Inspection on 24/11/05 for Peel House Nursing and Residential Home

This inspection was carried out on 24th November 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

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

Peel House Nursing and... 02/08/06

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 Isolina Reilly Unannounced Inspection 24th November 2005 12:00 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.V262282.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 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 Mrs Pamela Ann Johnson 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.V262282.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must not be admitted under the age of 50. Date of last inspection 4th July 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. Peel House is owned by Mr and Mrs Afgan, who employ a registered manager. 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 en-suite 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.V262282.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection for this service that took place over one day. The opportunity was taken to look around the home, view records, procedures and talk with residents and staff. The inspector also had the opportunity to observe the evening meal and interaction between residents and staff. The inspector was able to speak with several residents, relatives, registered nurses, carers, cleaners and kitchen staff were spoken with who stated that they felt the home provides a good service. There was an additional visit undertaken by the inspector on 2nd November 2005, following concerns raised about care being given by the home. The visit was part a Vulnerable Adult’s planned investigation involving Adult service (Social Services) care managers, was partially substantiated. The three immediate requirements issued at this additional visit were assessed on this inspection and have all been met. A full summary of the home’s assessment against the key National Minimum Standards is available by reading this and this year’s previous inspection report of 4th July 2005. What the service does well: What has improved since the last inspection? Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 6 The home has a system in place for looking at the quality of the service they provide that they intend to develop further. This includes gaining the opinions of the residents, family and friends, health and social professionals. This helps them look at how to improve their service. Since the last inspection, the home has met the three immediate requirements issued at the additional visit. This includes training all new staff in the safe and correct way to move and manual handle residents before they staff working as a carer. All new staff have the necessary checks prior to starting work at the home. The fires safety doorstop that automatically releases when the fire alarm goes off has been repaired and is now working properly. The registered nurses responsible for training of staff with moving and handling are in the process of assessing that all staff are moving and handling residents in the correct way so not to cause discomfort. The home looks homely, comfortable and suitable for the service users because of the on going redecoration and replacement of carpets and furniture. 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.V262282.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key standards were assessed and met at the previous inspection on the 4th July 2005. EVIDENCE: Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 The care planning system continues to improve providing staff with easily accessible information they need to meet residents’ needs. Key standards 8, 9 and 10 were assessed and met at the previous inspection on the 2nd July 2005. EVIDENCE: The two residents spoken with at length felt the care provided by the home was good and relevant. Stating that staff are very helpful, polite, appear to know what they are doing. Following an additional visit to the home to investigate a complaint regarding poor moving and handling techniques an immediate requirements was issued. The immediate requirement has been met with all new staff being trained and assessed as competent with regards moving and handling prior to stating work within residents. This was confirmed by the new staff spoken with and training records sampled. The inspector sampled five residents’ care files looking specifically as individual moving and handling risk assessments and care instruction to staff. All five files sampled had records that included basic risk assessments for mobility and Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 10 appropriate instruction for care staff. The new manager stated she would be reviewing care planning with in the home to how it maybe improved. The inspector observed the staff interacting with the residents and found them attentive and professional. There were staff around most of the time in the communal areas. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 11 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 and 13 The residents experience a stimulating and varied life at the home with visitors made welcome. Links with the community are good and enrich residents’ social and cultural opportunities both within the home environment and external. EVIDENCE: The inspector observed residents reading large print books and daily newspapers. The home has three large lounge areas that is divided into various quiet areas through the positioning of chairs. Some of the residents explained that they take part in organised activities. The home has dedicated activities co-ordinator that works two days a week. The co-ordinator works with individuals and small groups. A record is kept of activities and the residents that choose to participate. These were sampled and found to be satisfactory. The home provides regular hairdressing, newspapers, periodicals, manicures and hand and arm massages. There are visiting external musicians, entertainers, stroke club and church services. A specially trained ’pat a dog’ also visits the home regularly. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 12 The relatives spoken with feel the clients are very well cared for and that they are made very welcome and part of the home. The inspector observed that all the relatives visiting that day had been offered refreshments. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 The home has a satisfactory complaints procedure that residents are able to use. The staff have an understanding of Adult Protection issues that protects service users from abuse. The home has an open and positive approach to listening to residents and staff views and improving. EVIDENCE: All the residents spoken with stated that they would go straight to the manager or the nurse in charge if they had a concern or complaint. They all stated that the staff are good and listen to individuals concerns. The relatives also felt that the staff were patient, caring and willing to listen. The home’s complaint procedure included the address for the Commission and that all complaints will be dealt with promptly within 28 days. The home has received three complaints to date. There is a system for logging complaints and the manager showed the inspector a file with correspondence from relatives and residents complimenting and thanking the home for the care received. The records for the complaints were available on this inspection. All the residents spoken with stated that they always felt safe at the home. The relatives spoken to also confirmed this. The staff spoken with confirmed that they have received instruction and are aware of the protection of vulnerable adults from abuse. They have attended training on recognising and reporting of concerns or suspicions. There have been two causes for concern raised at this home recently. The first was up held and the home dealt with in a professional way following their procedures. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 14 The second cause for concern was partially up held and the home has undertaken the necessary work to improve care and has met the immediate requirements issued at the additional visit. Each case was handled professionally and followed the appropriate policies and procedures. 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. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home presents as a clean, hygienic, homely and suitable environment for the residents. The décor within the home is good with evidence of on-going maintenance and improvements. EVIDENCE: The residents stated that the home is clean, warm and no offensive odours were detected. They also confirmed that there has been on going decorating including the entrance, hallways and bedrooms. The relatives spoken with felt that the recent changes to the communal areas have greatly improved the facilities. The staff spoken with also confirmed this. The residents and relatives spoken with liked their bedrooms. A random selection of bedrooms where seen on the tour around the home and were found to be clean, bright and warm, furnished to the individuals taste and personalised. During the tour of the home the inspector noticed that all the communal hand sinks have liquid soap for washing hands and disposable paper towels. There were gloves and plastic aprons available in the laundry room, toilets and Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 16 bathrooms. The staff confirmed that they have received regular training on infection control. It was noted that the bathroom on the ground floor has three separate areas of rust and worn away enamel. The new manager immediately put the bathroom out of commission and the owners stated that the bath would be reenamelled as a matter of urgency. An electric week chair is routinely charged outside the bedroom. However, it was noted that this restricted the fire exit. This was discussed with the manager and owners who gave a verbal undertaking to ensure that the issue would be fully risk assessed and action taken to make the area safe at all times. The fire safety door guard for bedroom 26 was fixed and works appropriately. This was one of the immediate requirements issued and met at the additional visit. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The home successfully supports staff to undertake appropriate qualifications and development within care that is relevant to this client group. The staff at the home are well trained, supported and employed in sufficient numbers to meet the residents needs. There are good recruitment procedures that ensure clients are not put at risk. EVIDENCE: The residents spoken with described the staff as ‘caring, friendly, helpful and there when they are needed.’ All the residents and relatives spoken with said there was sufficient staff around and that the staff know what they are doing. 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. The staff spoken with felt that the recruitment process within the home is thorough. The inspector was able to sample four different staff records and found that they were detailed with the necessary checks taken to ensure staff are fit to work at the home. The home has recently employed staff from overseas and a concern was raised regarding the poor level of spoken English. The overseas staff members on duty were spoken with during the additional and this visits. The level of understanding and spoken English varied. However, all the staff confirmed Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 18 that they are attending classes twice a week. The residents spoken with said that sometimes they were difficult to understand but were very caring and happy to repeat thinks. One member of staff was singled out as having the least language skills but she is being employed as a cleaner. Many of the staff and relatives spoken with stated that the overseas workers were understandable and many had improved since working at the home. The staff spoken with stated that he induction programme run by the home was useful and very detailed. The files sampled held records of the individual staff home’s own induction’ training covering the key areas with the signatures of the staff member and trainer. The manager confirmed that the home’s induction programme has been assessed against the Skills for Care Council induction standards. One new staff records were sampled looking specifically at the induction programme and training in manual handling. The record and staff spoken with confirmed that they had completed and been assessed as competent in manual handling and assisting with mobility prior to working a one of the carers on the rota. This immediate requirement was raised at the additional visit and met on this visit. The staff spoken with and the registered nurse responsible for manual handling training confirmed that training is on going including regular assessments to establish competency. Records sampled confirmed this. However, during discussion and observations of staff it was noted that some of the techniques being used are dated. The registered nurse responsible for staff training in manual handling stated that she would look into this with the training organisation that she receives her regular up date trainer training. The staff spoken with confirmed that the home continues to provide and support staff to achieve qualifications in care to National Vocational Qualification (NVQ) level 2 and 3 or have nursing qualification in their own country that equates to level 3 qualification, and professional updating training for registered nurses. It was calculated from the training records that currently the home has over 77 of the care staff with a care qualification or equivalent. The home’s training records shows that the home undertakes external and internal training utilising specialist skills and qualifications within the staff group. The staff confirmed that they undertake training regularly and the inspector sampled individual staff training needs analysis records. The home has a positive supportive ethos and staff training with a programme of one to one monthly supervisions, annual appraisals and various staff meetings that are minuted. The training records also show that staff receive training in relevant health and safety subjects including food hygiene, infection control, moving and handling, fire safety, first aid and medication. Other subjects covered include wound care, promotion of continence, diabetes, protection of vulnerable adults, care of the dying and syringe driver update. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 19 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, 33 and 38 The home is adequately run with a new manager who is supported by experience owners. The home has a satisfactory system in place for selfmonitoring, annual review and development. The residents’ health, safety and welfare are appropriately promoted by the home to ensure everyone is protected. Standards 35 and 36 was assessed and met at the previous inspection on 4th July 2005. EVIDENCE: The manager has many years experience as a qualified district nurse and management within the district nursing team. This is evident in the plans for review/assessment and application of new ideas discussed during this visit. The manager plans to maintain her skills and updates by undertakes regular training with the staff team and is planning to start on her National Vocational Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 20 Qualification Registered Manager’s Award in January 2006. The staff spoken with confirmed that there is a clear line of authority within the home. The inspector was able to sample the home’s quality audit findings. The residents and relatives confirmed that they had been asked to complete questionnaire on how the home is run. These were sampled by the inspector and found to be positive in the care provided and attitude of staff. The home is looking to send out questionnaires to health and social care professionals. It was discussed that a summary of the findings and actions taken could be made available to residents and other interested parties. Since the questionnaires received, the home has improved the labelling of residents clothing to try and minimise the mislaying of clothing during the laundry process. The staff spoken with also confirmed that they are regularly asked their opinion on how the home is performing and ideas are encouraged. This is done in various ways at the staff meetings that minuted, supervisions and general informal chats with management. The inspector was able to seen the maintenance certificates for the home’s electrical and gas systems and appliances demonstrating that the home is maintained within good working order. The home has a system of testing the fire alarm weekly. The residents spoken with confirmed that the fire alarm is regularly tested to ensure that it is working. The inspector was able to view records that confirmed that the home has tested the fire alarm, undertaken visual checks of fire extinguishers, emergency lighting and smoke alarms. There were also recent maintenance certificates for all fire safety equipment within the home. The inspector was able to see the home’s file and risk assessments for the safe storage and use of chemicals that may be hazardous to health. Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 21 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Peel House Nursing and Residential Home DS0000043173.V262282.R01.S.doc Version 5.0 Page 23 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. 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