Inspection on 02/08/06 for Peel House Nursing and Residential Home

This inspection was carried out on 2nd August 2006.

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

Peel House Nursing and... 23/11/07

Peel House Nursing and... 24/11/05

Peel House Nursing and... 04/07/05

Peel House Nursing and... 07/01/05

Peel House Nursing and... 03/08/04

Peel House Nursing and... 17/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Peel House Nursing and Residential Home Woodcote Lane Fareham Hampshire PO14 1AY Lead Inspector Anita Tengnah Unannounced Inspection 2nd August 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 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. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Peel House Nursing and Residential Home Address Woodcote Lane Fareham Hampshire PO14 1AY 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) 01329 667724 Mr Zamir Afghan Mrs Parigul Afghan Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46), Physical disability (9), Physical disability of places over 65 years of age (46), Terminally ill (9), Terminally ill over 65 years of age (46) Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be at least 50 years of age. Date of last inspection 24th November 2005 Brief Description of the Service: Peel House is a care home with nursing for service users over the age of 50 years. The Home is also registered to take service users who are terminally ill or have physical disability. The home can take up to 46 service users. The home is located in the rural outskirts of Fareham. There are some local shops and other amenities within easy reach. The home is a converted domestic type house with over two-storey building that has been extended to provide more communal accommodation on the ground floor. The home has a mixture of single rooms and double bedrooms some with ensuite facilities. There is a passenger lift that provides level access to the home. Peel House has a large mature and well- maintained garden, which is accessible to the service users. There is ample parking at the front of the house. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A fieldwork visit was undertaken on the 2nd of August 2006. The process included a tour of the service when a number of the bedrooms, communal areas, kitchen, and bathrooms were viewed. Staff practices were observed; service users and staff records were examined. As part of the case tracking a number of the service users and staff views were sought. Information gained from the pre inspection questionnaire will form part of the report. The current fees charged ranged between £435-£585. There were 35 service users accommodated at the time of the visit. The inspector had the opportunity to observe lunchtime meal being served. This was well managed and there were good interaction and service users were supported with their meals as required. The home does not have a registered manager at the time of the visit and the provider has started the process of recruiting a manager. The deputy manager has taken the management responsibility for the service and is supported by the provider. What the service does well: What has improved since the last inspection? Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 6 A programme of refurbishment is in place and a number of rooms have been refurbished. The sluice door marked as a fire door was not closing properly. This was rectified at the time of the visit. 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. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 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 Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 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): 3,6 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The pre admission process ensures that the home can meet the service users’ needs. EVIDENCE: A sample of a newly admitted service users’ records was seen as part of case tracking. There was detailed assessment record in place and care manager’s assessment was also available. Staff reported that these assessments are used as part of the care planning. Service users are offered the choice to visit the home prior to admission. Information pertaining to the statement of purpose and the service users’ guide are made available on admission. Staff confirmed that the service does not provide intermediate care. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 9 Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to the service. The care plans are detailed and provide adequate information to the staff. The review of care plans to reflect current needs of the service users will ensure that care needs are fully met. The health care needs of the service users are well managed. The medication management relating to topical creams should be reviewed as this can be to the detriment of the service users. The service users are treated with respect and their dignity maintained. EVIDENCE: As part of case tracking a sample of 4 service users’ care plans was examined. These were detailed and contained adequate information relating to moving and handling risk assessments, fall assessments and care instruction to staff. There was evidence that the care plans were reviewed. However as discussed with the nurse in charge these did not reflect the current status of the service users in some instances. Staff agreed that these needed to be addressed in Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 11 order to reflect the actual needs of the service users. There were good daily records maintained that included two entries for the day shifts and one at night. All the service users are registered with a GP and staff reported that they are supported by the local surgery. The nurse in charge said that the service users have access to external agency such as district nurses that are available for support in dealing with wound car as required. Continence advice was also available. A sample of Medication Administration Record (MAR) was seen as part of the visit. Records of oral medication as prescribed on the MAR sheet was maintained appropriately. The nurse in charge reported that none of the service users were self-medicating at present. Controlled drugs were stored safely. During the tour of the premises there were a number of ointments and topical creams found in service users’ rooms. These were not maintained safely and there were no records of these having been prescribed. Staff reported that some of these were administered to the service users, however these were not recorded in service users records. Some of these ointments were not labelled with the service users’ names. This has the potential of being used as communal in particular in the shared rooms and putting service users at risks. One ointment in a service user’s room was found to have expired and was brought to the attention of the nurse in charge who agreed that action would be taken to rectify this practice. The inspector observed the staff interacted well with the service users and found them friendly and respectful when dealing with them. It was evident from interaction observed and comments received that the staff have a good knowledge of the service users’ needs. Service users, comments included “this is a nice home”. Another service user said that “staff are good” and he likes living at the home. Two service users spoken with say that they are treated with respect and that meals were” very good” Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The social and recreational needs of the service users are well met. Contacts with family are encouraged and supported. Meals are good well balanced and meet with the satisfaction of the service users. EVIDENCE: There is a range of activities that are provided to suit the needs of the service users. The inspector observed that large print books and daily newspapers were available. The home has a dedicated activities co-ordinator that attends the home twice a week. Staff reported that activities are undertaken in small groups and sometimes individually and a record is kept of activities. Other activities included games, old time music and clothes show/ shop. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 13 The local vicar visited regularly and visitors from other churches attended the home on a monthly basis. Holy communion was available which one service user took part. The home has an open visiting policy and a record of all visitors to the home was maintained that showed that there was no restriction on visiting times. Service users said that they could see their visitors in private and in the large lounge or the dining room. The home has a planned menu that is rotated on a 4 weekly basis. Meal at lunchtime was observed. Meals appeared well presented, appetising and choices were available. It was evident from discussion with the chef that she had a good knowledge of the service users’ likes and dislikes and was committed in providing a high standard of meals that suited their tastes. Comments from the service users included that the food “was always good” and that they enjoyed the meals and that choices were offered. The environmental officer had inspected the home in March 06 and there was no recommendation from this visit. The kitchen was busy and appeared well organised and clean on the day of the visit. Staff were observed to offer support with meals in a sensitive manner and meals were not rushed. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The complaint procedure was available and contains information about how to make a complaint. Staff understanding of adult protection and the reporting process is adequate EVIDENCE: The home has a complaint policy and procedure in place. Staff reported that the procedure is available in large prints if requested. The nurse in charge deals with all complaints and refers to the provider as necessary. Staff spoken with were confident in approaching the person in charge with any issues. Service users spoken with say that they had no “grumbles” and would talk to the person in charge if they were unhappy. A complaint log was available The home has a copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure and it’s own policy and procedure reflects the guidelines from Hampshire County council’s own policy. Staff spoken with were aware of what constituted abuse and said that they would be confident in reporting this to the person in charge. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 15 Training in adult protection for all staff was discussed with the provider who will be putting this in place. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 16 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): 19,26 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The home provides the service users with a comfortable and pleasant environment to live in. The infection control procedure at the home is good and safeguard the service users. EVIDENCE: A tour of the building was undertaken as part of the visit. Accommodation is provided in a well- maintained, spacious and homely environment. Adaptation and equipment were available to maintain and support the service users in maintaining their independence. Service users spoken with said that they liked their rooms. Most of the bedrooms were personalised. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 17 There are ample communal spaces and furnishing was of good quality and appropriate to meet the needs of the service users. The décor within the home is good with evidence of on-going maintenance and improvements. The home has large well- maintained and mature gardens that are accessible to service users with limited mobility and seating was provided in the garden. Service users spoken with say that the home is “very nice” and some of them spoke about their nice rooms. Most of the rooms were personalised with evidence that the service users are encouraged to bring in with them items of personal belongings. There was no offensive odour when the inspector toured the service. It was noted that one of the shared room was bland and did not provide a warm and comfortable environment and the paintwork was in need of attention. The provider reported that the two service users did not have relatives and that the home will be addressing these issues. It was noted at the last visit that the bathroom on the ground floor has three separate areas of rust and worn away enamel. This has not been rectified and the provider said that this would be dealt with. The call bell needed to be fixed to the wall in the bathroom/ toilet, as this may not be accessible to the service users. The doors to the communal bathrooms were not accessible from the outside in an emergency and posed risks of entrapment. The provider reported that this will be looked into and made safe. The home has a laundry room and all the service users’ laundry is undertaken internally. Staff were observed top follow infection control procedures. Gloves, liquid soap dispensers and aprons were available and training in infection control is provided. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 18 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): 27,29,30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The staffing level was good and staff felt supported. A training programme is in place that ensures that staff have regular updates to maintain their skills. This included a thorough induction programme. The recruitment process is satisfactory. EVIDENCE: The home has a roster for the carers and a separate roster for the ancillary staff. The rotas showed that a minimum of two registered nurses and six carers in the morning. Two registered nursed and five carers in the evening and one registered nurse and four carers awake each night. These figures exclude management and administrator. The home also employs a cook, kitchen assistants and cleaners to support the carers. The home has a “bank” system to cover for sickness and extra duties. Staff reported that they do not use agency and that the bank system provides with good support and continuity of care. The staff spoken with felt that the recruitment process within the home is thorough. A sample of four staff records was seen as part of the visit. Staff Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 19 records and found that they were detailed with the necessary checks taken to ensure staff are fit to work at the home. Some of the staff had been employed following receipt of POVA first check but prior to CRB clearance. The provider said that staff are supervised during that period as CRB clearance continued to take a long time. Staff records showed that there is a thorough induction programme in place. All records of the new staff showed that they had completed the induction programme. There is an ongoing training programme in place. Staff spoken with confirmed that they attended regular training/ updates and that training was adequate. Some of the staff spoken with said that they would like further input regarding learning disability, as there is one client in this category accommodated. The provider said that he would source training in learning disability in order to support staff in caring for this service user. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 20 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): 31,35,38 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. The appointment of a manager will provide staff with stability. The financial interests of the service users are well managed and ensure that they are protected. The residents’ health, safety and welfare are appropriately promoted by the home to ensure everyone is protected. EVIDENCE: The home does not have a manager at the time of the visit as the manager had left 2 weeks previously. The provider has started the recruitment process Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 21 and is hoping for a replacement soon. The deputy manager has taken charge of the home and is supported by the provider. There was good interaction observed between the staff. The provider is aware that the new manager will need to be registered with the commission. A sample of 5 service users’ personal allowance as managed by the home was examined. The home’s administrator has a good system in place. All moneys were kept separately. Receipts of all transactions were kept and two signatures sought for all transactions. There are 2 service users who manage their own financial affairs. There are 25 service users who have Power of Attorney and the family deals with the other service users’ finance. The health and safety of the service users are maintained. All substances that are hazardous to health were kept safely. The fire safety officer visited in June 06 and had made some recommendations for the home to action. The provider reported that this was underway and a further visit from the fire officer is scheduled for the end of August 06. The maintenance person is now responsible for fire alarm testing and will be introducing random fire testing for the night staff. A fire log was maintained and included weekly fire alarm testing and drills. A fire risk assessment was completed in June 06. Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 22 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) 17(1) (a) schedule 3 Requirement The registered person must ensure that all medications are kept safely at all times. Records of all medications administered to the service users must be maintained. Timescale for action 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton 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. Extracts may not be used or reproduced without the express permission of CSCI Peel House Nursing and Residential Home DS0000043173.V305630.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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