Inspection on 03/11/05 for Quenby Rest Home

This inspection was carried out on 3rd November 2005.

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 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 28/06/05

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 Inspection 3rd November 2005 09:30 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 Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 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 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) Mr A Sandhu Mr Avtur Singh Sandhu, Mr Sukvir Singh Sandhu, Mr Surinder Sandhu Ms Alison Simmons Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 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) 28th June 2005 Date of last inspection 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 DS0000017915.V263070.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on the 3rd November 2005 and took 6 hours to complete. During the visit opportunity was taken to speak to service users, the manager and staff, as well as review documentation relating to the provision of care. The application to vary the category of care to accept service users with dementia was settled 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 agree to registration of 11 beds within the existing number to cater for the specialist needs of service users with dementia. 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: What has improved since the last inspection? The proprietors had since the previous inspection made further commitments to provide a quality service provision for service users with dementia. This included seeking advice from the Alzheimer’s Society in respect of the layout, signage and décor of the home, activities and equipment. Additionally they had recruited an activities coordinator to provide a substantive lead in this area of care. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 6 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 DS0000017915.V263070.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Assessments of need are carried out prior to the admission of service users. The home does not provide intermediate care. EVIDENCE: The files of service users sampled contained assessments of need and the manager was able to demonstrate that these were carried out prior to prospective service users moving into the home, and formed part of the judgment regarding the suitability of the service. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Care plans were in place and provided some insight into service users’ abilities. Service user health care was monitored and responded to appropriately. Staff were observed to uphold service users’ rights. Medication administration adheres to the home’s policy and good practice. EVIDENCE: The files of four service users sampled at the inspection provided evidence of the care planning process in operation. The documents provided a general insight into the individual’s abilities and needs, but they were not specific in their assessment or instructions to staff. Statements such as needs help with personal care; staff to provide assistance, did not support how staff should provide an individually tailored approach to caring for service users. A greater emphasis was needed to ensure a person centred approach that provided staff with specific understanding of the support service users needed. This was discussed with the manager and advice given in relation to further professional guidance. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 10 Care plans did provide information of service user health and welfare and how these were responded to by the home and health professionals. Staff conduct and interaction with service users was at all times respectful and assistance given to service users supported their dignity, in both the manner they were addressed and the practical acts of support. Medication administration was reassessed at this inspection, and observations of practice and records held on service users’ files demonstrated adherence to the home’s policy and good practice. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15. The home has placed a greater emphasis on enhancing the service users’ experience of daily living. The service users are supported in maintaining relationships. A varied and appealing choice of menu is provided to service users. EVIDENCE: The proprietors had allocated additional care staff hours to create an activities coordinators post. The post had been appointed to and the postholder had commenced her role the week of the inspection. During the inspection there was opportunity to observe the type of activity on offer and discuss with the manager and activities coordinator how the role was to be used. They were able to inform the inspector of how the activities programme would be identified with service users, and that equipment was being purchased to support activities. The proprietor confirmed that the activities coordinator would be subscribing to membership of NAPA and that support and advice was being taken from an outreach worker of the Alzheimer’s Society. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 12 In addition, following advice from the Alzheimer’s Society, the proprietors have reconsidered the creation of a snoozelem room and instead purchase a minibus. In the meantime the activities coordinator was planning outings using the local dial a ride service. She was able to demonstrate a good awareness of current good practice developments in activities provision. The service users enjoyed the meal served during the inspection and a planned menu with alternatives for each meal was on offer. Service users were asked in advance of the meal for their preferences. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Complaints were recorded and the complaints policy and procedures were available. Protection of vulnerable adults policy and procedures were in place and known to staff working at the home. EVIDENCE: The complaints procedures were satisfactory and a record maintained of complaints raised with the home, and their outcomes. There had been no reported complaints in the period since the last inspection. The home’s policy in relation to protection of vulnerable adults was in place and the subject was included in staff training programmes. Staff were aware of whistle blowing procedures and were confident that they would be able to complain to the manager and proprietors. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26. The environment is being regularly updated and maintained to meet the assessed needs of service users. The environment appeared clean and hygienic, with suitable systems to maintain these levels in place. EVIDENCE: The outstanding works to the premises highlighted at the last inspection had been addressed. The manager advised that advice had been sought from a dementia specialist in relation to the layout and décor of the home. The outcomes of this were intended to be included in the maintenance programme for the home. The initiatives included signage and use of colour to support service users’ independence in moving around the home. Overall the premises were maintained at a suitable level of cleanliness and hygiene, although the laundry area required urgent refurbishment of worktop surfaces and sink areas. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. The staffing numbers are sufficient to support service users’ needs. Staff recruitment generally meets good practice and requirements of POVA. The annual staff training programme had not yet been developed at the time of inspection. EVIDENCE: The manager advised that staffing numbers were arrived at using the residential forum calculation and represents the numbers needed to meet the assessed needs of service users. Observations on the day of inspection, supported the evidence that the numbers of staff on duty provide sufficient support to service users. They were unhurried in carrying out their duties and reported that they did not feel under pressure. There are also auxiliary staff hours provided for laundry, cooking, and cleaning duties. Staff files sampled contained the documentation required to provide evidence of a robust recruitment system. During the inspection discussions with staff members supported this evidence of generally sound systems, however one member of staff had commenced employment without a POVA check and CRB report being sought by the home. The manager stated that as the individual had a recent CRB report from their previous employment, the home had considered the risks and applied for a CRB as soon as the person commenced employment. The inspector referred the manager back to the information from Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 16 the Criminal Records Bureau and the stipulation regarding employment of staff in care settings. The manager advised that the training programme was not committed at the time of the inspection, but that training was ongoing and this was supported by staff files. The inspector advised the manager to consider the present level of dementia training provided to staff as an induction level and to seek ways in which this could be developed further when considering the contents of the annual training programme. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 35 and 36. The manager is capable of fulfilling her duties. The accounting procedures of the home protect service users’ interests. Staff supervision is regular, although the quality requires development. EVIDENCE: The Manager, Alison Simmons, is appropriately experienced. At the time of this inspection she was undertaking the Registered Managers Award. Ms Simmons is a qualified Nurse. Based upon observation, discussion with Ms Simmons and care staff, the management regime, overall, enabled an open and positive atmosphere. The accounts for service users’ monies held by the home were considered again at this inspection. The home does not directly hold individual service users monies, and instead operates an invoicing system whereby these Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 18 monies are held centrally and audited by an external account manager. The home uses a float system to purchase items requested by service users and these are then billed to the individuals’ accounts. Running records of individual service users’ expenditure, income and totals held are then provided to the home. This accounting system is acceptable and secure, provided service users are fully able to access monies as required. The staff files contained reference and records of supervision sessions with line management. The format of these met the expectations of the NMS and identified not only the individual’s performance, but how training should be offered to support their role. However the quality of the completion of the interview record varied and the manager was advised to audit this work. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 2 X X Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 20 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. Service user plans of care require further development to meet with National Minimum Standards. Timescale for action 01/03/06 2. OP7 55 01/03/06 3. OP9 12 4. OP12 16 This is a repeat requirement since July 2003. The registered person must 01/03/06 ensure that the medication practice in administration and recording meets the Royal Pharmaceutical Society guidelines. The registered person must 01/03/06 ensure that service users are able to exercise choice in relation to social, recreational and leisure interests. This is a repeat requirement since August 2004. Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 21 5. OP19 16 The premises remain in need of minor works and attention to environmental hazards. This is a repeat requirement since July 2003. 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. 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. 01/03/06 6. OP21 16 01/03/06 7. OP22 23(2)(n) 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 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. This standard was not assessed at this visit and is therefore carried over to the next inspection. It is recommended that the registered person gains further information in respect of service users wishes at the point of dying and following their death. 2. OP11 Quenby Rest Home DS0000017915.V263070.R01.S.doc Version 5.0 Page 22 3. OP28 4. 5. OP30 OP31 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. 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 DS0000017915.V263070.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 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 DS0000017915.V263070.R01.S.doc Version 5.0 Page 24 - 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!