Inspection on 14/06/05 for Peterhouse

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Peterhouse 27/11/08

Peterhouse 12/12/06

Peterhouse 20/12/05

Peterhouse 17/02/05

Peterhouse 19/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Peterhouse Church Street Old Town Bexhill on Sea, East Sussex TN40 2HF Lead Inspector Niki Palmer Unannounced 14 June 2005 08:45 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. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Peterhouse Address Church Street Old Town Bexhill on Sea East Sussex TN40 2HF 01424 730809 01424 731204 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) NABS Lesley Crisford Care Home (CRH) 36 Category(ies) of Old age not falling within any other category registration, with number (OP) 36 of places Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. That only older people may be accommodated. 2. That residents accommodated will be aged sixty five (65) years or over on admission. 3. That the maximum number of residents to be accommodated will not exceed thirty six (36). 4. That the maximum number of residents in receipt of nursing care must not exceed twenty six (26). 5. That the maximum number of residents receiving residential care must not exceed ten (10). Date of last inspection 17 February 2005 Brief Description of the Service: Peterhouse is a purpose built care home situated in a quiet part of the old town in Bexhill on Sea. It is within a short walking distance of local shops, church and train station. There are several close amenities that include a GP surgery and pharmacy, C of E Church, community centre, public house and a corner shop. The East Wing at Peterhouse is registered to accommodate 26 older people who require nursing care and 10 residential places for those requiring only a level of personal care. Accommodation is provided over two floors. Shaft lifts are fitted to assist those residents who have additional mobility needs. A number of sheltered housing flats adjoin the care home with some shared facilities. There is level access to well-maintained communal gardens. Peterhouse is owned by the National Advertising Benevolent Society (NABS), which is a charitable organisation providing support to those who have worked in the advertising and related industries. Peterhouse is its only care home. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Peterhouse will be referred to as ‘residents’. The unannounced inspection took place on a Tuesday in May between 8.45am and 1.45pm. At the time of the inspection 22 residents were accommodated requiring nursing care, and 10 residential care. The inspection began with discussions with the registered manager of the care home in respect of progress made since the last inspection. In addition conversations were held with the care manager, two members of care staff and three visiting relatives. Individual discussions took place with four residents, whilst others commented on their care during lunchtime, the inspector having been invited to join them for a meal. A detailed inspection of the premises and its facilities took place. Records and documentation inspected included: six residents files and care plans, medication records, various policies and procedures, staffing rotas, staff training files and the home’s quality assurance systems. What the service does well: What has improved since the last inspection? The home has worked hard to meet the requirements and recommendations of the previous inspection. The entrance system at reception is now straightforward and easy to use, whilst maintaining the safety of residents. Clear procedures and guidance have been developed regarding protecting the legal rights of residents, particularly when it is deemed that they do not have the capacity to make an informed decision to consent. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 6 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. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 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 Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 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 very good systems in place to assess all prospective residents; this ensures that no one is admitted to the home, whose needs cannot be met. EVIDENCE: All three pre-admission assessments were found to be exceptionally detailed and thorough. All areas of personal care and level of need had been recorded, including health and social care needs, history of mental state and cognition, personal safety and risk. It is made clear from the assessment whether or not the home can meet the assessed needs. The registered manager currently undertakes all pre-admission assessments and the detail recorded is probably indicative of her level of experience and underpinning knowledge as opposed to the content and layout of the document. The registered manager is keen for some of the senior nursing staff to become involved and experienced in the pre-admission process. A recommendation has been made in respect of joint assessments being carried out initially in order to see if the form itself may need revising to include additional prompts for information. Intermediate care is not provided. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 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, 9 and 10. The home has good systems in place to plan for the care needs of residents but they need to be more inclusive of individuals’ views and preferences. EVIDENCE: Six plans of care were seen on the day of inspection. Long-term needs are clearly identified and the action which is to be carried out by staff to meet the assessed needs. Since the last inspection individual social care needs are now included in the care plans, however there is no evidence that residents and their relatives are involved in the care planning process. This was confirmed by three of the relatives spoken with. A number of assessments are in place within the care plans including: continence, wheelchair assessment, nutrition and mental health and wellbeing. In addition detailed risk assessments are carried out for the prevention of falls and pressure area care. The homes medicine storage and administration system was viewed. The home uses a monitored dosage system provided by the local pharmacy. All medicines were found to be stored appropriately and clearly labelled. All controlled drugs were examined and no errors found, however procedures were not consistent in regards to recording. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 10 Throughout the course of the inspection all staff were observed to treat residents with dignity and respect, from nursing and care staff to housekeepers and administration staff. Since the last inspection the home have begun to ask residents and their relatives if they have any preference with regard to members of staff from the opposite sex providing personal care, this was confirmed by two of the residents, but there was no evidence of this within the care plans. A recommendation has been made in respect of this. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 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) 13 and 15. The home encourages residents to maintain social activities. The variety and availability of desserts offered to residents needs to be improved. EVIDENCE: Since the last inspection the home has reviewed its entry system at reception in consultation with visitors to the home. There are clear instructions in place to allow straight-forward, yet safe access to the building. Feedback from residents and visitors was positive. All relatives spoken with said that they are welcomed by the home throughout the day. One of the residents spoken with said that he had recently celebrated his birthday at the local community centre. Although he planned the majority of the arrangements himself, he said that all of the staff were supportive and that many of the staff and residents attended. The home has very recently employed a new chef. On the whole feedback from residents regarding the food provided was positive, however one of the residents commented that diabetic desserts are not always available, whilst another said that at supper-time it is ‘luck of the draw’ if residents get the dessert that they have chosen. On the day of inspection the vegetarian lunchtime option was tried; it was found to be tasty, hot and nutritious. The dining area is presented nicely, relaxed and sociable. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 12 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) 17. The home has clear systems and documentation in place to protect the rights of residents unable to make decisions for themselves. EVIDENCE: In response to a previous requirement made, the home has worked hard to develop clear procedures and documentation relating to obtaining consent from residents. Up to date information was collated from the Department of Health and amended to meet the needs of the residents accommodated at Peterhouse. The documentation includes twelve key points around the ‘rules’ of consent and the home have developed a flowchart to support staff through each stage. In addition clear guidelines are in place for staff and other professionals to follow when it is deemed that a person does not have the capacity to make an informed decision for themselves. Relatives and other health professionals are included throughout this process. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 13 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) 24 and 25. Peterhouse provides residents with a safe, comfortable and well-maintained place to live. EVIDENCE: Six individual bedrooms were seen on the day of inspection; all were furnished and equipped to a high standard. All of the rooms contained personal belongings of the residents including furniture, bedding, pictures and photographs. Height adjustable beds are provided by the home for all residents receiving nursing care. Residents and relatives spoke highly of the accommodation and cleanliness at Peterhouse. Since the last inspection the home has completed risk assessments for the three unguarded radiators. Consequently two are due to be removed, and the other guarded in due course. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 14 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) 27, 28 and 30. Peterhouse ensures adequate staffing levels a high standard of staff training to meet the care and nursing needs of residents. EVIDENCE: Since the last inspection records are kept of the time it takes staff to attend to bells. On average all calls are attended to within a maximum of three minutes. The home employs a variety of staff including: Registered General Nurses, 27 care staff (12 of which are trained to at least NVQ level 2), kitchen and housekeeping staff. Current staffing levels are one carer to three residents; this level of staffing is considered to be adequate to meet the needs of residents. Over the course of the inspection residents and relatives said that staff are ‘often busy and pushed’. Two care staff commented that the home has sufficient staffing levels when ‘everyone on duty pulls their weight’. A recommendation has been made in respect of the registered manager reviewing these levels on a regular basis in consultation with residents and their relatives. Staff training in this home has improved considerably since the registered manager has been in position. Since the previous inspection the home has provided external training to staff around the management of epilepsy, the Protection of Vulnerable Adults, medication, parkinsons disease and dementia. In addition in-house training as been facilitated for confidentiality, first aid, fire safety, moving and handling and infection control. Notices of staff training days are displayed throughout the home. Two of the care staff spoken with said that they have really benefited from the training and on many occasions have chosen to attend training in the home in their own time. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 15 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) 33, 36 and 37. Peterhouse has good management and administration systems in place, but work is needed to ensure that the views of residents and relatives are sought in respect of how the home is performing. EVIDENCE: Since the last inspection the registered manager has worked hard to implement audit and quality monitoring systems within the home. She has begun to use a recognised audit tool supplied by the Care Homes Association, which is based on meeting the National Minimum Standards. At the end of each section an assessment summary is recorded, which gives details and action points as to how the home will work towards improving standards. There is however no evidence that active consultation is taking place with residents and their relatives. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 16 Since the last inspection the home has implemented clear structures for staff supervision. Four staff supervision files were seen, which showed that staff are receiving supervision on a regular basis. This was confirmed by two of the care staff. A recommendation has been made that at the end of each session, a further date is planned. During the last inspection concerns were raised in respect of care plans being left in residents’ rooms containing confidential and personal information. Since this time all care plans have been removed from rooms to the nursing station; this has concerned some relatives. The registered manager has been advised to liaise with residents and relatives regarding their wishes, whilst ensuring that confidentiality is maintained. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 17 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 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 2 COMPLAINTS AND PROTECTION x x x x x 3 2 x STAFFING Standard No Score 27 3 28 2 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 4 x x x 2 x x 3 3 x Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 18 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 OP7 Regulation 15(1) Requirement That all care plans are drawn up and reviewed with the involvement of residents and their relatives as much as is practicable [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION]. All omitted medicines must be clearly documented on the medication administration forms. That residents receive a variety of low sugar and alternative desserts. That the three unguarded radiators are guarded/removed as per their risk assessment. That residents and relatives views are sought in respect of the quality of care provided in the home. Timescale for action With immediate effect. 2. 3. 4. 5. OP9 OP15 OP25 OP33 17(1)(a) Schedule 3(k) 16(2)(i) 13(4)(a) (c) 24(3) With immediate effect. With immediate effect. 14/08/05 14/09/05 Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 19 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. 2. 3. 4. 5. Refer to Standard OP3 OP10 OP27 OP28 OP36 Good Practice Recommendations That nursing staff who wish to carry out pre-admission assessments are supported and supervised to do so by the registered manager. That the wishes of residents and their relatives are documented in regard to staff providing personal care. That staffing levels are reviewed on a regular basis. That 50 of care staff are trained to at least NVQ level 2 by December 2005. That staff supervision is arranged and planned in advance. Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Peterhouse H59-H10 S14025 Peterhouse V228321 140605 Stage 4.doc Version 1.30 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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