CARE HOMES FOR OLDER PEOPLE
Princess House 19 Cliffe Park Seaburn Sunderland SR6 9NS Lead Inspector
Clifford Renwick Unannounced 30 June 2005 10:00am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Princess House Address 19 Cliffe Park Seaburn Sunderland SR6 9NS 0191 548 3723 0191 548 4198 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr J Young & Mrs J Young Care home only 19 Category(ies) of OP Old age (19) registration, with number MD Mental Disorder (5) of places Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 25 January 2005 Brief Description of the Service: Princess House is a detached house standing in its own grounds and overlooking the seafront at Seaburn. Some people have described it as a landmark as it stands adjacent to the area, which is used to host the yearly Sunderland Air show.Though it is a three-storey building only the ground and first floor are used for residential accommodation. The top floor is used for administrative purposes and can also be utilised for staff training.Most of the bedrooms are single occupancy and many of the rooms have a sea-view. It is only a short walk from a busy shopping parade in Fulwell as well as being close to facilities in Seaburn. In addition to this a local bus service offers easy access to Sunderland City centre. The home as its own garden which offers disabled access and also a patio area to the side of the building as well as a conservatory, which offers sweeping views of the coastline.The home provides a service to older people over the age of 65 years and is registered to provide personal care for a maximum of 19 people that includes four people who may have needs related to dementia. It is not registered for people who have a physical disability.The home does not provide nursing care but individual service users can access services provided by the Community Health team and their own GP. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours and was carried out as part of the statutory twice-yearly inspection process. Selected areas of the premises, which included communal areas and some bedrooms, were viewed. Care records were examined as well as records that related to health and safety and social activities. Discussion took place with the staff on duty throughout the visit. Discussion also took place with 8 service users and one relative and time was spent observing staff practices and how staff spoke to residents. It was established that the people who live in this home preferred to be known as residents therefore this term of reference is used throughout the report. The judgements made are based on the evidence available at the time of the inspection. What the service does well:
There is a positive commitment by the owner to staff training and this has ensured that staff have had opportunities to develop their individual knowledge and skills. There is stability within the staff team with many of the staff having worked in the home for a considerable number of years and this has ensured that they are consistent with their work. There is also a nice atmosphere in the home and which residents stated was one of the nicest things about living in the home. This comment was also supported by a relative who stated that there is always a nice atmosphere when they visit the home and that staff are always pleasant. Staff work well with residents and ensure that residents wherever possible are encouraged to lead a full and active lifestyle both inside and outside of the home and this was evident from observations and also from discussion held with residents. Observations made confirmed that staff are professional in their approach with residents whilst at the same time able to share a laugh and a joke and this contributed to the positive atmosphere. Residents stated that this is a “nice home” and “they like living here”. The building is well maintained, clean, in good decorative order and residents are encouraged to arrange the furniture in their rooms to suit them.
Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 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. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 A comprehensive assessment is completed for all prospective residents prior to moving into the home to ensure that their individual needs can be met. The manager then reassures residents and their relatives that their needs can be met in the home and confirms this in writing to them. EVIDENCE: Since the last inspection two new people have moved into the home. Examination of their case files confirmed that comprehensive assessments are in place in addition to risk assessments and these have led to care plans being developed to demonstrate how assessed needs are to be met. The manager and staff have involved relatives and families of service users in compiling personal information about resident’s previous lifestyle to assist them in delivering personal care. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 The Health and personal care needs of residents based on their care plans are met in a way, which treats them with respect and promotes their rights and privacy. EVIDENCE: Individual care plans are used which demonstrates how staff will meet individual residents needs. Each resident has a named key worker who holds special responsibility for developing the care plans with support from the manager to ensure that the appropriate level of need is being addressed. Examination of individual care files confirmed that staff carry out monthly evaluations and make any amendments to the care plan to reflect changing needs. Work in this area is continuing to be developed by staff and the manager and advice was offered as to how these could be developed further. Daily health sheets that staff have introduced demonstrate how individual residents health needs are met and offer clear evidence that all NHS services are accessed. Observations throughout the visit confirmed that staff are respectful in their discussions with residents and refer to them by their chosen form of address. Personal and intimate care tasks are carried out in private and staff were observed knocking on bedroom doors and waiting to be invited in before entering the room.
Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 10 There was a good rapport between staff and residents and also visiting relatives and this is consistent with previous visits to the service. For those residents who are able, staff encourages them to become involved with their individual care plan. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15 Social activities both in and outside of the home are well managed enabling residents to make positive choices about how they spend their day and friends and families are very much a part of this process. The meals services are good and residents are involved in menu planning. This contributes to the promotion of healthy eating. EVIDENCE: Information contained in resident’s files confirmed that their interests and routines are recorded and this assists staff in ensuring that the service meets the resident’s expectations. For one resident this is very specific and includes guidance for staff as to what breakfast arrangements have to be in place and what foodstuffs have to be provided and this has ensured that the resident is satisfied with the arrangements in the home. Throughout the day residents went out with staff or their family and also unaccompanied and in discussion with residents they said that this was good thing being able to go out. A daily bulletin sheet listed activities which are planned for the day and which cover one month. Discussion with residents confirmed that the activities take place and that they enjoyed them. Some of the activities included knitting and listening to talking books and these had been included at the resident’s request.
Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 12 A meal was taken with residents and this was hot, well presented, sufficient in quantity and very tasty. A range of hot and cold drinks were available throughout the meal and the process of dining in the home was relaxed and unhurried offering residents the opportunity to sit and chat after the meal. Menus confirmed that a good range of meals are provided and these included what residents described as being good old fashioned cooking. Discussion with residents confirmed that they looked forward to meal times and they confirmed that the food is always nice. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 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 standard(s) 18 Complaints in the home are handled objectively and openly with the manager and staff encouraging residents, their friends and families to offer comment on the services that are offered. Residents are confident that any complaints made would be acted upon. EVIDENCE: Discussion with the manager confirmed that each resident and their relative have been issued with a copy of the homes complaints procedure. In addition to this a copy of the homes complaints procedure is available on display in the entrance lobby. In discussion with residents they stated that they had no complaints about the service but if they did they would just inform the owner/manager knowing that it would be acted upon immediately. In discussion with a relative who was visiting the home they to confirmed that they would have no hesitation in discussing any concerns with any of the staff knowing that staff would respond positively. They went on to say that staff listened to the views of the residents and were always pleasant and this in their view was a quality, which ensured that there are rarely any complaints. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 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 standard(s) 19, 26 The building is well maintained and in good decorative order, which ensures that residents have a pleasant and safe environment to live in, however the practice of staff wedging doors open must cease. EVIDENCE: Some upgrading has been carried out in the home and this has involved new fire sensors and a fire panel to ensure that the home continues to comply with the safety requirements of the fire authority. Discussion took place with the manager and staff about the use of wedges to hold open doors and advice was offered as to what alternative methods and devices are available in order to ensure that the safety of residents and staff is not compromised. The home is clean and tidy and the gardens, which offer a pleasant area for residents to sit in, are well maintained. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 The deployment and number of staff on all shifts is appropriate to ensure that at all times residents are supported by an experienced group of staff. All staff as well as the manager is undergoing training appropriate to their work and this ensures that they are up to date with current practices. EVIDENCE: One of the owners recently achieved the Registered Managers Award and the Lord Mayor at an official ceremony presented his certificate of achievement. One person has ceased to work in the home and the staff team are covering the hours until a person can be appointed. Staff rarely leaves this home and this has contributed to a stable workforce who work well as a team. Staff have completed training in moving and assisting and are currently receiving training in infection control. Discussion with the manager confirmed that arrangements are being made for staff to receive specialist training in caring for people with dementia type illnesses. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 38 One of the owners who also carries out the managers role offers clear leadership and direction to the staff and this has resulted in well-trained workforce who offer consistency of care to the residents. The practices of wedging doors open and storing items inappropriately could compromise the safety of service users and as such must cease. EVIDENCE: All staff are designated as a key worker for residents and they are involved in developing the care plans with them and also their families. The manager is offering support and any training and development needs are identified in staff appraisals. Written evidence was available which confirmed that all electrical equipment is tested on a regular basis to ensure that it is safe. A maintenance plan is in place that ensures that an external company carry out safety checks. An internal quality assurance system is in place, which demonstrates how policies and procedures are regularly evaluated and amended as required.
Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 17 As previously stated in this report staff were wedging doors open and also a resident had chosen to wedge their door open. This compromises safety and staff should look at alternative methods of doors being held open by devices, which are approved by the fire authority. An assisted bathroom was being used for storage and advice was offered on this matter. Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 4
COMPLAINTS AND PROTECTION 2 x x x x x x 3 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 Standard No 16 17 18 Score x x 4 x 3 3 3 x x x 2 Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 19 No 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. Standard 7 38 Regulation 15 23 Requirement Timescale for action 31.12.05 Residents care plans must continue to be developed as disucssed during the inspection. Fire doors must not be wedged Immediate open and bathrooms must not be used for storage. 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. Refer to Standard Good Practice Recommendations Princess House B52 B02 S15714 Princess House V219607 300605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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