Inspection on 28/06/05 for Quenby Rest Home

This inspection was carried out on 28th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Quenby Rest Home 10/01/08

Quenby Rest Home 16/05/07

Quenby Rest Home 16/11/06

Quenby Rest Home 03/11/05

Quenby Rest Home 05/01/05

Quenby Rest Home 12/08/04

Quenby Rest Home 09/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Quenby Rest Home Brightlingsea Road Thorrington Colchester, Essex CO7 8JH Lead Inspector Sara Naylor-Wild Unannounced 28 June 2005 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. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Quenby Rest Home Address Brightlingsea Road Thorrington Colchester Essex CO7 8JH 01206 250370 01206 250787 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 A Sandhu, Mr Avtur S Sandhu Mr Sukvir S Sandhu and Mr Surinder Sandhu Ms Alison Simmons Care Home (CRH) 26 Category(ies) of Old age, not falling within any other category registration, with number (OP), 26 of places Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 26 persons). Date of last inspection 05/01/2005 Brief Description of the Service: Quenby is a former domestic dwelling located on the main Colchester road to Brightlingsea. The property is among established houses of similar age and design. The premises have been extended to the rear to provide the current accommodation comprising of mainly single rooms, most of which have ensuite facilities. There are four lounge/dining areas located to the front, centre and rear of the building providing varied and accessible space. The front garden is mainly laid to hard standing for vehicle parking. The rear garden is mainly laid to lawn with shrubs and trees. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was carried out in June over 6 hours although the inspection process was not completed until 22nd July when additional information was provided by the provider. A total of 23 standards were assessed on this occasion, and of these 15 were rated at 3 and meet the National Minimum Standards. This represents an approximate compliance level of 65 , and is an improvement from the previous inspection. Of the 7 National Minimum Standards inspected that were rated below 3, four are repeat requirements. Overall this indicates an improving service which is gaining ground in meeting the National Minimum Standards, and it is the task of the management team to ensure that this will continue to be reflected at subsequent inspections. The application to vary the category of care to accept service users with dementia was considered again at this inspection. Although there is continuing work to be done in areas such as care planning and activities, there was sufficient progress, in areas such as training and development, for the Commission to consider a partial and staged development of this specialism, in line with the development of the skills and experience of the service and staff group. The inspection process included discussions with service users, the manager and staff, a tour of the home and examination of documents relating to the service, such as care plans. What the service does well: The manager and staff are responsive to developments in good care practice and demonstrated a commitment to improving the service. The care planning records contain a good level of information that indicates to staff how service users’ needs can generally be met. The home’s wish to develop specialist dementia care as part of the service it offers, requires further development of these documents to ensure they provide a more person centred approach, which highlights abilities of service users as well as their need for support. Service users’ comments regarding meal provision has consistently been positive, and there was a proactive response to monitoring preferences and meals taken by service users. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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 Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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) 2, 3 and 6. Each resident is provided with a statement of terms and conditions and/or a contract with the home. There are assessments of need carried out prior to prospective residents’ admissions. The home does not provide intermediate care. EVIDENCE: A selection of residents’ files sampled contained copies of contracts that set out the terms and conditions of residency and the fees charged. These were signed off by a representative of the home and the resident or their representative. Residents’ files also contained evidence of assessments that had been carried out prior to admission to determine the individual’s needs and how these should be met. The home does not provide intermediate care and all relevant documentation, such as Statements of Purpose, clearly set this out. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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, 6, 9,10 and 11. There are care plans for each individual resident, however these require further development to demonstrate a person centred approach to care provision. Residents’ health care is appropriately monitored by the home. Medication administration did not meet the standard at this visit. Residents are treated with dignity and respect by staff. The wishes of residents in regard to death and dying are discussed and recorded by the home. EVIDENCE: The care plans of three residents were sampled at this inspection. These contained information that would to some extent support staff in addressing residents’ assessed needs. However, from discussions with staff and observations of issues affecting residents, it was clear that the general sweep of objectives and the instructions to staff were not specific or person centred Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 10 enough. This means that whilst staff could, for example, generally support a resident’s needs in upholding their personal hygiene standards, they would not from the instructions in care planning understand the specific way in which this should be done to increase the service user’s independence in this task. The care plans identified residents’ health concerns and the assistance and advice sought from health professionals. Discussions with the staff and manager identified issues relating to out of hours calls to GPs for minor wound dressing. These calls to local surgeries had been redirected to paramedic services. The manager was advised to approach the surgery with this issue, in her capacity as advocate for residents’ access to health services. Inspection of the records and practice relating to administration of medication was, on the day of inspection, to a good standard. However, a cross reference of medication records and tablets dispensed highlighted several incidents of non-compliance. This was brought to the manager’s attention at the time and discussions held regarding the action required to address this. Residents spoken with during the inspection all felt the staff were of a high quality. In particular, they felt that staff were always polite and ensured that their privacy was upheld. They never heard them discussing other service users and said they had faith that confidentiality was maintained. Residents’ care plans included a sheet that asked for details of service user’s wishes and arrangements in the event of terminal illness and death. These were fairly basic details that may need adding to as they discover more about residents. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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, 13,14 and 15. The home provides some opportunities for participation in activities, however these should be reviewed to ensure they provide sufficient scope to meet service users’ individual expectations and abilities. The home supports the contact between service users and their families and friends. There is a variety of good quality foods on offer which provides a balanced health diet to service users. EVIDENCE: Service users spoken with during the inspection day, identified that although they were aware of some activities provided by the home, they did not feel that there was sufficient variety to interest all service users. Service users also stated that they were supported in maintaining contact with their family and friends, through visits, letters and telephone calls. They felt that visitors were made to feel welcome and the home and staff offered visitors refreshments. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 12 They also discussed with the inspector aspects of their daily routine and were clear about the range of choice they had in determining how their day was spent. This varied according to the abilities of the service user, but generally it was felt that they were not restricted by the home or its policies. The meals served during the inspection visit appeared appetising. There was a choice of main course during the lunchtime serving and the inspector was able to ask service users during the meal for their comments. Generally these were favourable, with compliments for the range and variety of meals on offer. Some comments regarding the cooking of vegetables and individual tastes were made to the inspector, which service users said they had made the cook aware of. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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) 16 and 18. The home’s complaints policy is operational and service users were aware of the procedures. The adult protection procedures are in place to protect service users. EVIDENCE: The manager confirmed that the home had not investigated any complaints about the service during the period since the previous inspection. The CSCI had not received any complaints about the service during the same period. The complaints procedure complied with National Minimum Standards. Service users were aware of the procedures and a copy was included in the Service User Guide. The adult protection and whistle blowing procedures comply with National Minimum Standards. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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 and 26. In respect of premises, further work is required to improve the décor and facilities on offer. The arrangements for laundry management and prevention of infection were satisfactory. EVIDENCE: Issues relating to the premises which were highlighted at the last inspection had been partially addressed. The bathroom that had been in a poor state of decorative repair had bee re-tiled, although the finish to doors, etc, was not yet complete and the bath itself was dirty. The ground floor toilet at the back of the building had frayed carpet at the threshold that required attention, and some other areas of flooring were worn in places. Decorating work was taking place at the time of inspection and some communal areas had been decorated in a brown marbling style of décor, which did not enhance the appearance of these areas. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 15 Not all the issues raised at the previous inspection were fully considered at this visit and will therefore be reviewed at subsequent visits. The arrangements for processing laundry were satisfactory and supported the hygiene control programme. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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 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 and 30. The staffing numbers are sufficient to meet the assessed dependency levels of service users. The records relating to recruitment in order to protect service users were in place. The induction programme meets professional standards, however the training programme had not been fully developed. EVIDENCE: There had been a calculation of staffing numbers carried out, according to the assessed needs of service users. The staffing provision reflected this number and was sufficient to meet the needs of service users. The records relating to employment of staff had been improved and from the four files sampled during the inspection there was sufficient evidence of CRB returns, references, etc, which together ensure that the home’s recruitment practices protect service users from potential abuse. There was a comprehensive induction programme based on the TOPPS standards, with staff completing competencies workbooks. The annual training programme had not yet been developed at the time of the inspection, although all staff had attended a certificated workshop in dementia Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 17 care provided through the Alzheimer’s Society. Further developments in training were suggested to the manager and the need to have a programme operating discussed. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 18 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, 35, 37 and 38. There is a quality assurance programme operating in the home that provides feedback from service users and their supporters in respect of the service delivery. The home has suitable processes in place to manage the service users’ funds they hold responsibility for. The records and procedures relating to the home’s operations are satisfactory. EVIDENCE: The quality assurance system was available for scrutiny at this inspection and provided insight into how the home collected service users’ views regarding the service provision and what action was taken to address these issues. The questionnaires used in the system were not anonymous and the need to Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 19 ensure anonymity was provided in the system was discussed with the Quality Assurance Manager, who was present at the inspection. The arrangements and records relating to cash held in safe custody on behalf of service users were available for inspection on this occasion. The inspector was able to determine that these records were accurate and met with the current good practice guidance. Some of the records relating to the safe operation of the home were inspected at this visit and met with the expectations of good practice and regulation. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 20 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 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x 3 3 Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4,5,6 Requirement The Statement of Purpose requires minor amendment and the Service Users Guide requires amendment. This standard was not assessed at this visit and is therefore carried over to the next inspection. 2. OP7 55 Service user plans of care require further development to meet with National Minimum Standards. This is a repeat requirement since July 2003. 3. OP9 12 The registered person must ensure that the medication practice in administration and recording meets the Royal Pharmaceutical Society guidelines. 1st September 2005 1st November 2005 Timescale for action 1st December 2005 4. OP12 16 The registered person must 1st ensure that service users are December able to exercise choice in relation 2005 to social, recreational and leisure interests. I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 22 Quenby Rest Home This is a repeat requirement since August 2004. 5. OP19 16 The premises remain in need of minor works and attention to environmental hazards. This is a repeat requirement since July 2003. 6. OP21 16 The registered person must ensure that the premises meet with requirements. This standard was not assessed at this visit and is therefore carried over to the next inspection. 7. OP22 23(2)(n) The registered person must ensure that the premises are suitable for the service user group accommodated and therefore an assessment of the premises must be undertaken. This standard was not assessed at this visit and is therefore carried over to the next inspection. 8. 9. 1st December 2005 1st December 2005 1st December 2005 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 OP25 Good Practice Recommendations It is recommended that the registered person ensures that where fluorescent strip lighting is installed, a diffuser cover is fitted to prevent risk caused by accidental damage to the lamp tube. I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 23 Quenby Rest Home 2. OP11 This standard was not assessed at this visit and is therefore carried over to the next inspection. It is recommeded that the registered person gains further information in respect of service users wishes at the point of dying and following their death. It is recommended that the registered person ensures that at least 50 of staff attain a National Vocational Qualification level 2, or equivalent, by April 2005. This is a repeat recommendation This standard was not assessed at this visit and is therefore carried over to the next inspection. 3. OP28 4. 5. OP30 OP31 The registered person should ensure that an annual staff training programme is in place. It is recommended that the registered person addresses how the manager will have completed National Vocational Qualification level 4 or equivalent by April 2005. This standard was not assessed at this visit and is therefore carried over to the next inspection. Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Quenby Rest Home I56 - I05 S1795 Quenby Rest Home V235634 280605 Stage 4.doc Version 1.40 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. 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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