CARE HOMES FOR OLDER PEOPLE
Nova House Belgrave Road Seaford East Sussex BN25 2EG Lead Inspector
Angela Gunning Unannounced Inspection 24th January 2006 11:00 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 Nova House DS0000021175.V263334.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. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Nova House Address Belgrave Road Seaford East Sussex BN25 2EG 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) 01323 896629 Mr David Ham Mrs Dorothy Ham Mrs Roberta Rutherford Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty (20). Service users must be older people aged sixty-five (65) years or over on admission. 26th August 2005 Date of last inspection Brief Description of the Service: Nova House is a care home registered to provide accomodation and care for (20) older people. The home is a large detached house situated in a residential area of Seaford, within a short distance of the seafront and town centre amenities. The accommodation comprises of nineteen (19) single rooms with twelve (12) of these providing en-suite facilities. The home is furnished and decorated to a high standard. The home provides a passenger lift and a stair/chair lift to enable service users to gain easy access to all communal and private areas, which are located on three floors. There is a large lounge with a separate dining room, both with views out to a large and well-maintained rear garden. There are four bathrooms, three of which have an assisted bath seat. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Nova House have requested to be referred to as ‘residents’. This unannounced inspection took place over four and a half hours on the 24th January 2006. This is the second inspection of this year and therefore this report should be read in conjunction with the report from the inspection carried out on the 26th August 2005. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. Parts of the environment were inspected, including the communal areas and some of the bedrooms. Two care plans and medication records were examined. Several people were spoken to, including four residents, the Provider, the Manager, the cook and three care staff. What the service does well:
Nova House is always kept very clean and tidy, with all communal and private rooms decorated and furnished to a high standard. There is an ongoing programme of refurbishment and when bedrooms are empty they are fitted with new carpets and redecorated. One relative considers that ‘the overall cleanliness standard of the property is extremely high’. The arrangements for leisure and social activities inside and outside the home provide good opportunity for mental and physical stimulation and promote independence and choice. A weekly programme of activities is displayed in the dining room and the activities manager carries out activities, such as reminiscent bingo, armchair exercises and sing-along sessions, two afternoons and one morning a week. There continues to be a competent and effective staff team who work positively to ensure residents have a good quality of life. One resident spoken with during the inspection said that ‘every one is so kind’ another said ‘I wont have anything said against the girls, I see them as my friends’. One relative considers that ‘the staff are extremely friendly and caring.’ Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Nova House DS0000021175.V263334.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 Nova House DS0000021175.V263334.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 The home’s Statement of Purpose, Service User Guide and contract provide prospective residents and their relatives with adequate information to enable them to make an informed choice and be aware of the facilities and services provided. There is a satisfactory pre-admission assessment procedure in place to ensure the home can meet each person’s needs. EVIDENCE: Nova House provides a Statement of Purpose and a brochure, which provides information on the accommodation and facilities provided at Nova House. Two residents who have moved in since the last inspection confirmed that they had been given a Service User Guide and a contract of terms and conditions with the home. The Manager or Deputy Manager had carried out a preadmission assessment of these two residents prior to them moving into the home. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 The home has a satisfactory care planning system to monitor the health and welfare of residents. Residents are protected by the systems in place to manage medication safely. EVIDENCE: Each resident has a care plan and an assessment checklist that is reviewed monthly. Where resident’s needs have changed prior to reviews, these needs and how staff are to care for them are appropriately documented. Staff have a thorough handover and write a daily record at the end of each shift. All residents appeared to be well cared for and residents spoken with confirmed that they are being well looked after. Nova House uses a monitored dosage system for the administration of prescribed medicines and there is a policy in place with regard to the procedures for medication administration. Staff have received training in the administration of medication, recording, storage and disposal of medicines. Medication is stored and recorded appropriately. It was noted that where a new resident has been assessed as capable or not capable of self-administering his or her own medication, the agreed strategy and risk assessment was not documented in their care plan.
Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 The arrangements for leisure and social activities inside and outside the home provide good opportunity for mental and physical stimulation and promote independence and choice. A varied and nutritious menu is provided, with dietary needs, likes and dislikes being catered for. EVIDENCE: Nova House employ an activities manager to assist the Manager and staff in providing a range of activities for service users to participate in. A weekly programme of activities is displayed in the dining room and the activities manager carries out activities, such as reminiscent bingo, armchair exercises and sing-along sessions, two afternoons and one morning a week. One resident spoken to said he ‘enjoyed a recent trip out in the mini bus to a local small farm.’ It was noted that the home encourages and support residents to retain their independence and contact with relatives and friends. Residents spoken with confirmed that Nova House continues to provide good quality homemade meals and that they are offered an alternative meal if they don’t like what is on the menu. The menu is displayed in the dining room and residents said they are asked what they want for a supper meal. One resident who went out for lunch on the day of the inspection said that he ‘was offered the lunchtime meal for super as it was one of his favourites’. One relative considers that ‘the variety and quality is extremely high’. The lunchtime meal
Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 11 is a relaxed and enjoyable time, in an aesthetically pleasing room that looks out to a well-maintained garden. Hot drinks and homemade cakes and biscuits are provided throughout the day. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 12 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, 18 The homes’ policy and procedures for dealing with concerns or complaints ensures that residents and relatives are listened to and that complaints will be acted upon. The home has been developing their arrangements for staff knowledge and understanding of Adult Protection issues to prevent residents being placed at possible risk of harm or abuse. EVIDENCE: Nova House has a complaints policy and procedure, which is displayed in the main hallway of the home and is contained within their Statement of Purpose and Service Users Guide, which is given to new residents and their relatives. These documents explain the procedures for making and dealing with a complaint. A complaint was received by the CSCI in September 2005 raising concerns in respect of the standard of care and support following incidents and this was upheld; awareness and understanding of adult protection issues and procedures and this was upheld; informing relatives about the care being provided and this was partially upheld. On the day of the inspection the Manager, Deputy Manager and a senior carer had attended training in adult abuse prevention and protection. The Manager confirmed that all other care staff have now undergone in-house training in adult abuse prevention and protection. The Provider and Manager are aware of the East Sussex, Brighton and Hove Policy and Procedures for the Protection of Vulnerable Adults and have been fully involved and supportive during an Adult Protection investigation.
Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 13 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 Nova House offers a clean, comfortable and homely environment for residents. Residents have access to all parts of the home and there are environmental adaptations to meet the needs of the residents. EVIDENCE: Nova House was seen to be clean and tidy, with all communal and private rooms decorated and furnished to a high standard. There is an ongoing programme of refurbishment and some empty rooms had been fitted with new carpets and been redecorated. One relative considers that ‘the overall cleanliness standard of the property is extremely high’. The home provides a passenger lift to access the first floor accommodation and there is a chair lift to access the bedrooms on the second floor. The emergency call alarm for the lift is now connected to the main emergency call system and can be clearly heard on all floors. There is an emergency call bell system throughout the home, which was in working order on the day of the inspection. Nova House provides an assisted bath on each of the three floors. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 There is a competent and effective staff team who work positively to ensure residents have a good quality of life. The Provider and Manager proactively encourage and support staff to enable them to acquire the skills and knowledge to ensure that residents are in safe hands at all time. EVIDENCE: There were sixteen (16) residents at the time of the inspection and the staff rota indicated that there are three care staff and the manager on duty during the morning, two during the afternoon and two carers at night. One resident spoken with during the inspection said that ‘every one is so kind’ another said ‘I wont have anything said against the girls, I see them as my friends’. One relative considers that ‘the staff are extremely friendly and caring.’ The home has been proactive in ensuring that staff receive a National Vocational Qualification (NVQ ) in Care. Four members of staff have completed an NVQ Level 2 and one is working towards this qualification. Another member of staff has achieved an NVQ Level 3. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed at this inspection. EVIDENCE: Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x 3 x X 3 4 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 17 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations Where a new resident has been assessed as capable or not capable of self-administering his or her own medication, the agreed strategy and risk assessment is to be documented in their care plan. Nova House DS0000021175.V263334.R01.S.doc Version 5.0 Page 18 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
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