Inspection on 20/12/05 for Peterhouse

This inspection was carried out on 20th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 14/06/05

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 Inspection 20th December 2005 11:45 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 Peterhouse DS0000014025.V270459.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. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Peterhouse Address Church Street Old Town Bexhill On Sea East Sussex TN40 2HF 01424-730809 01424-731204 l.crisford@nabs.org.uk 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) NABS Lesley Crisford Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. That only older people may be accommodated That service users accommodated will be aged sixty five (65) years or over on admission That the maximum number of service users to be accommodated will not exceed thirty six (36) That the maximum number of service users in receipt of nursing care must not exceed twenty six (26) That the maximum number of service users receiving residential care must not exceed ten (10) 14th June 2005 Date of last inspection 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, community centre, public house and a corner shop. The East Wing at Peterhouse is registered to accommodate up to 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 based in London. The charity provides a wide range of support to those who have worked in the advertising and related industries, but opened its services to local people not connected to the industry in 2002. Peterhouse is its only care home. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 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, uses 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’. This unannounced inspection took place on Tuesday 20th December 2005 between 11:45am and 5:00pm. The inspection began by having discussions with the Registered Manager of the home in respect of progress made since the last report, followed by an inspection of the premises and its facilities. In order to gather evidence on how the home is performing, individual discussions took place with six residents, three visiting relatives and one Registered Nurse. 33 residents were accommodated at the time of the inspection. Other records and documentation inspected included: the home’s Statement of Purpose and Service Users’ Guide, medication procedures, the home’s complaints procedure and systems in place for the protection of vulnerable adults, quality assurance systems, staffing levels, staff recruitment files and the management of residents’ finances. In order that a balanced and thorough view of the home is obtained, this inspection report should to be read in conjunction with the previous inspection report carried out on 14th June 2005. What the service does well: What has improved since the last inspection? The home has worked hard to meet many of the requirements made at the last inspection. Residents’ views and opinions have been sought in relation to the running of the home. This has been achieved in part through the use of questionnaires, which were handed out to all residents. The Registered Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 6 Manager has also consulted with residents regarding the ways in which they would like be kept informed and more involved in the care planning process. 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 DS0000014025.V270459.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 Peterhouse DS0000014025.V270459.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): 1, 2 and 3. Residents are provided with sufficient information to help them judge if the home is appropriate for them. Good systems are in place to assess all prospective residents; this ensures that no one is admitted to the home, whose needs cannot be met. EVIDENCE: The home has a comprehensive Statement of Purpose and Service Users’ Guide in place. They provide prospective residents and their families with detailed information regarding the organisational structure of the home, service users’ rights, complaints and protection procedures, the environment, staffing levels and their relevant qualifications, management and administration systems, facilities and services of the home, the age range and needs of residents, the provision for social activities and details of the Commission for Social Care Inspection (CSCI). The Service Users’ Guide also contains a copy of the home’s terms and conditions of contract. All of the residents and relatives spoken with confirmed that they found this information to be most helpful when choosing a place to live. One family have recently written to the home to thank them for their brochures and explanatory Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 9 literature, which was provided at the time of their unannounced informal visit to the home. A number of new residents have been admitted to the home since the last inspection. It was pleasing to note that the Registered Manager is providing a good level of support to the newly appointed Care Manager of the East Wing in respect of completing thorough pre-admission assessments. It is anticipated that the Senior Carers of the residential wing will be trained and supported to carry out pre-admission assessments for those residents who are in need of personal care only. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 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, 9 and 10. Residents are kept informed of their changing healthcare needs. Whilst the systems have improved to ensure that residents’ privacy and dignity is maintained, the procedures for the administration of medication are inadequate. This could potentially place residents at risk. EVIDENCE: All residents’ health, personal and social care needs are sufficiently detailed within individual plans of care. In an attempt to involve residents in the care planning process, the Registered Manager has discussed with them the ways in which they would like be kept informed and more involved. These discussions took place through a number of residents’ meetings. Residents and their relatives spoken with on the day of inspection said that they are happy with the current arrangements, staff verbally updating them as necessary. The home’s medicine storage and administration systems were viewed. The home uses a monitored dosage system, which can easily be monitored. Whilst all medicines were found to be stored appropriately and clearly labelled, it was noted that there was no criteria in place for staff to follow in relation to medicines prescribed on an ‘as and when required’ basis. In addition it was Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 11 noted that some gaps were apparent on the medication administration records where either a signature or reason for non-administration should be. This is outstanding from the previous inspection report. In accordance with recent changes in legislation the home has all unused and discarded medicines disposed of safely by a licensed company. The home is required however to update it’s policies and procedures in respect of this. A recommendation was made in the previous inspection report for the home to document the wishes of residents in relation to staff from the opposite sex providing personal care. Since this time the home has implemented a new policy, which states that male care staff are not to provide personal care to female residents unless a female carer is present. This helps to ensure that the dignity and respect of residents is maintained. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 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, 14 and 15. Residents are provided with a variety of stimulating and meaningful activities. The standard of food has deteriorated; residents do not receive a wholesome and nutritious diet. EVIDENCE: A number of different activities are available for residents throughout the year. These include: twice-weekly visits to different supermarkets, table games, group outings, beetle drive and trips to the seafront. Those who are able to can choose to come and go from the home as they wish. In addition, the home has a bar located in the television lounge, which serves alcoholic and non-alcoholic drinks. The vast majority of residents spoken with seemed particularly pleased with a newly implemented activity – Yoga. The Christmas programme was on display throughout the home on the day of the inspection. It consisted of carol singers, a coffee and mince pie morning, gift-wrapping with canapés and a Christmas quiz. A total of 60 people comprising of residents and their relatives and residents from the adjoining flats were invited to attend a sit down Christmas buffet the week prior to the inspection. All of those who attended spoke very positively of the effort that had been made by the home in organising it. Many of the residents have chosen to stay at the home during the festive period. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 13 The vast majority of residents spoken with said that the nursing and care staff encourage them to take some level of control and choice over their lives particularly in relation to the daily routines. Residents’ preferences are recorded within their plans of care for example their preferred time, choice of going bed and getting up in the morning, their meals and chosen activities. The Service Users’ Guide contains details of local advocacy groups that can be accessed as wished. A number of concerns were raised on the day of inspection in relation to the provision of food. Comments included ‘the food has deteriorated badly’, ‘it’s either really good or really bad’ and ‘it’s awful’. The Registered Manager is well aware of this and in response to several complaints is in the process of addressing this issue. This will be followed up at subsequent inspections. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 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): The home has good systems in place to ensure that all complaints will be handled appropriately and that all residents are protected from harm, neglect and abuse. EVIDENCE: The home has a detailed complaints procedure, which is on display throughout the home. It is also detailed within the Statement of Purpose and Service Users’ Guide. Records of all complaints and compliments are kept within the main office. Not surprisingly the majority of all recent complaints were regarding the provision of food. All residents spoken with were aware of the home’s complaints procedure and did say that they do feel that their concerns are listened to and taken on board. This was very pleasing to hear. No complaints have been made to the CSCI since the last inspection. Clear policies and procedures are in place for the protection of vulnerable adults. These were last updated in September 2005. They define the different types of abuse, relevant legislation, the signs of abuse and the procedures that are to be followed in the event of reporting suspected abuse. All staff receive training during their initial induction period; this is then followed up with inhouse training on a regular basis. All senior staff have recently attended a certified course with East Sussex Social Services. A recent adult protection alert has been raised by the home, which is currently under investigation. This was initially raised through the home’s whistle-blowing policy. Peterhouse DS0000014025.V270459.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, 25 and 26. The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: The home has been redecorated and refurbished gradually over the last 12 months. Many of the residents commented that this has made a vast improvement to the home. New chairs and tables have been purchased for the lounge, dining and communal areas and new curtains have been hung throughout. Some bedrooms have recently had hand-basins moved to more accessible areas and fitted wardrobes installed in order to make better use of the space available. Five new height adjustable beds and overlay pressure-relieving mattresses have been purchased and carpets replaced. Many of the bedrooms seen on the day of inspection had Christmas decorations displayed. This gave the impression of a homely environment, however it was noted that one particular resident’s television was extremely loud and therefore could be heard in many Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 16 of the other bedrooms. This was discussed with the Registered Manager and a requirement made. Unguarded radiators have been risk assessed and appropriate action taken. It is anticipated that one bathroom on the first floor of the East Wing will be removed and replaced with a wet/shower room. It was evident on the day of the inspection that housekeeping staff work tremendously hard to maintain a clean, safe and hygienic home. Peterhouse DS0000014025.V270459.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 and 29. Adequate numbers of staff are employed to meet the assessed needs of residents. The procedures for the recruitment of staff are good; this helps to ensure the safety of residents living in the home. EVIDENCE: Since the last inspection a new Care Manager for the East Wing has been appointed. She normally works between 8-4pm daily and is supernumerary to oversee the nursing care provided. There is always at least one other trained nurse on duty in addition to a senior care assistant, eight care staff, housekeeping and kitchen staff. Residents commented that staffing levels within the home are appropriate and that since the Registered Manager has been in post the staff team has been consistent and reliable. Agency staff are only used on an emergency basis or to cover staff sickness. Of the 22 care assistants employed, nine are trained to at least NVQ level 2 in care, whilst five are currently working towards this and four are due to start. Three staff recruitment files were seen on the day of inspection. It was pleasing to note that all files contained proof of a POVA First and Criminal Record Bureau check (CRB), written references, proof of identification and a full history of employment. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 18 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, 35 and 36. The Registered Manager is supported well by the senior staff. This ensures that the home is run effectively and in the best interests of residents. EVIDENCE: The Registered Manager has been in post since June 2004. She is a Registered Nurse and Health Visitor and holds a degree in Community Health Studies. She has worked with older people for many years and is currently working towards her Registered Managers Award. Without exception, all of the residents, relatives and staff spoke highly of her management and leadership skills. She is supported in her role by a Care Manager, Resource Manager and administrative staff. Since the last inspection a residents’ questionnaire was devised and given to all residents to complete anonymously. The questionnaire focused on five main areas: catering and food, personal care and support, daily living, premises and management. A large number were completed, which were very Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 19 positive indeed. The Registered Manager has yet to collate the data, publish and make the results available to residents, their relatives and the CSCI. A small number of residents from Peterhouse kindly agreed to support the CSCI in carrying out a pilot. The aim of this work was to involve residents more in the inspection process. This involved handing out questionnaires to other residents within the home from the CSCI, which would normally have been distributed by the Registered Manager in advance of an announced inspection. This work is currently still being undertaken. One of the residents involved said that this has been an enjoyable experience. The CSCI would like to thank the home and the residents involved for their time and effort. Small amounts of residents’ monies are kept securely in the home, for purchases such as hairdressing, toiletries and outings. Only designated people (Senior administrative staff) have access to these. Clear written records for each transaction are kept including receipts and countersigned signatures. All balances are checked weekly. A small sample of these were viewed and found to be in order. Clear staff supervision structures are in place. It was pleasing to note that since the last inspection the home are now planning supervision dates in advance. Records of each session are kept. Staff spoken with said that although they were initially unsure of the purpose of supervision, they have found it helpful, particularly in relation to identifying any training needs. Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 20 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X X Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 17(1)(a) Sch 3(k) Requirement That medication records contain either a signature or a reason for non-administration [THIS IS OUTSTANDING FROM THE PREVIOUS INSPECTION]. That written criteria is in place for the administration of medicines prescribed on an ‘as and when required’ basis. That the home’s policies and procedures are updated in accordance with recent legislation regarding the safe disposal of unused medicines. That the provision of food is reviewed in consultation with residents. That the volume of personal televisions is kept at an acceptable level. That the results of the most recent residents’ questionnaire are collated, published and made available to residents, relatives and the CSCI. Timescale for action 20/12/05 2. OP9 17)(1)(a) Sch 3(k) 13(2) 31/03/06 3. OP9 31/03/06 4. 5. 6. OP15 OP25 OP33 16(2)(i) 16(2)(m) 24(3) 20/01/06 20/12/05 31/03/06 Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 22 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 Peterhouse DS0000014025.V270459.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office 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. 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