CARE HOMES FOR OLDER PEOPLE
Queensmead 1 Bronte Avenue Christchurch Dorset BH23 2LX Lead Inspector
Trevor Julian Unannounced Inspection 23rd January 2006 01:30 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 Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 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. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Queensmead Address 1 Bronte Avenue Christchurch Dorset BH23 2LX 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) 01202 485176 01202 487805 queensmead@dorsettrust.co.uk Care South Mrs L Thornhill Care Home 40 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (4), Old age, not falling within any other category (36) Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 36 in the category OP (Old Age) and 4 in the categories DE(E) and/or MD(E). 17th August 2005 Date of last inspection Brief Description of the Service: Queensmead is registered with the Commission for Social Care Inspection to accommodate 40 older people; this includes 4 places for people with a diagnosis of dementia or mental illness. Queensmead is operated by Care South, a non-profit making organisation with several residential homes and community services across the South West. Mrs L Thornhill is the registered manager. The home is situated in a residential estate close to Christchurch Hospital and one mile from the town centre. Queensmead is a purpose built home set in large, well-maintained grounds. Local shops and amenities are available within a short distance. The premises extend over 3 floors with service users accommodated on every floor. The ground floor comprises of 11 bedrooms, an assisted bathroom, 8 separate toilets, a dining room, two lounges, a conservatory and a smokers lounge. The first floor houses 15 single rooms, 2 bathrooms, one shower room and two separate toilets. The second floor has the remaining 14 bedrooms, two further bathrooms and two separate toilets. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place 23rd January 2006 between 13:30 and 16:30. The deputy manager was on the premises throughout the visit. The time taken for the preparation, travelling, inspection and report writing totalled eight hours. This was the second statutory visit carried out during the inspection year. Before the visit, comment cards had been received from residents and visitors to the home. Overall, the responses showed good levels of satisfaction with the care provided. Not all key standards are covered within this report; please refer to the previous inspection report for those standards. During the visit the views of the residents, visitors, staff and the deputy manager were sought. Further information was obtained through a tour of the premises and examination of records. For the purpose of this report the terms resident and service user are interchangeable. What the service does well:
Medication is safely stored and managed by the staff the procedures include checks and audits to reduce the risk of errors. Residents said the senior staff took the medication role seriously and they were confident that the correct tablets were given. The home offers a balanced and varied diet and there were plenty of drinks offered during the day and evening. One person was an early riser and said she appreciated her early morning cup of tea. The staff ask residents their opinion on the meals provided this is passed on to the chef. The manager was hoping to be able to carry out refurbishment the home and had applied for budget approval. The property was clean throughout. Residents said their clothes were normally returned from the laundry in good order. The washing machine had a sluicing cycle helping to aid infection control. The laundry was sited away from the food preparation and storage areas. The home had been successful in recruiting additional staff and reducing the reliance on agency carers to cover vacant shifts. Residents were pleased as it had improved their continuity of care. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 6 Staff confirmed the organisation had a good programme for both core and specialist topics. They identified areas for development and training during their regular staff supervision meetings. They were also encouraged to complete NVQ training. The home followed good recruitment practice and only employed people once the required clearances and references had been obtained. The senior team have good levels of experience and the manger has the required qualifications. Residents said the management were approachable and they could discuss any problems with them. Fire safety training and testing was up to date, lifting equipment had been tested by approved contractors. 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. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 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 Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 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): Not assessed during this visit. EVIDENCE: Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 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): 9 The home’s medication procedure helps to ensure that residents’ medication is safely stored and administered. EVIDENCE: The medication records showed that medication was checked into the home to provide an audit trail. The home uses a monitored dosage system supplied weekly by a local chemist. There were systems in place to record items started part way through the cycle, a second person checked manuscript entries to ensure there were no transcription errors. Medication stocks were held securely. Only senior staff were approved to manage the medication. There was a process for unused items to be returned to the chemist for disposal. The supplying chemist was due to complete an audit of the medication system. Residents confirmed that only senior staff managed their medication. One person said the tablets were administered at the correct time and she said there had been no problems with her medication.
Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 10 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): 15 The home offered a good choice of food for the residents, the available options were not always made obvious and the quality was sometimes poor. EVIDENCE: Since the last inspection the home had recruited a new chef and a new assistant was due to start shortly. Several people commented that they felt the standard of food was variable. One person commented that the residents were consulted after each meal by the care staff and the chef about the quality of the meal, they added that they had noticed an general improvement recently but said there was still room for improvement. The menu was written on the notice board in the dining room. In the entrance lobby there was further information about the menu including the option for omelette or salad if the two main choices were not suitable. One person said she had an omelette on one occasion; other people did not seem to know of the alternatives available. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 11 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): Not fully assessed during this visit. EVIDENCE: Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 12 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 premises provide the residents with a safe and clean environment. EVIDENCE: There were plans for ongoing refurbishment of the property and this had been included for budget approval. There were no major structural changes planned. The organisation had a maintenance team which carried out minor repairs. The rooms seen comfortable and warm. Residents were encouraged to personalise the rooms by use of pictures and photographs, items of furniture could be brought into the home subject to prior agreement. The rooms and main areas were cleaned to a good standard. The residents seen said the home was kept at a comfortable temperature and the staff worked hard to keep it clean. The laundry had one commercial washing machine and tumble dryer. As an aid to infection control the machine had a sluicing/disinfection cycle. Residents said the clothes were returned in good order from the laundry.
Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 13 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): 28, 29, 30 The initial and ongoing training programme helps to ensure that competent staff can provide the residents’ care safely. The organisation’s recruitment procedure helps to protect the residents by only recruiting suitable individuals. EVIDENCE: The home had been successful in recruiting more care staff. Residents said they felt the staffing of the home had improved and there was less reliance on agency workers to cover vacant shifts. Staff seen during the visit said the organisation’s training programme covered core skills including moving and handling, food safety, fire safety. The initial training covered basic skills and adult protection. Several staff had completed NVQ level 2 in care, the actual numbers were not checked during this inspection. Records were available showing the training each member of staff had completed. Training needs were discussed during one to one supervision meetings.
Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 14 The records of three new members of staff were checked, the records showed the home had followed good recruitment practice and evidence of the required references and clearances were on the file. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 15 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, 38 An experienced and competent team managed the home providing security and safety to the residents. Generally the home promoted good levels of safety for the residents one aspect of fire precautions needed to be addressed. EVIDENCE: The home continues to be well run by an experienced management team. The manager has the required qualifications. Residents said they could always raise concerns with the senior staff. Fire inspection records were up to date and the fire safety training programme showed the staff received three monthly updates. The fire drill records showed they were overdue and needed attention.
Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 16 During the tour of the premises several portable hoists and bath hoists were check each showed an approved contractor had inspected them. There were no hazardous chemicals seen left unattended. Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 17 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 18 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 OP38 Regulation 23 (4) e Requirement The registered provider must ensure that fire drills take place to ensure staff and residents are able to practice evacuation procedures. Timescale for action 28/02/06 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 Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Queensmead DS0000026862.V280236.R01.S.doc Version 5.1 Page 20 - 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!
