either sex, that are 65 years of age or over. The current proprietors have been have been the owners since 31st October 2003. Service users have access to a lovely garden area, weather permitting. There is adequate street parking available outside the home. North Corner DS0000055776.V249970.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 on the 9th November between 10 am and 5pm. As part of the Inspection the Registered Manager completed a Pre Inspection Questionnaire to provide statistical information about the running of the home and service users and their relatives were given the opportunity to complete comment cards and return them to the Inspector. Discussions took place with the Registered Manager and Deputy Manager as to the day-to-day running of the home and the Inspector joined the service users for lunch. A selection of the homes policies, procedures and records were also examined including, service users care plans, records pertaining to food and menus, health and safety records and staff training records. What the service does well: What has improved since the last inspection? The management team have worked hard to improve the pre admission assessments and care planning processes both of which now meet the minimum standards. The scoring for these standards have been made to reflect the level of commitment the management have shown in both meeting North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 6 these requirements and in involving the service users and their representatives in the processes. Recruitment procedures are being consistently followed and all the required security checks are undertaken prior to staff being deployed in the home. Water temperatures are now regulated to a temperature were scalding cannot occur whilst still protecting from Legionellas’ Disease. Staff supervision is in the process of being developed but has not yet been fully implemented. 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. North Corner DS0000055776.V249970.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 North Corner DS0000055776.V249970.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): 1,2,3,4,5. Prospective service users are provided with the information required to make an informed decision about whether to reside in the home. All service users receive a contract/statement of terms and conditions. EVIDENCE: The homes’ Residents’ Guide, Statement of Purpose and contract/statement of terms and conditions were examined. These documents have been recently reviewed and updated by the management and are comprehensive and informative. The manager explained that prospective service users are provided with a pack containing all these documents and that they are given the opportunity to visit the home prior to moving in and service users confirmed this. There has been a marked improvement in the recording of pre admission assessments 4 of which were examined and were found to be comprehensive, detailed and relevant. These assessments had been written in consultation with the service users and or their relatives or representatives. Of particular note is the pen portrait and personal history section of some of the assessments which North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 9 will provide valuable information for care workers to assist them in getting to know the service user and help them settle in to the home. It is worthy of note that the management invited all service users and their relatives to be involved in a re assessment of their needs. As a result, a pre admission assessment has been completed for all residents including those who have been resident for a number of years. The completed pre admission assessments formed the basis for new revised care plans to be written. North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10,11. Service users health care needs are fully met with multi disciplinary working practice taking place on a regular basis. Medication policies and procedures are adequate. Service users are treated with dignity and their wishes on death and dying are respected. EVIDENCE: Following a reassessment of the needs of all the service users resident at the home, service users care plans have been reviewed and rewritten. Four of these care plans were examined and found to be comprehensive and to provide all the information and guidance required for staff to adequately support the service users in all aspects of their daily living. These care plans had been reviewed on a regular basis. Through the examination of care plans and daily records it is evident that the management and care staff monitor the physical and emotional health care needs of service users and make referrals as needed. There is evidence of regular multi agency working. The homes medication policies and procedures were examined and are adequate. Medication records were also examined and found to be in order. Service users are able to take their own medication North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 11 subject to a risk assessment. Arrangements for the administration of medication are specified on the care plan. Service users stated that they receive their mail themselves and that should they need to make or receive a phone call they can do so on cordless phone in the privacy of their own room. They also stated that they always see the doctor or nurse in private and that they are referred to as Mr or Mrs by the management and care staff. Staff receive training on induction on how to treat service users respectfully. Service users’ wishes on death and dying are specified on their care plan. Staff also receive training from a funeral director in respect of sensitivity, dignity and respect of service users and their family. North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 the following standard(s): 12,14,15. Service users are offered the opportunity to participate in stimulating and meaningful activities. Service users are supported to lead an autonomous lifestyle. The arrangements for the provision of food at mealtimes are good. EVIDENCE: There is a range of stimulating and meaningful activities on offer in the home. Service users stated that they are happy with the current level of activities and that they enjoy them. Activities include arts and craft, exercises, music session, reminiscence, trips out, singers etc. Although service users can watch television in their own rooms should they wish, the television is not ordinarily on in communal areas during the day and service users are encouraged to participate in other activities. A relative stated, “My aunt is extremely happy with all aspects of her life and care at North Corner. All staff are kind and attentive and ever helpful. Nothing is too much bother for them. She really enjoys her life here.” Feed back from discussions with service users and the examination of care plans indicates that service users can exercise control over their lives and are supported to do so. Service users or their relatives handle their financial affairs though the home does manage a small amount of money of money for the purchase of toiletries etc for most of the service users. Service users can bring their own furniture into the home and most have chosen to do so. All service North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 13 users or their representatives are involved in the writing of their care plans and this is documented. The inspector joined service users for lunch in the dining room. Food was served from a Bain Marie and was hot home made and wholesome. An alternative was available to the main course on offer and the days’ menu was on display in the hallway. The tables were laid formally with napkins and tablecloths. Hot drinks are served at set times throughout the day, there is a cold water dispenser in the hall way and there are drink making facilities for the use of visitors. Service users confirmed that additional hot drinks are available if required. Special diets are catered for and a nutritional assessment is carried out on admission. Records confirmed that a varied diet is provided. Feedback from service users relatives was positive one relative commented, “The meals always smell and look appetizing.” North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 the following standard(s): 16,17,18. The complaints policy and procedure are adequate. Service users legal rights are protected. There are no arrangements in place for raising an adult protection alert. EVIDENCE: The complaints policy and procedures were examined and found to be adequate. The complaints policy is on display on the hallway of the home and specifies the contact details for the Commission for Social Care Inspection. The policy is referred to in the homes’ Resident Guide and Statement of Purpose. Service users legal rights are protected. Service users are supported to vote, arrangements are made for them to have a postal vote or to have transport to the polling station. Following the Inspection it came to light that the home does not have a copy of the local guidance, the Brighton & Hove Multi Agency, Policy, Procedure and Guidelines for the Protection of Vulnerable Adults. It is a requirement that a copy of this guidance is obtained without delay. All staff employed by the home must be made aware of these guidelines and the procedures that they must follow should they suspect an incident of abuse has occurred. North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 the following standard(s): 19,22,25,26. The environment is safe, well maintained, comfortable, homely and clean. The home has not been adequately assessed in respect of service users health and safety. EVIDENCE: In addition to care staff the home employs, a chef, a kitchen porter, 2 domestic staff, a gardener and a maintenance person. All the areas of the home inspected were clean and hygienic and appeared to be well maintained. The gardens are well kept and there is seating outside. Arrangements for infection control are good and protective clothing is available. The home is decorated and furnished in a comfortable and homely in style. The dining room and lounge are available for the service users to use for activities and socialising. A consultant has undertaken a fire risk assessment of the home and this is satisfactory. The heating and lighting in the home meets the required standards and water is stored in such a way as to prevent the risk from Legionella and to prevent the risk of scalding to service users. North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 16 The requirement made at previous Inspections for the home to be assessed by an Occupational Therapist has not been met so a further requirement is made. The deputy manager did explain that they hope to have the home assessed in the near future. North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 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. The staff employed by the home can meet the needs of the service users who reside there. Procedures for the recruitment, induction and training of staff are good and consistently followed. EVIDENCE: The home is working hard to achieve 50 of the care staff employed at the home holding a National Vocational Qualification (NVQ) in Care Level 2 or above. The information provided by the management and on the Pre Inspection Questionnaire states that home currently employ 8 carers of whom one has achieved an NVQ Level 3, two are studying towards NVQ Level 2 and the deputy manager explained that the remaining are to be enrolled on NVQ Level 2 early in 2006. Two staff recruitment files were examined and found to be in order, all the required checks had been carried out prior to new staff being deployed. The employment procedures and induction processes have improved since the last inspection and the home now fully meets all the required standards in this area. New members of staff undergo a comprehensive induction to the homes policies and procedures and in how they expect staff to treat service users resident in the home. Specialist additional training is also provided to ensure the staff can meet service users’ needs. A relative wrote ”The staff are always friendly and welcoming. Mum is definitely well cared for.” North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 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): 33,35,37,38 This home is run in the best interest of the resident service users. Service users finances, rights and best interests are safeguarded. Service users health, safety and welfare is not adequately promoted and protected. EVIDENCE: Documentation relating to quality assurance and quality monitoring systems were examined. Feedback is sought from family and friends of service users and other stakeholders on an annual basis in the form of a questionnaire. Group discussions take place with service users re their views on the running of the home and several have taken place this year. Comment cards received by the Inspector prior to the Inspection indicated that service users and their relatives had been made aware of the Inspection and it was noted that the News Letter produced by the home also gave details of the Inspection stating the date, the Inspectors name and inviting people to contact the Inspector if they had any questions. A service users daughter commented, “The North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 19 Schoonraads have created something very special – I am delighted with the care of my mother and their constant strive to improve.” Supervision for staff is in the process of being developed. The Registered Manager explained that she works alongside all members of staff on a regular basis so she can monitor performance and keep in touch with service users needs. The Deputy Manager explained that the home has no involvement with service users finances other than to manage an allowance for small purchases such as toiletries etc. Records for these were examined and found to be accurate. Secure lockable storage is available for service users for the safe keeping of money and other valuables. All the records that were examined on the day were found to be accurate, legible, complete and stored appropriately. Service users or their representatives are involved in writing their own care plans and are aware of the records that are kept about them. Following the Inspection it came to light that the home does not have a copy of the local guidance in relation to Adult Protection and must obtain a copy without delay. The home must also be assessed in respect of security and the vulnerability and safety of the service users and window restrictors must be fitted to all windows where a risk is identified North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 1 3 X X 2 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 x 3 2 North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP18 Timescale for action 12(1a,5ab A copy of local adult protection 12/12/05 )13(6,7,8) guidance must be obtained and all staff made aware of the procedures they must follow should they suspect an incident of abuse has taken place. 16 (1,2c) The home must be assessed by 30/03/05 23(1a,2n) an Occupational Therapist as to service users’ health and safety. 16 A suitably qualified person must 20/12/05 23(1a2n)1 undertake risk assessments in 3(3,4,6) respect of security and service users’ vulnerability and safety. Window restrictors must be fitted to all windows where a risk is identified. Regulation Requirement 2. 3. OP22 OP22 OP38 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations North Corner DS0000055776.V249970.R01.S.doc Version 5.0 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI North Corner DS0000055776.V249970.R01.S.doc Version 5.0 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!