Inspection on 07/09/05 for Pax Hill Residential Home EMF Unit

This inspection was carried out on 7th September 2005.

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

The inspector 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

Pax Hill Residential Home EMF... 23/10/06

Pax Hill Residential Home EMF... 26/04/05

Pax Hill Residential Home EMF... 26/10/04

Pax Hill Residential Home EMF... 17/05/04

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

CARE HOMES FOR OLDER PEOPLE Pax Hill Residential Home EMF Unit Pax Hill Bentley Farnham, Surrey GU10 5NG Lead Inspector Val Sevier Unannounced 07/09/05 10:00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Pax Hill Residential Home EMF Unit Address Pax Hill, Bentley, Farnham, Surrey, GU10 5NG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01483 760791 Dr Nuzahat Nasreen Zaki CRH 26 Category(ies) of DE, DE(E) registration, with number of places Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the DE category can be admitted from 55 years of age. Date of last inspection 26/04/05 Brief Description of the Service: Paxhill EMF is registered to accommodate 26 service users with mental health frailty mainly dementia. The home is situated in the grounds of the larger home with the same name, in the village of Bentley. The home is situated over ground and first floor levels with a passenger lift. There are 26 bedrooms all are ensuite with either a shower or bath. There is a garden, which is secure, and views from all rooms across the countryside. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over 3 hours; the inspector was able to speak with the newly appointed manager and the proprietor about changes at the home since the last inspection. During the inspection the inspector spoke with four residents about their life at the home. The Commission for Social Care Inspection has received many positive comment cards regarding the home and the service it offers. What the service does well: What has improved since the last inspection? The new manger has met the requests for action from the last inspection since starting in August. There is an improvement in the care planning, pre admission assessments and medication systems at the home. The manager Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 6 has undertaken staff supervision and appraisals and has prioritised training for the next six months. 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. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 5. The home has an understanding of residents needs using the assessment process. There is sufficient information for prospective residents and families to make an informed choice about the home EVIDENCE: The inspector looked at 2 pre admission assessments; one individual had moved in last month the other was due soon. The assessments contain information about the needs of the individuals. There was also evidence that that other information had been used from professionals in making the assessment of need. It was observed that the information gained through the assessment had been used to complete the care plan where the individual had been admitted to the home the month prior to the inspection. A relative visited the home on the day of inspection to obtain information so that a decision could be made about a placement. The residents spoken with although able to speak for themselves had been unable to visit the home due to physical and mental frailty. Some relatives have commented in their feedback cards that they felt that the admission process had worked, that they had been given adequate information to assist with the decision making Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 9 process. Some of the relatives commented that they felt that the needs could be met. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9. The care plans seen were sufficiently comprehensive in the areas identified, with involvement of other professionals as needed. The systems for the administration of medication have improved and now ensure that resident’s medication needs are met. Staff were observed to behave appropriately with residents identifying their emotional and physical needs. EVIDENCE: The inspector viewed two care plans in conjunction with a sample of medication records and other health monitoring tools used at the home. When looking that the care plans it was seen that other professionals were also involved as necessary, with some individuals receiving continuing support from psychiatric services for example. The new manager has been working on the care plans and it was seen that there is an improvement in them since the last inspection. The care plans had clear identified needs and action to be taken by staff to assist the residents. It also had the strengths and abilities of the individuals, which staff could then help to maintain. There were risk assessments and action to reduce risk such Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 11 as moving and handling. The manager has established a key worker system and there are two members of staff assigned to six residents. The care plans had been reviewed and daily notes had been written enabling the inspector to have a picture of the daily life at the home for some. The staff spoken to expressed their knowledge and skills to care for the needs of people at the home, this is formerly evidenced in the care plans. From speaking with staff and from relative’s feedback evidence suggests that no one is afraid to ask questions about issues of concern about needs. It was seen in the care plans that physical health needs are also addressed, with references to dentures, glasses and hearing aids. The residents themselves evidenced this, where they had glasses they were clean and mouth care seemed to have been carried out. It was also seen that residents have access to opticians and dentists as needed. There was evidence on one of the care plans that a relative had been involved in the care planning with comments and advice on how to provide care to his wife. The manager that the recent audit had highlighted some concerns regarding the medication and its administration. The inspector was able to see the action taken to resolve this had worked and that all procedures were followed as regards to the storage, administration and ordering of medication. Staff were observed speaking and assisting the residents with dignity and respect and it had been seen on care plans that the preferred choice of name had been recoded and staff were heard to speak to residents by the name they wished. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were seen at the previous inspection please refer to last report. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were seen at the previous inspection please refer to last report. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 , 21, 22, 23, 24, 25 and 26. The home appears homely and clean, with personalisation encouraged. EVIDENCE: The inspector undertook a tour of the home and was able to see that many rooms had been personalised with resident’s personal belongings. In others where there were few personal possessions the home undertakes to make them as ‘homely’ as possible. All rooms have ensuite facilities with either a bath or a shower. There is a communal bath and shower for those that may want an alternative to that provided in their room. All rooms have wardrobes, dressing tables and other storage facilities. There were no odours detected in the home. The laundry room was seen and soiled and clean linen are dealt with in line with policy. It was noted that the laundry door was open with the machines in Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 15 operation and two bottles of chemicals on top. This was highlighted to the manager who took immediate action. She reassured that this was not usual and that the chemicals were usually locked away after use and the door closed when no staff were in there. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 and 30. The level of staff and training programme would seem to meet the needs of the residents. The home undertakes mainly sufficient checks within the recruitment process to ensure residents safety however some improvement is needed. EVIDENCE: The home has a clear recruitment policy that covers all the elements for the protection of residents including criminal records checks, POVA checks and references. Staff files that were read evidenced that this policy was being met on the whole with the exception of the criminal bureau check for the manager. The new manager has identified training for the staff and there is a training programme for the forthcoming year including mandatory training and areas needed to meet resident’s needs such as infection control and dementia. The manager has prioritised training based on appraisals and observation of need. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36, 37 and 38 The home regularly reviews aspects of its performance through a good programme of self-review with evidence that the views of staff and residents are listened to and acted upon. There was evidence that health and safety is attended to protecting the well being of all at the home. EVIDENCE: The manager has been at the home for a month prior to the inspection. Previously she was a deputy and a manager of other homes for older persons. She is a trained nurse but is not working in this capacity in this home. She has already held a staff meeting and intends to hold these every three months. The manager has also undertaken appraisals and supervision for staff. They will all receive supervision six times a year. Staff spoken with seem happy under the Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 18 new manager, many of them are new also and the inspector home feels that the home is more stable than on the last visit. The new manager holds the qualified first aider certificate and is qualified to train staff in moving and handling, fire and health and safety. The auditing tool that she has established is to be used monthly and quarterly in some areas. It has been useful to establish needs of the staff in regards to their caring for the residents. It has highlighted areas for improvement and where the standard is being met. The fire safety checks were seen to have been carried out and training is up to date. Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x 3 3 3 Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Pax Hill Residential Home EMF Unit H54 S39926 Pax Hill EMF V244704 070905.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton, Hants SO15 1GW 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. 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