Inspection on 08/01/07 for Prideaux House

This inspection was carried out on 8th January 2007.

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.

Other inspections for this house

Prideaux House 14/01/09

Prideaux House 22/02/06

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 Gwyneth Bryant Unannounced Inspection 8th January 2007 08:00 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.V323498.R01.S.doc Version 5.2 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.V323498.R01.S.doc Version 5.2 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 01323 749449 adrianaustin@hotmail.co.uk Prideaux House Care Limited Vacant Care Home 20 Category(ies) of Dementia (20) registration, with number of places Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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. Those only service users with a dementia type illness are accommodated. 22nd February 2006 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 with a stair lift giving access to the upper floor. There is a large lounge at the front of the house and a separate dining room that providing direct access to the large attractive garden at the rear of the property. Accommodation comprises sixteen single and two double rooms, of which four have full en-suite facilities. All bedrooms have at least a wash hand basin. There are five communal toilets and three bathrooms all of which are assisted. The service provides prospective service users or their representatives with a copy of the homes brochure, statement of purpose, service users guide and an offer to visit in the first instance. Contracts are completed at the time of admission and a copy of the homes latest inspection report is available on request. The range of fees charged as from 1 April 2006 is from £500 to £700 per week which includes in-house activities. Additional charges are made for hairdressing, toiletries, chiropody, newspapers and dry cleaning. Intermediate care is not provided. Currently the home does not have a website. Work is on going to upgrade the electrical and call bell systems and to refurbish and renovate all areas of the home. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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 ‘residents’ to describe those living in care home settings. For the purpose of this report, those living at Prideaux House will be referred to as ’residents’ at their own request. This was an unannounced inspection and there were eighteen people in residence on the day. The inspection was undertaken over 8.5 hours and a number of documents and records were viewed; including personnel files, medication charts and care plans. A tour of the premises was carried out. Four residents, three relatives, two carers, the acting manager and registered provider were spoken with during the site visit. Prior to the inspection a preinspection questionnaire was sent to the home to be completed with information required as part of the inspection process. This was returned and information detailed is used in this report. Six service user surveys were returned and in the main comments were positive and included: ‘the food is excellent’. ‘overall I am happy with the care and support I receive’. ‘I am as happy as I can expect to be when I am not in my own home’. ‘(re complaints) I don’t have any to make’. ‘staff are generally very helpful and will listen if you need help’. ‘the care given to me by staff has always been very satisfactory’. ‘very good care and attention’. Discussion with the acting manager and registered provider found that they welcomed the site visit and were keen to address any shortfalls as quickly as possible. What the service does well: The staff team are competent and enthusiastic and aim to provide person centred care to each resident. The home liaises well with a variety of healthcare professionals who support the acting manager and staff to ensure that residents’ health and welfare needs are met. Staff were observed to interact positively with residents and it was evident that staff and resident relationships are based on trust and respect. The residents spoken with all had very positive comments to make about the home and its staff. The home has a satisfactory care planning system that ensures most of residents’ needs are identified and planned for. The atmosphere in the home was very comfortable and communication between the staff and residents was friendly and relaxed. All parts of the home are clean, tidy. Furnishings are of good quality and the décor is good throughout. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 6 Menus are varied and provide a well balanced diet, with alternatives to the main meal available. Residents are encouraged to undertake varied activities within the home and visitors are welcome at all times. 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. The summary of this inspection report can be made available in other formats on request. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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.V323498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4. Standard 6 is not applicable Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives are provided with sufficient information on the services provided to enable them to make a decision as to whether or not the home can meet their needs. Improvements need to be made to the pre-admission care assessment process to ensure the home is able to meet residents assessed needs. EVIDENCE: The home has a statement of purpose, brochure and residents guide which are included in the information pack given to prospective residents or their representatives. All residents or their representatives are provided with a contract which includes the terms and conditions of residence and a copy is held on file. One relative spoken with confirmed that they were given information at the time of admission and this was also confirmed in the returned surveys. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 9 A pre-admission assessment is made prior to residents moving into the home, the assessment sheet needs to be expanded to incorporate all aspects of residents social, physical and emotional needs and demonstrate how needs are to be met. Intermediate care is not provided. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All aspects of residents’ health, social and care must be identified and planned for, in order to clearly direct staff in the delivery of appropriate care. EVIDENCE: A computerised care planning system has been implemented and five of the plans were viewed, in conjunction with the daily records and it is evident that residents care needs are identified and that pre-admission assessments are used to inform the care planning process. While the plans were generally satisfactory, some shortfalls were identified. In order to ensure staff are clearly directed in the delivery of care, the plans need to be more specific. One plan said that the resident was to be encouraged to take short daily walks but this had not been programmed into the daily routines. While staff were observed to deliver appropriate care and both residents and relatives said good care was given, this is not recorded, therefore care documents do not accurately reflect the work carried out by staff and the positive outcomes for residents. Basic risk assessments had been carried out but those relating to falls need to be Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 11 more detailed, as there have been a high number of falls during the last three months. Care plans included detailed information on healthcare needs including dental, hearing and eyesight checks. There was evidence to demonstrate that input from GP’s and district nurses was obtained when required. Residents and relatives spoken with were positive about all aspect of the care given and comments included: ‘they (staff) are marvellous’ ‘I cant fault them’. ‘they are always so cheerful’ ‘they are so kind, always’. Relatives spoken with said they are kept informed of any changes to residents care needs and, are consulted regularly on the care given. Medication storage and administration records were inspected and it was found that some prescribed creams and eye drops needed to be stored in the fridge. This was discussed with the acting manager who addressed this immediately and placed the items in the medication fridge. Two items of medication were found to be in unlabelled containers, this puts residents at risk as staff are unable to determine what the medication is for nor for whom it is intended and this needs to be rectified. Throughout the site visit staff were observed to treat residents with care and respect. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service There are systems in place for residents to experience a lifestyle that matches their expectations, choice and preferences in respect of both leisure and meals. EVIDENCE: The home has a daily programme of activities and outings to local theatres are also arranged. Activities provided include music for health, exercises, art and crafts and visiting entertainers. All residents and relatives spoken with confirmed there is a variety of activities and this was confirmed in the surveys with responses to the question about activities comments including: ‘I think they do very well’ ‘there are activities every day but sometimes I am unable to participate, but that is my choice’. ‘the staff are helpful and very good with activities’. ‘activities are arranged every day but I do not always wish to participate’. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 13 ‘there is freedom to invite my friends and family and always they are made to feel welcome and I have been welcomed here’. Three relatives were spoken with during the site visit and they each confirmed that they are always made welcome and offered refreshments. One confirmed that visitors may stay for meals if they wish to do so. On the day of the site visit three activities were provided, including a ‘sing a long’ led by staff, an exercise session and a manicure session. It was evident that residents welcomed these activities and very much enjoyed them. Activities were discussed with the acting manager who was aware that short and varied activities were best suited to this client group. The menus were viewed and it is evident that balanced and nutritious meals are provided daily. Alternatives to the main meal are offered each day and snacks and drinks provided at regular intervals. Food was an area that was highly praised by those people spoken with on the day and in response to the survey questions. Comments included: ‘the food is excellent’ ‘there is always a good choice of food and always an alternative if you dislike something. The food is of a good standard’. ‘I have an option to choose’. ‘being a vegetarian I am always given the food that I like’. ‘the food is always lovely’. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that residents feel that their views are listened to and acted upon and residents are further protected by satisfactory adult protection systems. EVIDENCE: The home has detailed policies and procedures on complaints and the homes complaint book was viewed. There was evidence to demonstrate that complaints are listened to and appropriate action taken to address any issues. Responses to the survey question on complaints included: ‘I would speak to one of the staff’ ‘ I would look to (name) and (name) for any help I needed’. ‘I would go to headquarters and ask them to put it right’. Residents spoken to on the day confirmed they could speak to the acting manager, registered provider or staff if they had any concerns. All said they have yet to find a reason to make a complaint. The home has detailed policies and procedures on adult protection and all staff have been trained and knowledgeable about adult protection procedures. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The standard of decor within the home is good, and all areas are homely, safe and comfortable for residents. EVIDENCE: A tour of the premises was carried out and there is a planned and wellmanaged refurbishment programme in progress. The programme includes upgrading and refurbishing residents’ bedrooms and this was discussed with the registered provider who confirmed that residents are actively encouraged to choose the style of bedroom furniture and the colour scheme. On the day of the site visit, one resident was looking at some recently refurbished rooms so she could decide which she would prefer in her own room. Residents’ rooms were attractively decorated and it was evident that many had taken the opportunity to personalise their rooms with pictures and ornaments. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 16 The gardens are attractive and well maintained and all residents spoken with said how much they enjoyed taking walks in the garden, weather permitting. Laundry facilities are clean and hygienic. Systems are in place for the control of infection and all staff have been trained in this area and were observed to be working in ways that minimised the risk of infection, by wearing gloves and aprons when required. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service The number of staff and the skill mix is such that residents’ needs are met and consistent care is provided but improvements need to be made to staff induction. The recruitment practice is not robust and does not provide sufficient safeguards for the protection of residents. EVIDENCE: Pre-inspection information from the manager indicates that staffing ratios are sufficient to meet residents assessed needs and this information also confirmed that five staff have achieved National Vocational Qualification level 2 or above, in care, and there is a plan to ensure that the target of 50 of staff with this qualification is met as soon as possible. Two staff spoken with confirmed they are due to begin the NVQ 2 course during January. Residents and relatives spoken with confirmed that there always appeared to be sufficient staff on duty and that staff had time to chat. Evidence was available to demonstrate staff also received additional training in manual handling, emergency first aid, health and safety and the safe handling of medication to ensure they are sufficiently skilled to meet residents’ needs Residents spoken with said they felt well cared for and confirmed that staff answer call bells promptly. Staff spoken with were confident with the support and direction provided by the registered provider and acting manager. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 18 On viewing five staff recruitment files it was apparent that the required level of documentation was not in place for all staff, although Protection of Vulnerable Adults first checks and Criminal Record Bureau checks had been obtained for all staff. Improvements to the recruitment process need to be made in that a full employment history needs to be provided and a written explanation made for all gaps in employment. In addition proof of identity such as passport, birth certificate needs to be provided and all staff need to have two written references, proof of qualifications, and work permits for overseas staff. Although there is a staff training programme in place, records showed that staff induction was carried out in one day and this is insufficient to ensure new staff understand care practices at Prideaux House. The two staff spoken with confirmed that induction was carried out within one day. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Staff and residents benefit from clear leadership and direction and all aspects of residents’ health, safety and welfare are protected and promoted. EVIDENCE: The acting manager has achieved NVQ 3 in care and is due to complete the registered managers award within the next eight weeks. She was noted to be knowledgeable about good care practices and was aware of residents individual care needs. It was evident that staff were comfortable in approaching both her and the registered provider with any concerns, which indicates an open, inclusive and positive approach to management. The registered provider visits the home at least once a month and the subsequent reports were available for inspection and comment cards are given to relatives as part of the quality monitoring system. Quality monitoring needs Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 20 to be further developed to encompass all parts of the service to enable the provider to objectively evaluate the service and ensure it is run in residents’ best interests. Relatives spoken with confirmed that they are encouraged to speak to the manager or provider should they have any concerns. The home does not handle the finances of any resident and their representatives are notified if residents need anything. Staff documents showed that regular supervision is provided and staff spoken with confirmed these sessions were useful in providing an opportunity to discuss care practice and training needs. Information in the pre-inspection document confirmed that safety checks are carried out on all electrical and gas systems and appliances and that they are serviced annually. In addition documents relating to safe working practices and Health and Safety are available and regularly reviewed. Accident records were viewed and it was found that they are maintained in accordance with health and safety guidance. The acting manager confirmed that all the requirements made by the fire safety officer had been met and work was ongoing to address the recommendations made. There was evidence to demonstrate that all staff had received fire safety training and fire drills had also been carried out. Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 21 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 22 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 OP3 Regulation 14 (1ac) (2ab) Requirement Timescale for action 08/03/07 2. OP7 3. 4. OP9 OP29 4 5 OP30 OP33 That pre-admission assessment documents are expanded to include all the information under Standard 3. 13 (4) aThat risk assessments for those c) at risk of falls are more detailed and include direction to staff in reducing the risk. 13 (2) That all medicines are appropriately labelled. 19(4)(a-c) That all staff provide the required documentation prior to appointment, including a full employment history and written explanation of any gaps, work permits if appropriate, evidence of qualifications, proof of identity and 2 references. 18(1ac) That induction is carried out in (i)(ii) accordance with the Care Skills Sector guidance. 24 (1ab) That formal quality monitoring (2)(3) and quality assurance systems be expanded to include all aspects of the service. 08/03/07 08/02/07 08/02/07 08/03/07 08/03/07 Prideaux House DS0000064971.V323498.R01.S.doc Version 5.2 Page 23 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.V323498.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V323498.R01.S.doc Version 5.2 Page 25 - 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. 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