Inspection on 18/01/05 for Old Hastings House

Care Home For Older PeopleOld Hastings HouseHigh Street Hastings East Sussex TN34 3ETUnannounced Inspection18th January 2005 Commission for Social Care InspectionLaunched in April 2004, the Commission for Social Care Inspection (CSCI) is the single inspectorate for social care in England. The Commission combines the work formerly done by the Social Services Inspectorate (SSI), the SSI/Audit Commission Joint Review Team and the National Care Standards Commission. The role of CSCI is to: · Promote improvement in social care · Inspect all social care - for adults and children - in the public, private and voluntary sectors · Publish annual reports to Parliament on the performance of social care and on the state of the social care market · Inspect and assess `Value for Money of council social services · Hold performance statistics on social care · Publish the `star ratings for council social services · Register and inspect services against national standards · Host the Childrens Rights Director role.Inspection Methods & FindingsSECTION B of this report summarises key findings and evidence from this inspection. The following 4-point scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase Standard met? The 4-point scale ranges from: 4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls) O or blank in the Standard met? box denotes standard not assessed on this occasion. 9 in the Standard met? box denotes standard not applicable. X is used where a percentage value or numerical value is not applicable. ESTABLISHMENT INFORMATION Name of establishment Old Hastings House Address High Street, Hastings, East Sussex, TN34 3ET Email address Name of registered provider(s)/company (if applicable) Magdalen & Lasher Charity Name of registered manager (if applicable) Natasha Jane Seymour Type of registration Care Home No. of places registered (if applicable) 45 Tel No: 01424 424027 Fax No:Category(ies) of registration, with (number of places) Old age, not falling within any other category (45) Registration number H100000806 Date first registeredDate of latest registration certificate 1st October 2004Was the home registered under the Registered Homes Act 1984? Do additional conditions of registration apply ? Date of last inspectionYES NO 08/06/04 If Yes refer to Part COld Hastings HousePage 1 Date of inspection visit Time of inspection visit Name of inspector 118th January 2005 9:30 am Jason Denny Frances Hasler [National CSCI Head of Service user involvement Inspection]ID Code123163Name of inspector Name of inspector2 3Name of inspector 4 Name of specialist (e.g. Interpreter/Signer) (if applicable) Name of establishment representative at the time of inspectionNatasha Seymour, Judith CubinsonOld Hastings HousePage 2 CONTENTSIntroduction to Report and Inspection Inspection Visits Brief Description of the Services Provided Part A: Summary of Inspection Findings Inspectors Summary Statutory Requirements/Good Practice Recommendations from last Inspection Conditions of Registration Statutory Requirements/ Good Practice Recommendations from this Inspection Inspection Methods & Findings National Minimum Standards For Older People: Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management & Administration Compliance with Conditions (if applicable) Providers Response Providers Comments Action Plan Providers AgreementPart B:Part C: Part D: D.1. D.2. D.3.Old Hastings HousePage 3 INTRODUCTION TO REPORT AND INSPECTION Every establishment that falls within the jurisdiction of the Commission for Social Care Inspection (CSCI), is subject to inspection, to establish if the establishment is meeting the National Minimum Standards relevant to that setting and the requirements of the Care Standards Act 2000. This document summarises the inspection findings of the CSCI in respect of Old Hastings House. The inspection findings relate to the National Minimum Standards (NMS) for Care Homes for Older People published by the Secretary of State under the Care Standards Act 2000. The Regulations applicable to the inspected service are secondary legislation, with which a service provider must comply. Service providers are expected to comply fully with the National Minimum Standards. The National Minimum Standards will form the basis for judgements by the CSCI regarding registration, the imposition and variation of registration conditions and any enforcement action. The report follows the format of the NMS and the numbering shown in the report corresponds to that of the Standards. The report will show the following: · Inspection methods used · Key findings and evidence · Overall ratings in relation to the standards · Compliance with the Regulations · Required actions on the part of the provider · Recommended good practice · Summary of the findings · Providers response and proposed action plan to address findings This report is a public document. INSPECTION VISITS Inspections are undertaken in line with the agreed regulatory framework with additional visits as required. This is in accordance with the provisions of the Care Standards Act 2000. The report is based on the findings of the specified inspection dates.Old Hastings HousePage 4 BRIEF DESCRIPTION OF THE SERVICES PROVIDED. Old Hastings House is a detached building on four floors, in which the main part of the building is listed. It is situated in the old town area of Hastings, close to the High Street and town centre, which is accessed by many of the service users. There is public transport routes near and also a main line railway station. The Décor and furnishings are maintained to a good standard with an ongoing decorating plan to further enhance and update the home. The home has a number of Georgian period features. Service user accommodation comprises of 45 single bedrooms. There are a range of communal areas, which comprise of three dining rooms two on the ground floor, and on the first floor, a lounge and conservatory on the ground floor. There are further seating areas at the top of the stairs on the first floor and also a further lounge on this floor. There are tea corners on the first, second and third floors, which are well used by service users. The home continues to expand activity provision. Service users have the option of a weekly minibus excursion along with a range of indoor activities such as coffee mornings, luncheon clubs, quizzes, bible studies, hand massage and manicure, and wine evenings. The home has a number of strong links with the local community. Some bedrooms can only be accessed by those with good mobility. The home has a number of Ramps around its external grounds and entrances to facilitate disabled access. The home has two lifts, one of which is a passenger lift.Old Hastings HousePage 5 PART A SUMMARY OF INSPECTION FINDINGSINSPECTORS SUMMARY (This is an overview of the inspectors findings, which includes good practice, quality issues, areas to be addressed or developed and any other concerns.) This was an Unannounced Inspection, which covered 19 all of the 38 standards available, and found that with one exception, all were fully met with 6 standards exceeded. Those standards exceeded included Care-planning, activities, service user choice, meal arrangements, quality assurance and the openness and supportiveness of the homes management. This report should be read in conjunction with the Announced inspection report of June 8, 2004, which inspected all standards. 19 of those standards met last time, including the environment, were not been inspected on this occasion. The home had one unmet requirement and recommendation from this inspection and no new requirements or recommendations. The requirement and recommendation related to the Homes Recruitment, policy, and procedure in light of the new P.O.V. A - guidance effective from July 27, 2004, and the need for a comprehensive application form which accounts for gaps in employment history. The home was found to have made a further range of Improvements in relation to activity provision, care-plans, quality assurance, staff inductions, staff training, service user guide, contracts, and general administration. The inspection focused on service user involvement in the home and found that the related standards had been exceeded resulting in highly positive outcomes for service users as evidenced during the inspection. Frances Hasler, the Commissions National Head of Service user Involvement Inspection, accompanied the Inspector during his visit. The Inspectors were able to talk to a high number of service users and staff, as well as examining records, all of which indicated the wide range of routes open to service users to be involved in the running of the home and have their preferred needs met. The home was found to have an excellent meetings culture at all levels, with service users fully consulted and participative in the services they receive. Since the last inspection a house committee has been formed made up of service users and representatives of other people involved in the home such as the managing committee. The Inspector would like to thank all those who participated in the Inspection. Choice of Home (Standards 1-6) Old Hastings House Page 6 Of the 5 standards assessed all 5 were met. The homes contract of residence is comprehensive and the service user has to sign that they have read and agreed with the terms of the agreement. The Service user guide and statement of purpose are combined and put on display in the home along with the inspection report. These documents were found to be comprehensive and include service user views. Health and Personal Care (Standards 7-11) Of the 1 standards assessed this was exceeded. Care plans were found to now exceed the standard in terms of their scope, presentation, detail, service user involvement, and frequency of review. Daily Life and Social Activities (Standards 12-15) Of the 4 standards assessed all 4 were met with 3 exceeded. There is a full programme of activities made available to service users, which are discussed at the resident meetings. Activities along with meals and service user choice were found to have exceeded the standard. Service users spoken too confirmed how their expectations and preferences are met along with their high level of involvement in the home. Complaints and Protection (Standards 16-18) Of the 2 standards assessed all 2 were met. The home has a complaints procedure policy in place, and this is explained to the service users on arrival at the home. The home has received 1 unsubstantiated complaint over the last year, which was dealt with correctly and comprehensively. Service users were found to be active in the electoral and civic process. Environment (Standards 19-26) None of these standards were assessed and all were found to meet the standard at the last inspection. Those cubicles remaining to be installed in 3 bedrooms will be done when these rooms are vacated in accordance with the homes agreed policy. Staffing (Standards 27-30) Of the 1 standard assessed 0 were met. Staff, should not commence employment in the home until a P.OV.A First has been obtained, whilst it waits for an enhanced CRB to come back. The home was also advised to update its recruitment policy to reflect recent amendments to the Care Standards Act effective from July 27th 2004. The home were given one month to make these adjustments and also ensure that the umbrella organisation organising P.O.V.A First and CRB checks, were giving the home all necessary information. The application form can improve further to allow the applicant to account for any gaps in their employment history over the last 10 years. Management and Administration (Standards 31-38) Of the 6 standards assessed all were met, with 2 exceeded. The inclusive management of the home, and the quality assurance strategies and practice were found to exceed the standard.The management team demonstrated a commitment to an open, supportive and inclusive atmosphere. Old Hastings House Page 7 The home has regular meetings across all levels with agenda items published in advance. Service users spoke well of their monthly meetings, which the manager attends. Service users and their representatives complete wide-ranging questionnaires on a sixmonthly basis. The inspectors saw completed service user questionnaires and the resulting statistics compiled by the homes management based on service users responses. Action plans were found to follow these surveys with improvements implemented. The home has developed a new induction pack that ensures inductions for all staff and training plans comply with National Training Organisational Targets and TOPSS. The inspector saw a completed example, which met the standard.Requirements from last Inspection visit fully actioned? If No please list belowNOSTATUTORY REQUIREMENTS Identified below are areas not addressed from the last inspection report which indicate a non-compliance with the Care Standards Act 2000 and accompanying Regulations. The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Regulation Standard Required actions Timescale for actionAction is being taken by the Commission for Social Care Inspection to ensure compliance in regard to the above requirements. RECOMMENDATIONS Identified below are recommendations from the last inspection that have not been implemented No. Refer to Good Practice Recommendations StandardOld Hastings HousePage 8 CONDITIONS OF REGISTRATION THAT APPLY (OTHER THAN NUMBERS AND CATEGORY OF SERVICE USERS).Met (Yes / No)Old Hastings HousePage 9 STATUTORY REQUIREMENTS IDENTIFIED DURING THE INSPECTION Action Plan: The Registered Person is requested to provide the Commission with an Action Plan, which indicates how requirements are to be addressed with the time scale within which such actions will be taken. This action plan will be made available on request to the Area Office.STATUTORY REQUIREMENTS Identified below are areas addressed in the main body of the report, which indicate noncompliance with the Care Standards Act 2000, and accompanying Regulations 2001 and the National Minimum Standards. The Registered Provider(s) is/are required to comply within the given time scales. The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Regulation Standard * Requirement Timescale for action That the registered person ensures that the home operates a thorough recruitment procedure and that all staff are employed on the basis that the home has obtained all necessary documentation. [Requirement from the last inspection] OP29 Timescale Extension19 CSA schedule 2 1 Amendme nts to Care Homes Regulation s 2001 Reg 18That the home has an appropriate recruitment policy in place, which includes mention of 19.02.2005 staff not commencing employment employed until, a P.O.V.A first has been obtained. That this policy includes mention of new POVA rules following amendments to the Care homes regulations effective from July 27 2004.RECOMMENDATIONS Identified below are areas addressed in the main body of the report, which relate to National Minimum Standards and are seen as good practice issues which should be considered for implementation by the registered Provider(s). The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Refer to Good Practice Recommendations Standard * 1 OP29 That the application form allows the applicant to account for any gaps in their employment history over the last 10 years or since leaving school.Old Hastings HousePage 10 * Note: You may refer to the relevant standard in the remainder of the report by omitting the 2-letter prefix e.g. OP10 refers to Standard 10.Old Hastings HousePage 11 PART BINSPECTION METHODS & FINDINGSThe following inspection methods have been used in the production of this report Direct observation Indirect observation Sampling · Pre-inspection questionnaire · Records · Care plans / Care pathways · Meals · Activities · Other (Specify) `Tracking care and support Group discussion with service users Individual discussion with service users Group discussion with staff Individual discussion with staff Discussion with management Service user survey Relatives/significant others survey/feedback Visiting professionals survey / feedback Tour of premises Formal interviews Document reading Additional inspection information: Number of service users spoken to at time of inspection Number of relatives/significant others the inspectors had contact with Number of letters received in respect of the service CRB check for the responsible individual seen CRB check for the manager seen Certificate of registration was displayed at the time of the inspection Certificate of registration accurately reflected the situation in the service at the time of inspection Total number of care staff employed (excluding managers) Total number of staff with nursing qualifications employed Date of inspection Time of inspection Duration of inspection (hrs) YES YES NO YES YES YES NO NO YES YES YES YES YES YES NO NO NO NO NO YES 17 0 0 YES YES YES YES X X 18/01/05 09.30 5Old Hastings HousePage 12 The following pages summarise the key findings and evidence from this inspection, together with the CSCI assessment of the extent to which the National Minimum Standards for Care homes for older people have been met. The following scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase Standard met? The scale ranges from: 4 - Standard Exceeded 3 - Standard Met 2 - Standard Almost Met 1 - Standard Not Met (Commendable) (No shortfalls) (Minor shortfalls) (Major shortfalls)0 or blank in the Standard met? box denotes standard not assessed on this occasion. 9 in the Standard met? box denotes standard not applicable. X is used where a percentage value or numerical value is not applicable.Old Hastings HousePage 13 Choice of HomeThe intended outcomes for the following set of standards are: · · · · · · 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.Standard 1 (1.1 ­ 1.3) The registered person produces and makes available to service users an up to date statement of purpose setting out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home; and provides a service users guide to the home for current and prospective residents. The statement of purpose clearly sets out the physical environmental standards met by a home in relation to standards 20.1, 20.4, 21.3, 21.4, 22.2, 22.5, 23.3 and 23.10: a summary of this information appears in the homes service users guide. Range of fees charged From (£) 282 To (£) 315Any charges for extras If yes, please state what the extras are: Key findings/EvidenceYES HAIRDRESSING/CHIROPDY/ PERSONAL ITEMS 3 Standard met?The Service user guide, Statement of purpose, and service user home handbook, are combined into one guide and put on display in various parts of the home along with the inspection report. These documents were found to be comprehensive including a copy of the contract and a periodical report on service user views. The home sends all relevant documents including the guide, to prospective new service users and their representatives. This information is also discussed with new service users and is reviewed via resident/service user meetings. Those service users with a visual impairment have this information read to them. The home were found to also be exploring talking tape options.Old Hastings HousePage 14 Standard 2 (2.1 ­ 2.2) Each service user is provided with a statement of terms and conditions at the point of moving into the home (or contract if purchasing their care privately). 3 Key findings/Evidence Standard met? The homes contract of residence is comprehensive and the service user has to sign that they have read and agreed with the terms of the agreement. The contract includes the fee charged and who is liable for the charge. The inspector examined contracts of the newest service users and found them to be comprehensive, informative, and user friendly.Standard 3 (3.1 ­ 3.5) New service users are admitted only on the basis of a full assessment undertaken by people trained to do so, and to which the prospective service user, his/her representatives (if any) and relevant professionals have been party. 3 Key findings/Evidence Standard met? Admittance to the home occurs only after the manager and a senior member of staff have carried out a full assessment. They visit the prospective service user at home or in hospital. The home have since the last inspection further improved their assessment pro forma to fully cover all areas listed in the standard. Those pre- assessments inspected were found to meet the standard. Standard 4 (4.1 - 4.4) The registered person is able to demonstrate the homes capacity to meet the assessed needs (including specialist needs) of individuals admitted to the home. 3 Key findings/Evidence Standard met? A range of evidence, including Care-plans, discussions with management, staff, and service users, and the inspectors observations, showed that the home was meeting all needs. The home were again found to be pro-active in supporting service users to move onto alternative care, such as nursing, when the home assessed that they could no longer meet needs.Old Hastings HousePage 15 Standard 5 (5.1 ­ 5.3) The registered person ensures that prospective service users are invited to visit the home and to move in on a trial basis, before they and / or their representatives make a decision to stay; unplanned admissions are avoided where possible. 3 Key findings/Evidence Standard met? All prospective service users are invited to visit the home prior to admittance. They are invited to lunch, coffee mornings, and if a room is vacant they can have respite care. Old Hastings House is well established in the town and most of the residents are local people, therefore prospective service users are usually local. The home has strong links with all the local churches and recommendations often come via their parishioners. A number of service users spoken too confirmed that they had entered themselves on a waiting list before moving in and had visited the home on number of occasions. Standard 6 (6.1 - 6.5) Where service users are admitted only for intermediate care, dedicated accommodation is provided together with specialised facilities, equipment and staff, to deliver short term intensive rehabilitation and enable service users to return home. 9 Key findings/Evidence Standard met? Not Applicable.Old Hastings HousePage 16 Health and Personal CareThe intended outcomes for the following set of standards are: · · · · · The service users health, personal and social care needs are set out in an individual plan of care. Service users make decisions about their lives with assistance as needed. Service users, where appropriate, are responsible for their own medication, and are protected by the homes 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.Standard 7 (7.1 ­ 7.6) A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. 4 Key findings/Evidence Standard met? Care plans were found to now exceed the standard in terms of their scope, detail, service user involvement and frequency of review. The home was found to have worked hard on these plans over recent inspections. The plans covers all necessary information areas for each individual service user as evidenced in the 3 plans inspected. The plans also show how needs will be met in practice. All care plans are rewritten after the first month after the admittance of a new service user and thereafter every six months with full involvement from the service user and other relevant parties as evidenced in signatures and comments. The plans are also reviewed monthly and are well presented. Service users spoken too confirmed their involvement in the care-plans. Staff interviewed confirmed the importance and utility of the care-plans and their importance as reference guides. The home demonstrated a good knowledge of the needs of service users as evidenced in discussions with management, staff, and service users. All staff especially key workers and senior key workers are encouraged to be actively involved in the care- plans.Old Hastings HousePage 17 Standard 8 (8.1 ­ 8.13) The registered person promotes and maintains service users health and ensures access to health care services to meet assessed needs. No. of incidents where service users have been taken to Accident and Emergency during last 12 months No. of service users with pressure sores at time of inspection (from information taken from care notes) Key findings/Evidence Not Inspected on this occasion. X X Standard met? 0Standard 9 (9.1 ­ 9.11) The registered person ensures that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. 0 Key findings/Evidence Standard Met? Not Inspected on this occasion.Standard 10 (10.1 ­ 10.7) The arrangements for health and personal care ensure that service users privacy and dignity are respected at all times, and with particular regard to: personal care giving, including nursing, bathing, washing, using the toilet or commode, consultation with, and examination by, health and social care professionals, consultation with legal and financial advisors, maintaining social contacts with relatives and friends, entering bedrooms, toilets and bathrooms, and following death. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 18 Standard 11 (11.1 ­ 11.12). Care and comfort are given to service users who are dying, their death is handled with dignity and propriety, and their spiritual needs, rites and functions observed. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 19 Daily Life and Social ActivitiesThe intended outcomes for the following set of standards are: · · · · 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.Standard 12 (12.1 ­ 12.4) The routines of daily living and activities made available are flexible and varied to suit service users expectations, preferences and capacities. 4 Key findings/Evidence Standard met? There is a full programme of activities made available to service users, which are discussed on admission and at the resident meetings. Activities were again judged to have exceeded the standard given the further development over the last year. Service users spoken too confirmed how their expectations and preferences are met. On the day of the last inspection the local news was relayed on a tape, there were bible studies for some, and manicure and hand massage in on of the lounges. A number of service users were either gardening or out on community walks. Activities also include quizzes, cheese and wine evenings, library trips and mini-bus excursions. The inspector was shown on this inspection further improvements including the introduction of luncheon clubs, toenail cutting and massage service in a dedicated new suite. The inspector was informed by service users of the significant range of Christmas events recently enjoyed. During the inspection a number of service user made themselves available for a resident forum with the inspector and a representative from the commissions head office. Service users spoken to confirmed that activities continue to increase and meet their needs with themselves through regular meetings contributing to their development. The home displays full schedules, which include regular monthly and fortnightly events along with weekly timetables, on a number of notice boards in the home. Service users have a choice between a number of different Church denominational services. Which take place in the home.Old Hastings HousePage 20 Standard 13 (13.1 ­ 13.6) Service users are able to have visitors at any reasonable time and links with the local community are developed and/or maintained in accordance with service users preferences. 3 Key findings/Evidence Standard met? Most service users are local to Hastings and the St Leonards area and therefore still have community links family and friends; this also includes visits from the local churches and their priests and parishioners. Many service users are mobile and go out shopping, visit friends and family, and attend church services. A range of evidence indicated the lengths to which the home goes to in meeting the needs, or, occasional concerns from visitors.Standard 14 (14.1 ­ 14.5) The registered person conducts the home so as to maximise service users capacity to exercise personal autonomy and choice. 4 Key findings/Evidence Standard met? It was evident at this inspection that the manager ensures that the service users have autonomy and choice to a point that exceeds the minimal standard. The Commissions head of service user involvement inspection, that accompanied the Inspector, confirmed this view based on the evidence of such a wide range of routes by which service users can express their views on the home. The home has since the last inspection formed a House committee, which includes 2 service users. The care plans, menus, talking to service users and staff and the detailed minutes of the monthly resident meetings, indicated how this standard had been exceeded. Service users have recently had their wish of obtaining a cheaper way of receiving chiropody treatment met, by securing an agreement to use Age Concern services. The home has supported this by creating a dedicated clinic suite, which can also facilitate massage Service users confirmed that they involved in choosing their 2 key-workers.Old Hastings HousePage 21 Standard 15 (15.1 ­ 15.9) The registered person ensures that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements, and that meals are taken in a congenial setting and at flexible times. 4 Key findings/Evidence Standard met? The inspector took a meal in the home from a choice of 2 dishes. The meal was well cooked and presented and contained a variety of fresh products. Choice for service users is not just extended to between 2 dishes, but also to how ingredients are cooked. There was a range of deserts. There is also a range of choice at teatime. The vegetarian menu was imaginative and comprehensive. Meals are served in three spacious congenial dining rooms, which benefit from nice views. The provision of three dining rooms provides those service users who require more support with dignity and allows more able service users opportunities to socialise and chat together. The timing of the meal is flexible with food served over an allotted time slot. From the features mentioned it was the Inspectors opinion that the home had again exceeded the minimum standard in respect of meal arrangements. The menu is on a 6-week rolling basis with a distinctive summer and Winter menu. Service users interviewed were unanimous in their satisfaction with meal arrangements with particular mention on both the quality and quantity of food served.Old Hastings HousePage 22 Complaints and ProtectionThe intended outcomes for the following set of standards are: · · · 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.Standard 16 (16.1 ­ 16.4) The registered person ensures that there is a simple, clear and accessible complaints procedure which includes the stages and time-scales for the process, and that complaints are dealt with promptly and effectively. No. of complaints made to the home during last 12 months No. of these complaints fully substantiated No. of these complaints partly substantiated No. of these complaints not substantiated No. of these complaints not yet resolved No. of complaints sent direct to CSCI Percentage of complaints responded to within 28 days Key findings/Evidence 1 0 0 1 0 0 100 3Standard met?The home has a complaints procedure policy in place, and this is explained to the service users on arrival in the home. The home has had 1 complaint made to it over the last 12 months, which after a detailed investigation was found to be unsubstantiated and had no bearing on the welfare of service users. The complaint was in 2 parts, with the first part withdrawn by the complainant. The inspector was satisfied with the careful and correct way that the home has dealt with the complaint. The home had also developed a plan on how a future similar situation could be diffused and dealt with informally. There was no evidence to support the complainants claim, the evidence that did exist, supported the homes practice. The Inspector did discuss with service users interviewed if they were aware of the complaints procedure in the home and would they know how to use it. They all confirmed they understood the procedure and would always feel comfortable talking to the manager and staff.Old Hastings HousePage 23 Standard 17 (17.1 ­ 17.3) Service users have their legal rights protected, are enabled to exercise their legal rights directly and participate in the civic process if they wish. 3 Key findings/Evidence Standard met? Most of the service users have postal votes at election times. The home encourages service users to have access to advocates from the community, Age Concern and their own families. Service users also supported to attend polling stations if they so wish.Standard 18 (18.1 ­ 18.6) The registered person ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies. The home has an Adult Protection procedure (including Whistle Blowing) which complies with the Public Disclosure Act 1998 and the Department of Health Guidance No Secrets No. of staff referred for inclusion on POVA lists Key findings/Evidence Not Inspected on this occasion. Standard met? YES X 0Old Hastings HousePage 24 EnvironmentThe intended outcomes for the following set of standards are: · · · · · · · · 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.Standard 19 (19.1 ­ 19.6) The location and layout of the home is suitable for its stated purpose; it is accessible, safe and well maintained; meets service users individual and collective needs in a comfortable and homely way and has been designed with reference to relevant guidance. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Standard 20. (20.1 ­ 20.7) In all newly built homes and first time registrations the home provides sitting, recreational and dining space (referred to collectively as communal space) apart from service users private accommodation and excluding corridors and entrance hall amounting to at least 4.1 sq. metres for each service user. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Standard 21 (21.1 ­ 21.8) Toilet, washing and bathing facilities are provided to meet the needs of service users. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 25 Standard 22 (22.1 ­ 22.8) The registered person demonstrates that an assessment of the premises and facilities has been made by suitably qualified persons, including a qualified occupational therapist, with specialist knowledge of the client groups catered for, and provides evidence that the recommended disability equipment has been secured or provided and environmental adaptations made to meet the needs of service users. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 26 Standard 23 (23.1 ­ 23.11) The home provides accommodation for each service user which meets minimum space as prescribed Total number of single bedrooms with at least 10 sq.m usable space or additional compensatory space Pre-existing homes only (1 April 2003) - single bedrooms below 10 sq.m usable space or additional compensatory space Total number of wheelchair users accommodated for in rooms at least 12sq.m Total number of wheelchair users accommodated for in rooms at less than 12sq.m Total number of shared rooms at least 16 sq.m Total number shared rooms less than 16 sq.m Percentage of places within single rooms: 100 80 - 99 Less than 80 Total number of single bedrooms Total number of single rooms with en suite Total number of double rooms Total number of double rooms with en suite Key findings/Evidence Not Inspected on this occasion. YES NO NO 45 45 0 0 Standard met? 0 0 451 0 0 0Old Hastings HousePage 27 Standard 24 (24.1 ­ 24.8) The home provides private accommodation for each service user which is furnished and equipped to assure comfort and privacy, and meets the assessed needs of the service user. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Standard 25 (25.1 ­ 25 8) The heating, lighting, water supply and ventilation of service users accommodation meet the relevant environmental health and safety requirements and the needs of individual service users. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Standard 26 (26.1 ­ 26.9) The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 28 StaffingThe intended outcomes for the following set of standards are: · · · · 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 homes recruitment policy and practices. Staff are trained and competent to do their jobs.Standard 27 (27.1 ­ 27.7) Staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed need of the service users, the size, the layout and purpose of the home, at all times. Number of staff /hours in respect of service user needs based on guidance recommended by Department of Health. Personal Nursing Care No. service users High No. staff hours X X X needs allocated No. service users Medium needs No. service users Low needs No. of staff hours required No. of full time equivalent first level registered nurses No. of care staff No. of ancillary staff Key findings/Evidence Not Inspected on this occasion. X X X No. staff hours allocated No. staff hours allocated No. of staff hours provided X X X X X XX X X Standard met? 0Old Hastings HousePage 29 Standard 28 (28.1 ­ 28.3) A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 2005, excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of the care staff who are registered nurses. No. care staff (excluding registered nurses) with NVQ level 2 or equivalent of care staff with NVQ level 2 Key findings/Evidence Not Inspected on this occasion. X X Standard met? 0Standard 29 (29.1 ­ 29.6) The registered person operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. 2 Key findings/Evidence Standard met? The inspector sampled records of the most recently appointed staff. Most records were in place along with Police CRB checks. However staff, should not commence employment in the home until a P.OV.A First has been obtained, whilst it waits for an enhanced CRB to come back. The home was also advised to update its recruitment policy to reflect recent amendments to the Care Standards Act effective from July 27th 2004. The home were given one month to make these adjustments and also ensure that the umbrella organisation organising P.O.V.A First and CRB checks were giving the home all necessary information. The home now ensures that written references are received before staff commences employment and carries out all other checks. Staff are also closely supervised during their first few weeks before a police CRB check is obtained. The application form can improve further to allow the applicant to account for any gaps in their employment history over the last 10 years or since leaving school. Standard 30 (30.1 ­ 30.4) The registered person ensures that there is a staff training and development programme which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 30 Management and AdministrationThe intended outcomes for the following set of standards are: · · · · · · · · 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 homes record keeping policies and procedures. The health, safety and welfare of service users and staff are promoted and protected.Standard 31 (31.1 ­ 31.8) The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. 3 Key findings/Evidence Standard met? The manager has experience as a senior member of staff and deputy manager in the home over the course of 7 years. The Manager has completed her NVQ level 4 in the Management of Care and the Registered managers Award, which represents the full qualification required. The manager also gained experience from her previous employment in a nursing home. The manager successfully gained registration status in August of 2004 and has now managed the home for over a year. Service users and staff praised the Manager without exception, for her motivation and further development of the service as evidenced in her work on activity provision, quality assurance, and service user involvement initiatives. Two of the homes team leaders are currently studying NVQ 4s and have a range of senior management experience, and along with one other person will manage the home when the manager goes on maternity leave. The management of the home was found to be continuously proactive. It was evident from the minutes of regular team meetings that practice issues are promptly addressed by the Manager.Old Hastings HousePage 31 Standard 32 (32.1 ­ 32.7) The registered manager ensures that the management approach of the home creates an open, positive and inclusive atmosphere. 4 Key findings/Evidence Standard met? It was clear from the inspection process and by direct observation that the home is competently run by both an experienced and competent manager but also by a management team committed to an open, supportive and inclusive atmosphere. The staff team were positively focused on their role. The home has regular meetings across all levels with agenda items published in advance. Service users spoke well of their monthly meetings, which the manager attends. As previously reported there was evidence of high levels of service user involvement in the home. The manager and the inspector discussed ways in which some service users could be offered opportunities to sit on staff recruitment/ interview panels.Standard 33 (33.1 ­ 33.10) Effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and the statement of purpose of the home. 4 Key findings/Evidence Standard met? There is a range of strategies in place within the home to measure the quality of service provision. The manager continues to work towards developing effective quality monitoring systems that are user friendly such as the recent introduction of house committees which involve a range of people including service users. Service users and their representatives complete wide-ranging questionnaires on a sixmonthly basis. The inspectors saw completed service user questionnaires and the resulting statistics compiled by the homes management based on service users responses. Action plans were found to follow these surveys with improvements implemented. A copy of this report was also found in the homes guide. The inspector formed the opinion that this standard had been exceeded as evidenced in the range of the homes quality assurance system and how this information was being acted upon. The extent of service user satisfaction was also evident along with the extent to which the home was meeting its stated aims.Old Hastings HousePage 32 Standard 34 (34.1 ­ 34.5) Suitable accounting and financial procedures are adopted to demonstrate current financial viability and to ensure there is effective and efficient management of the business. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Standard 35 (35.1 ­ 35.6) The registered manager ensures that service users control their own money except where they state that they do not wish to or they lack capacity and that safeguards are in place to protect the interests of the service user. Number of service users subject to Power of Attorney processes Number of service users subject to Enduring Power of Attorney processes Number of service users subject to Guardianship Orders Key findings/Evidence This standard was found to be wholly met. Thirteen service users handle their own financial affairs. The home has sensibly avoided being an appointee for any service users. Service users use their own external advocates, which in many cases includes their families. The home does not have information regarding the number of service users subject to powers of attorney. The service user, their representative, or their family solicitor holds this information. The home does not look after anyones savings apart from some personal allowances. The inspector sampled two records at the last inspection in relation to service users monies held by the home and found that the running balance and records were in good order. The home has supported some service users to open up individual accounts for those receiving direct payments. Social services legal team is currently supporting two service users to access their financial estate. Standard met? 3 X X 18Old Hastings HousePage 33 Standard 36 (36.1 ­ 36.5) The registered person ensures that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice. 3 Key findings/Evidence Standard met? The home has developed a new induction pack that ensures inductions for all staff and training plans comply with National Training Organisational Targets and TOPSS. The inspector saw a completed example, which met the standard. Most staff then go on to the NVQ level 2 if they have not already achieved this. Where staff have to wait for more than 6 months for this course or decline the opportunity, then the home are advised to ensure that they complete all the necessary foundational training elements within 6 months of joining the home. Staff interviewed confirmed that they had good inductions. The home has a rolling programme of training including Moving and Handling, Dementia, first aid, health and safety and food hygiene. All staff are employed with an appropriate contract as evidenced in records. Over 50 of staff already have at least NVQ 2 or above with a high number still on such courses. The inspector found that staff were receiving supervisions at least every two months with all staff scheduled to have supervision at least 6 times a year. Staff interviewed said that they found supervision useful.Standard 37 (37.1 ­ 37.3) Records required by regulation for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate. 0 Key findings/Evidence Standard met? Not Inspected on this occasion.Old Hastings HousePage 34 Standard 38 (38.1 ­ 38.9) The registered manager ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. 3 Key findings/Evidence Standard met? The home now ensures that all notifiable incidences are reported to the Commission without undue delay. The home has implemented all the recommendations from the last environmental health inspection in April 2004. It was evident that overall, appropriate steps are taken to ensure a safe working and living environment for service users and staff. Relevant training supported by written policies complement the arrangements. There is regular testing of Gas and Electrical systems and other equipment including Fire, and records maintained. Risk assessments of the building are undertaken annually. Testing for Legionella is continuously carried out. All service users have mobility and moving and Handling risk assessments. Staff recently undertook both Fire and Moving and Handling training. Most staff have current First aid and Food Hygiene certification. The home closely monitor service user falls and take any necessary action.Old Hastings HousePage 35 PART C(where applicable)COMPLIANCE WITH CONDITIONSCondition CommentsComplianceCondition CommentsComplianceCondition CommentsComplianceCondition CommentsComplianceLead Inspector Second Inspector Regulation Manager DateJason Denny Phil Hale 26/01/05Signature Signature SignaturePublic reports It should be noted that all CSCI inspection reports are public documents.Old Hastings HousePage 36 PART DD.1PROVIDERS RESPONSE TO IDENTIFIED STATUTORY REQUIREMENTSRegistered Persons comments/confirmation relating to the content and accuracy of the report for the above inspection.We would welcome comments on the content of this report relating to the Inspection conducted on 18th January 2005 and any factual inaccuracies: Please limit your comments to one side of A4 if possibleOld Hastings HousePage 37 Action taken by the CSCI in response to provider comments: Amendments to the report were necessary NOComments were received from the provider Provider comments/factual amendments were incorporated into the final inspection report Provider comments are available on file at the Area Office but have not been incorporated into the final inspection report. The inspector believes the report to be factually accurateNONONONote: In instances where there is a major difference of view between the Inspector and the Registered Provider both views will be made available on request to the Area Office. Please provide the Commission with a written Action Plan, which indicates how requirements are to be addressed and stating a clear timescale for completion. This will be kept on file and made available on request. You will also note that the Commission has identified in the inspection report good practice recommendations and it would be useful to have some indication as to whether you intend to take any action to progress these. Status of the Providers Action Plan at time of publication of the final inspection report: Action plan was required YES D.2Action plan was received at the point of publicationNOAction plan covers all the statutory requirements in a timely fashion Action plan did not cover all the statutory requirements and required further discussion Provider has declined to provide an action planNONOYESOther: enter details here NOOld Hastings HousePage 38 D.3PROVIDERS AGREEMENT Registered Persons statement of agreement/comments: Please complete the relevant section that applies.D.3.1 I of confirm that the contents of this report are a fair and accurate representation of the facts relating to the inspection conducted on the above date(s) and that I agree with the requirements made and will seek to comply with these. Print Name Signature Designation Date Or D.3.2 I of am unable to confirm that the contents of this report are a fair and accurate representation of the facts relating to the inspection conducted on the above date(s) for the following reasons:Print Name Signature Designation Date Note: In instance where there is a profound difference of view between the Inspector and the Registered Provider both views will be reported. Please attach any extra pages, as applicable.Old Hastings HousePage 39 Old Hastings House / 18th January 2005Commission for Social Care Inspection 33 Greycoat Street London SW1P 2QF Telephone: 020 7979 2000 Fax: 020 7979 2111 National Enquiry Line: 0845 015 0120 www.csci.org.ukS0000021179.V193341.R01© This report may only be used in its entirety. 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