Inspection on 22/02/06 for Prideaux House

This inspection was carried out on 22nd February 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Prideaux House 14/01/09

Prideaux House 08/01/07

Prideaux House 20/09/05

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

CARE HOMES FOR OLDER PEOPLE Prideaux House 21 Prideaux Road Eastbourne East Sussex BN21 2ND Lead Inspector Angela Gunning Unannounced Inspection 22nd February 2006 1:30 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 Prideaux House DS0000064971.V270293.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. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Prideaux House Address 21 Prideaux Road Eastbourne East Sussex BN21 2ND 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) 01323 726443 Prideaux House Care Limited Mrs Lynda Nichols Care Home 20 Category(ies) of Dementia (20) registration, with number of places Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That service users are aged sixty-five (65) years or over on admission. A maximum of twenty (20) service users are accommodated. That only service users with a dementia type illness are accommodated. 20th September 2005 Date of last inspection Brief Description of the Service: Prideaux House is a care home registered for 20 older people with a dementia type illness. The home is a large detached house situated in a residential area of Eastbourne, close to the town centre and the District General Hospital. Accommodation is situated on three floors that are accessed by stairs, with a newly installed stair-chair lift and grab rail to assist residents and staff. There is a large lounge at the front of the house and a separate dining room that has access to a large rear garden. The staff provide person centred care to each resident are a competent and enthusiastic team, who work well together. The home liaises well with a variety of healthcare professionals who support the Manager and staff to ensure that residents’ health and welfare needs are met. Prideaux House DS0000064971.V270293.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 Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Prideaux House have requested to be referred to as ‘residents’. This unannounced inspection took place over four hours on 22nd February 2006. This is the second inspection of this year and therefore this report should be read in conjunction with the report from the inspection carried out on 20th September 2005. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. Parts of the environment were inspected, including the communal areas and some of the bedrooms. Two care plans and two staff records were examined. Several people were spoken to, including six residents, a relative, the Manager, assistant manager, four carer assistants, the cook and the Provider. What the service does well: Prideaux House continues to maintain an effective staff team who attend competently and sympathetically to each person using their caring skills to ensure people’s health, emotional and social needs are met. Each resident has a person-centred care plan that offers the staff guidelines and plans on how to maximise each person’s wellbeing. The health needs of residents are monitored on a regular basis and are well met. Staff encourage service users to retain and make choices where possible and the individuality of each person is respected. The arrangements for leisure and social activities provide good opportunity for mental and physical stimulation and promote independence, choice and wellbeing. Prideaux House continues to provide a high standard of homemade and freshly prepared meals, with a varied and flexible menu that takes account of residents’ likes, dislikes and dietary needs. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Prideaux House DS0000064971.V270293.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 Prideaux House DS0000064971.V270293.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): 3 Although a pre-admission assessment is carried out on every individual prior to them moving into the home, the home needs to consider the acceptance of emergency placements to ensure that the home can meet each person’s physical, emotional and social needs. EVIDENCE: The manager carries out a preadmission assessment of prospective residents and obtains information from relatives before they move in. However, the CSCI carried out a complaint investigation in October 2005 and it was found that the Manager of Prideaux House was not given all the necessary information from all relevant parties involved in the placement of one resident and the home was asked to carefully consider the acceptance of emergency placements and to ensure that a thorough preadmission assessment is carried out to obtain all necessary and correct information i.e. where there is little or no family available for input, a discussion with the GP and other people who have been involved with the person, so as to be aware as possible of their needs. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 Each resident has a person-centred care plan that offers the staff guidelines and plans on how to maximise each person’s wellbeing. The health needs of residents are monitored on a regular basis and are well met. EVIDENCE: Each person’s care plans has been developed from the pre-admission information obtained by the manager, information from relatives and through awareness and observation during the first few weeks of residency. Each care plan contains both a short and long term assessment, with adequate information and guidelines to enable the staff to care for each person’s ongoing health and welfare needs. Staff confirmed that they ‘read through all the care plans during their induction training’ and it was noted that staff make use of the care plans in their day-to-day care giving. Throughout this year it has been noted that the manager and staff at Prideaux House endeavour to liaise effectively with a variety of healthcare professionals, such as General Practitioners and District Nurses and Community Psychiatric Nurses, following a needs assessment or at the request of the individual or their relative. Preventative measures are in place to ensure that resident’s pressure area needs are met. A Chiropodist and Hairdresser visit the home on Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 10 a regular basis. One resident’s son spoken with during the inspection said that the staff have assisted and encouraged his mother to regain her mobility, which was not happening at her previous care home. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The arrangements for leisure and social activities provide good opportunity for mental and physical stimulation and promote independence, choice and wellbeing. Prideaux House continues to provide a high standard of homemade and freshly prepared meals, with a varied and flexible menu that takes account of residents’ likes, dislikes and dietary needs. EVIDENCE: The home provides a variety of regular activities; such as music and singing entertainers every week and staff engage residents in quizzes, board games, and ball and beanbag exercises. During this inspection residents were noted to enjoy the weekly music man session and staff were noted to interact and engage positively with residents on a one to one basis. Residents are encouraged and supported to maintain contact with their relatives and friends and any hobbies or interests. Several relatives were visiting residents during this inspection. Staff encourage service users to retain and make choices where possible, such as what to wear, what to eat and what activities to be involved in. Residents Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 12 are asked where they would like to eat their meals. The individuality of each person is respected. Residents are provided with homemade and freshly prepared meals every day. The cooks prepare a roast dinner and fish dishes twice a week and on the day of the unannounced inspection, the residents, staff and the Inspector were given a chicken roast dinner with all the trimmings, such as bread sauce and stuffing balls. The Inspector noted there was an enjoyable and relaxed atmosphere in the dining room at suppertime and residents were offered a choice of cakes and were shown each one to assist them in making a choice. Hot drinks and homemade cakes and biscuits are provided for all residents and their visitors throughout the day. Prideaux House DS0000064971.V270293.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 The homes’ policy and procedures for dealing with concerns or complaints ensures that residents and relatives are listened to and that complaints will be acted upon. The home has developed their arrangements for staff knowledge and understanding of Adult Protection issues to prevent residents being placed at possible risk of harm or abuse. EVIDENCE: Residents know who to speak to if they are unhappy about their care at Prideaux House and relatives are fully aware of the home’s complaint procedure. The CSCI carried out a complaint investigation in September and October 2005 following an incident that had caused a neighbour concern, which was reported to the CSCI in September 2005. The incident raised concerns in respect of the standard of care and support given to residents at nighttime and this was found to be unsubstantiated. However, as highlighted earlier in the report it did raise issues around the acceptance of emergency placements and the importance of carrying out a thorough preadmission assessment. It also raised issues for Adult Social Care assessment and placing procedures as well as ensuring that prospective residents are made fully aware of the details of their placement. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 14 The new in-house training package provides some knowledge and understanding of Adult protection issues and the homes’ policy and procedures now reflects local multi-agency procedures to ensure that residents are not being placed at possible risk of harm or abuse. Prideaux House DS0000064971.V270293.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, 22, 24, 26 Prideaux House provides residents with an attractive, homely and wellmaintained place to live. Arrangements have been made to provide residents with easier access to all parts of the home. EVIDENCE: Prideaux House was seen to be clean and tidy, with all communal and private rooms decorated and furnished to a good standard. There is ongoing redecoration and refurbishment, with some new chairs in the lounge and the old ones are gradually being replaced. There are new carpets in the hallways and in some bedrooms and plans to replace them in the communal areas. A new stair/chair lift has been installed so that residents with mobility difficulties now easily access the bedrooms and bathrooms on the first and second floor. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Prideaux House continues to maintain an effective staff team who ensure residents’ needs are well met. The recruitment, induction and training of staff offer protection to the residents living at the home. EVIDENCE: It was noted that Prideaux House continues to maintain a good and supportive staff team. At the time of the inspection there were four care staff, the Manager and assistant manager in the home. The new Provider was also in the home and had done the shopping for the home. During the inspection one resident began to choke on her scone and it was noted that staff attended competently and sympathetically to this person and used their caring skills to ensure both her health and emotional needs were met and reassured her that she was safe. Staff are currently working through a new in-house training package that provides them with knowledge and understanding in various aspects of care, to enable them to perform their job appropriately. All staff receive external and in-house training in Dementia Care, which is ongoing. New staff have an extensive induction programme. Recruitment files were checked and these were seen to contain the relevant information, including Criminal Records Bureau (CRB) checks. Prideaux House DS0000064971.V270293.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, 33, 36, 38 There are clear lines of accountability within the home and the management team ensure that the home is managed appropriately. Satisfactory quality assurance procedures are being implemented to monitor the quality of the service and facilities provided by the home. The home needs to ensure there are satisfactory arrangements in place to ensure that the health, safety and welfare of residents and staff are maintained at all times. EVIDENCE: There is a Registered Manager in situ. However, she agreed to continue in this capacity as Manager to support and assist one of the senior carers to gain the experience and knowledge to be put forward as the registered manager. This arrangement is going well and the assistant manager has been proactive and effective in her duties to date. Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 18 Although formal monthly Regulation 26 monitoring visits have not been carried out by the Provider, he has been in the home on a regular basis monitoring the quality of service and facilities since the purchase and will now carry out these visits as required and produce a report that will be given to the Manager and CSCI. Staff are supervised on an ongoing informal basis and formal supervision (one to one support sessions) have now been implemented since the previous inspection. It was noted that some bedroom and communal doors were being wedged open and the Provider confirmed that he would look into supplying hold open safety devices to be fitted to doors in the communal areas and to residents bedroom doors, where they request these to be left open at night time. During the tour around the environment the Inspector requested that a bedroom screen that was propped up against a wall, be removed to reduce the risk of it falling on a resident. Also that some aerosol cans be put away as they were left on a sideboard. Prideaux House DS0000064971.V270293.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 2 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 X X 3 X 3 X 4 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 2 Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 20 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 2 3 4 Standard OP38 OP38 OP38 OP3 Regulation 23(4) 13(4) 13(4) 14(1) Requirement That doors are not wedged open. That bedroom screens are stored safely and appropriately. That all aerosol cans are not left out and are stored away as per COSHH procedures. The home needs to consider the acceptance of emergency placements to ensure that the home can meet each person’s physical, emotional and social needs. Timescale for action 22/02/06 22/02/06 22/02/06 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Prideaux House DS0000064971.V270293.R01.S.doc Version 5.0 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Prideaux House DS0000064971.V270293.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. 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