Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 24/10/05 for Philbeach Nursing Home

Also see our care home review for Philbeach Nursing Home for more information

This inspection was carried out on 24th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Good interaction was seen between staff and residents. The atmosphere was calm and relaxed. Staff are working as a team.

What has improved since the last inspection?

The improvement on care planning is sustained although a recommendation was made in this respect. The manager has audited staff competencies and devised a training programme. Training has been provided both in-house and through the local PCT. Formal staff supervision sessions have been introduced. Staff files have been ordered and tidied up. The home now has two deputy managers and with the appointment of a Director of Nursing, the management structure has been strengthened. The manager said that she is now able to delegate some of her many responsibilities to other senior staff.

CARE HOMES FOR OLDER PEOPLE Philbeach Nursing Home Tanners Hill Hythe Kent CT21 5UE Lead Inspector Unannounced Inspection 24th October 2005 10.40 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 Philbeach Nursing Home DS0000040740.V256991.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. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Philbeach Nursing Home Address Tanners Hill Hythe Kent CT21 5UE 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) 01303 262421 Philbeach Care Centre Ltd Care Home 61 Category(ies) of Old age, not falling within any other category registration, with number (61) of places Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2005 Brief Description of the Service: Philbeach Care Centre is a large detached three storey building set in 9 acres of attractive grounds. The home has a terrace with good views over the garden. It is situated on the outskirts of Hythe close to shops and other amenities. A refurbishing programme of decorating and installing en-suite facilities in bedrooms, in the long term, is in progress. The home provides residential and nursing care. The Company owns two other care homes, the bungalows in the grounds and two Domiciliary Care Agencies. The home is managed by Mrs Lorna Smitrh and overseen by a recently appointed Director of Nursing. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours and comprised discussions with the manager Mrs Lorna Smith, The Director of Nursing and other staff. A partial tour of the home was undertaken, a clinical room and sluice visited and records examined. Since the previous inspection the home had one additional visit. At that visit, the inspector met with the recently appointed Director of Nursing. New staff have been appointed and a small number of staff left. A few care staff vacancies exist. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be more comprehensive in respect of wound care and review. A malodour was noted in one of the home’s sluices and the standard of cleanliness was low. Whilst it was said that hot water checks are carried out throughout the home, those water temperatures checked on the top floor were too high and this must be addressed before any residents occupy those rooms. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 6 Following a recent problem with the heating system, though now resolved, the home must ensure that risks in respect of the system breaking down again be minimised. 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. Philbeach Nursing Home DS0000040740.V256991.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 Philbeach Nursing Home DS0000040740.V256991.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, 3, 6 1 Residents are provided with the information needed to make an informed choice about the facilities and services the home provides. Following recent changes to the management structure and registration this information needs to be updated. 3 Residents are only admitted to the home following a full assessment of need. 6 The home is making the appropriate preparations in order to care for residents requiring recuperative/intermediate care. EVIDENCE: Copies of the Statement of Purpose and Service User Guide were not examined on this occasion but it was agreed that following some of the recent changes these must be updated. From discussions with the manager and Director of Nursing it is ascertained that no residents are admitted to the home without a full assessment of need. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 9 The home has successfully tendered with the local authority to provide recuperative care for three residents on the top floor. At the time of the inspection, the finishing touches were applied to ensure that the rooms meet the standards. See standards 27 and 38 in this respect. As the recuperative care is to be provided for people from the age of 55, a variation to the registration was requested and granted. Philbeach Nursing Home DS0000040740.V256991.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, 10 7 The care planning system is well understood by the staff but needs further input to truly reflect all residents’ changing care needs. 9 Residents are protected by the home’s policies, procedures and practices for dealing with medicines. 10 Residents are treated with respect and due regard for their privacy. EVIDENCE: 7 The care planning format provides a structured framework, which is followed by staff. However, further refinement is needed to truly reflect residents’ needs. A summary of care needs was noted but some of these were not recorded in a care plan. Wound care documentation needs to be clearer in respect of carrying out of instructions and detail of evaluation. It was a recommended that care plans are audited regularly. 9 Medication charts were examined and well maintained. The home has come to grips with the requirement for disposal of unwanted and out of date medication. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 11 10 It was observed that personal care is offered in a respectful and dignified manner. Philbeach Nursing Home DS0000040740.V256991.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): 14 Residents are supported to exercise choice and control over their lives. EVIDENCE: From conversations with management and staff it is ascertained that residents are provided with choices in respect of meals, getting up and going to bed times. A resident’s request that a particular hoist be used for his moving and handling needs was considered and recorded. See also standard 33 in respect of satisfaction surveys. Philbeach Nursing Home DS0000040740.V256991.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, 18 Residents know that their concerns and complaints will be listened to and acted upon and that their legal rights are protected. Residents are protected from abuse. EVIDENCE: Since the previous inspection, one complaint has been received which the home is dealing with. A complaints procedure was seen on display. Staff demonstrated a good knowledge of adult protection issues and awareness of what to do if this was ever suspected or witnessed. Staff training has recently been provided. See also standard 30. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 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 the following standard(s): 19, 26 The standard of the décor within the home is good with attractive communal spaces. The home is clean and there were no noticeable odours. However, the standard of cleanliness in a sluice room was low. EVIDENCE: On the day of the inspection, work was being undertaken on the top floor in preparation for admission of residents with intermediate care. The home employs a maintenance person who is responsible for maintenance and safety checks, one of these relating to safe hot water. See also standard 38 Following a comment made at the previous inspection that here is no ramped wheelchair access from the conservatory to the patio, it was said that this is being addressed. All areas visited were clean except one sluice room. It was recommended that some of the urinals be replaced. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 A staffing structure is in place that provides consistency of care ensuring that residents’ needs are met. Residents are protected by the home’s recruitment policy and practice. A training programme ensures that staff are trained and competent to do their jobs. EVIDENCE: 27 Since the previous inspection, staffing has stabilised. Some adaptation nurses, having successfully completed their registration programme, have left and others recruited. Four members of staff are currently undergoing the adaptation programme. The inspector spoke briefly with one of the candidates who was enjoying the work and training programme. The home is accredited as a training centre for adaptation nurses. This means that candidates are already trained as nurses in their own country. The home provides mentorship in accordance with guidance provided by the Nurses and Midwives Council (NMC), which is the nurses’ regulatory body. The manager Mrs Smith is a qualified mentor. She and a deputy manager are to undertake further training in this respect. The duty rota was examined. For the morning shift, there were 2 registered nurses, 2 team leaders and 6 care staff. The manager reviews staffing levels regularly in order to ensure that staff numbers and competencies match the Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 16 dependency of the residents. With the new registration of intermediate care, additional staff are being recruited. Changes have been made to the management structure. As already referred to, a Director of Nursing has been appointed and there are now two deputy managers assisting the manager. See also standard 31 in respect of management. 29 Since the previous inspection, staff files have been reviewed and edited for which the member of staff responsible is commended. However, additional scrutiny must be evidenced of CRB requests and returns. It was said that job descriptions are being reviewed. 30 A training matrix and programme have been devised. NVQ training is encouraged. Recent training includes dementia care, adult protection and all statutory training. A senior team leader is currently enrolled in a management course and would also like to do an NVQ 3. For some staff whose first language is not English, English language classes are provided. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 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 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, 32, 33, 35, 36, 38 31 and 32 The manager, supported by a Director of Nursing and other senior staff has a clear development plan and vision for the home. 33 Residents’ views about the services the home provides are sought thus ensuring that the home is run in the best interest of the residents. 35 Residents financial interests are safeguarded. 36 and 38 The home’s policies and procedures, staff training and supervision ensure that the health, safety and welfare of the residents are safeguarded. However, an issue relating to safe hot water and central heating system was raised and needs to be addressed without delay. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 18 EVIDENCE: 31 and 32 Mrs Smith, the manager, has been in charge of Philbeach Care Centre since January 2005 and her application to be registered with the CSCI is currently being processed. She is half way through the Registered Manager’s Award. A Director of Nursing and two deputy managers support Mrs Smith. It is evident that the manager endeavours to run the home in the best interest of the residents 33 The home’s commitment to provide a good service is evident. Recently, residents were invited to complete a quality assurance questionnaire in respect of their satisfaction of the facilities and services the home provides. A summary of comments was seen. Feedback will be provided to all who contributed at the next residents’ meeting. 35 Excellent records were seen pertaining to the management of a residents’ personal allowance. 36 Following supervision training, a formal, recorded, two-monthly staff supervision programme has now commenced. In addition, structured staff meetings are carried out. These measures would ensure that staff are supervised, supported and well informed. 38 Recently the home experienced a problem with the hot water supply and heating system due to a boiler breakdown. The home managed well under the circumstances and the necessary repairs were carried out. In view of winter coming, the home must ensure that the heating system is adequate and in good order. Whilst hot water temperature checks are undertaken to ensure a safe temperature, these checks must include the top floor and if necessary, thermostatic control valves may have to be fitted. The responsible person, Mr Yilmaz, visits the home in accordance with Regulation 26. Accident records and incident reports are appropriately maintained and the manager informs the CSCI of every reportable event as per Regulation 37. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 3 x 2 Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 38.3 Regulation 23 (2) (p) Requirement That the central heating system is adequate and in good order. Timescale for action 30/11/05 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 Refer to Standard OP7 OP30 OP38 Good Practice Recommendations That care plans contain all care needs and provide sufficient detail for staff to provide the planned care. That the cause of malodour be investigated and the area kept clean at all times. That the hot water checks already carried out include the rooms on the top floor. Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Philbeach Nursing Home DS0000040740.V256991.R01.S.doc Version 5.0 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!