Inspection on 04/07/05 for Peel House Nursing and Residential Home

This inspection was carried out on 4th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

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

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

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

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 4/7/05 11:30am 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. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 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 Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01329 667721 Mrs Zamir Afgan Mrs Pamela Ann Johnson CRH 46 Category(ies) of OP- Older Persons: 46 registration, with number PD- Physical Disability: 9 of places PD(E)- Physical Disability over the age of 65 years: 46 TI- Terminally ill: 9 TI(E)- Terminally ill over the age of 65 years: 46 Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1- Service users must not be admitted under the age of 50 Date of last inspection 7/1/05 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 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 and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service users and staff spoken with preferred to be identified as residents. The manager and owners confirmed this. This unannounced inspection took place over one day as part of the normal regulation and inspection programme. 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 lunch period, and interaction between residents and staff. Six residents in depth, two registered nurses, five carers and the cook were spoken with who stated that they felt the home provides a good service. What the service does well: What has improved since the last inspection? The home has improved its system for recording care needs and instruction to carers on how to care for individuals providing clear records that help staff to look after the residents as they wish to be looked after. There is an on going improvement and redecorating programme within the home that keeps the house looking fresh and bright. Since the last inspection, the home has refurbished one sluice and one bathroom, converting the bath into an accessible shower; provided new dining furniture and redecorated the ground floor and various bedrooms. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 6 The Cook has implemented a new system for monitoring and reducing hazards and safety within the kitchen and continues to increase the range of choice for the residents. The manager has implemented formal staff supervisions and a quality assurance system that monitors how the home is performing. The manager has been given access to the home’s safe outside the working hours of the home’s administrator enabling residents to access their money. 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 and Residential Home H54 S43173 Peel House V237292 040705.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 Peel House and Residential Home H54 S43173 Peel House V237292 040705.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 and 6 The home has an improved admission process that is robust and well managed given residents clear information regarding the service. The home does not provide ‘Intermediate Care’. EVIDENCE: The residents explained to the inspector that a family member was able to visit the home before making the decision to stay. The manager or deputy undertakes an interview with the resident and completes a full assessment of needs and aspirations. Within the individual residents’ files sampled a full admission assessment was recorded that reflected the care needs the residents expect, their likes and dislikes and reflected Social Services care manager assessments of need. The recently admitted resident spoken with stated that the home asked lots of relevant questions and is looking after them very well. The manager confirmed that the home does not provide ‘intermediate care’ rehabilitative short-term type care for Social Services. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 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 standard(s) 7, 8 and 10 The home provides a good level of care for residents in respect of their personal, emotional and health care needs in such a way as to promote privacy and dignity. The care planning system has improved since the last inspection providing staff with easily accessible information they need to meet residents’ needs. EVIDENCE: The residents spoken with were all very complimentary of the care provided by the home. Stating that staff are very helpful, polite, appear to know what they are doing and look after them well. They also said that the staff are always respectful and mindful of their privacy and dignity. From the relatives/visitors comment cards stated that the home provides a good to satisfactory service and that they are always made welcome. 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. Refreshments for both residents and visitors were observed to be available throughout the day. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 10 The three out of the four resident files were discussed with each individual resident who confirmed that they recognised the records and the staff have discussed their needs and care with them. The care plans contained written risk assessments and instructions to staff on how to look after the individual. The records also included names of relatives, friends, health care professionals and social services care managers who are involved in supporting the client. A resent photograph was seen on all the files. Since the last inspection, the format and content of the care plans has been reviewed and improved to contain the necessary information for actions to be taken by care staff, involve the relatives and have been reviewed frequently. The staff spoken with all commented that they found the new system logical, improved and felt involved in the care planning/recording process. There were also records of doctor and nurse visits and information on outpatient, dental, optician and chiropractic appointments. Various residents stated that the visiting dentist and opticians had recently seen them. The recent treatment and the corresponding medical notes were present in the file. The home’s visiting hairdresser was available all day during this visit. The staff were observed administering medication appropriately and the good medication administration practices are reflected in the home’s policy and procedures sampled. The home administers from ‘single blister pack system’ provided by the local pharmacist and correctly stores the medication in appropriate cupboard within a locked medical room. The home uses the ‘Medicine Administration Record Sheets (MARS) system for recording the administration of medication. The receipt of each medicine is checked; quantity noted and signed. Each resident’s record also has a recent photograph. The registered nurses administer the medication. The receipt, administration and disposal records of medication were sampled by the inspector and found to be satisfactory. The manager and deputy informed the inspector that the Commission for Social Care Inspection (CSCI) pharmacist recently assessed the home’s medication system and it was identified that the previous requirements had been met in full. The home is awaiting the pharmacist’s CSCI report to arrive. On discussion with the manager and deputy the inspector decided to inspect standard 9 resident’s medication will be inspected at the next routine visit. The staff spoken with confirmed that since the last inspection they have received update training and have been assessed for competency in the ‘safe handling of medication’. The manager confirmed that she undertakes regular audits of the home’s medication practices, regularly assesses each registered nurse’s competency and records the findings. These were sampled and found to be satisfactory. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 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 standard(s) 14 and 15 The residents experience an individual and varied life at the home with visitors made welcome. The home is able to meet the cultural and religious needs on an individual preference. The meals in this home are good offering both choice and variety, catering for special dietary needs in pleasant surroundings. EVIDENCE: The inspector observed residents reading large print books, daily newspapers, and crosswords. The home has three separate lounge areas and a separately set out dining areas. There is a dedicated member of staff for resident’s activities. Some of the residents explained that they take part in organised activities and another state that they choose not to participate all the activities. The residents and manager confirmed that clergy visit the home regularly. The relatives written comments received state that they feel the residents are well cared for and that they are made welcome and part of the home. The inspector observed this during the visit. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 12 All the residents stated that the day routine is flexible and a meal can be put aside should they wish. The residents confirmed that staff will go around asking all residents’ choice from two options the day before and again at the beginning of each meal. The cooks confirmed that they make allowances for individuals who change their minds at the meal. The inspector sampled the four-week menu and found it to be variable, balanced with alternatives and hand amendments. The cook and kitchen assistant spoken with explained that they are continuously seeking residents likes and dislikes with a view to offering choice on a one to one basis when the two main meal choices are not to their liking. Most of the residents felt the food was excellent, with generous portions, varied and choices are available if they do not like what is on the menu. The residents stated were very happy with mealtime experiences and felt they were not rushed. Some of the long-standing residents stated that the food and choice has been consistently good. The meal was observed by the inspector and found to be relaxed, unhurried and the food attractively presented. The layout of the kitchen is utilised to maximum effect ensuring the efficient running of the kitchen. The cook explained that the home was in the process of piloting the local Environmental Health department’s new recording systems for ‘Safe food better business’. The home has undertaken detailed hazard analysis and implemented ‘critical control’ procedures. The new system of record keeping provides a fully auditable way of working. The cook and kitchen assistant stated that the system was very useful, easy to use and has enabled them to improve practice. The daily records were sampled of foods served and temperatures of hot probed meals and freezers and fridges are kept by the cooks and found to be satisfactory. The cook confirmed that the Environmental Health Office has visited on 6th May 2005 and no requirements or recommendations were issued. The inspector was shown the report. Peel House and Residential Home H54 S43173 Peel House V237292 040705.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) 18 Since the last inspection, the home has ensured that 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 very good and always listen to individuals concerns. 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. Since the last inspection, they have attended training on recognising and reporting of concerns or suspicions. There has been no allegation of abuse at this home. 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 and Residential Home H54 S43173 Peel House V237292 040705.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 and 26 The home presents as a clean, hygienic, homely and suitable environment for the residents. The communal facilities within the ground floor have been greatly improved since the last visit and the standard of the décor within the home is good with evidence of on-going maintenance and improvements. EVIDENCE: The residents stated that the home is always clean, warm and no offensive odours were detected. They also confirmed that there has been on going decorating including the entrance, hallways and bedrooms. Many of the residents spoken with felt that the recent changes to the communal areas have greatly improved the facilities for them. The staff spoken with also confirmed this. The home has also improved the gardens to the front of the house and included ramps into the conservatory style lounge area. The garden was looking very colourful and well maintained. All the residents like their bedrooms. The home’s radiators and pipe work are safe ensuring that all potential hot surfaces are kept to low temperature. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 15 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. All residents’ spoken with felt there were enough toilets and bathrooms or showers. 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 bathrooms. The residents stated that they see the staff using them. The staff confirmed that they have received regular training on infection control. The ground floor sluice has recently been refurbished and was seen being used by staff during the day. However, the ground floor sluice has yet to be refurbished and is currently not in use except as a storage area. This was discussed with the manager and owners who stated that they would look at improving this facility. Peel House and Residential Home H54 S43173 Peel House V237292 040705.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) The above key standards will be fully assessed on the next routine inspection. EVIDENCE: Peel House and Residential Home H54 S43173 Peel House V237292 040705.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) 35 and 36 The home has an improved access for residents’ to their money when kept within the home’s safe. There is an improved formal staff supervision process that ensures staff are appropriately supervised. The managers are looking to improve team working across the different staff teams. EVIDENCE: Since the last inspection the records for residents’ personal money kept in the home’s safe has been made accessible to the manager and deputy as well as the administrator. The manager and owners confirmed that the system has been improved. The manager and deputy manager has access to the home’s safe facilitating residents’ access to their money outside the working hours of the administrator. The staff spoken with stated that they receive regular supervision sessions with the manager or deputy manager. The deputy manager and manager also confirmed this. Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 18 Since the last inspection the owners have provided regular monthly Registered Care Homes regulation 26 reports and the manager has implemented a quality assurance process for the home that will be fully assessed at the next routine inspection. During discussions with the staff the inspector observed that there appeared to be reduced communication and problem solving between the different staff groups. The owners and manager also confirmed that communications issues had been identified with the staff teams and various strategies are in the process of being developed to improve the relationships and teamwork across the different staff teams. However, the communication issues to do appear to effect the residents who were all unanimous in their praise of all the staff and the good care that was provided by the home. Peel House and Residential Home H54 S43173 Peel House V237292 040705.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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x 3 3 x x Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 20 Yes 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 Peel House and Residential Home H54 S43173 Peel House V237292 040705.doc Version 1.40 Page 21 Commission for Social Care Inspection 4th Floor- Overline House Blechynden Terrace Southampton Hampshire 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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