Inspection on 25/10/05 for Quinton House

This inspection was carried out on 25th October 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

Quinton House 30/05/07

Quinton House 23/08/06

Quinton House 28/10/04

Quinton House 24/06/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Quinton House Harvey Street Watton Thetford Norfolk IP25 6EH Lead Inspector Ruth Hannent Unannounced Inspection 25th October 2005 9.30 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 Quinton House DS0000027480.V261985.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. Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Quinton House Address Harvey Street Watton Thetford Norfolk IP25 6EH 01953 882101 01953 882101 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) Quinton Care Homes Limited Position Vacant Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd June 2005 Brief Description of the Service: Quinton House is registered care home providing residential care for twenty three elderly people. It is a classical Georgian building with a modern extension. There are 21 single rooms, 15 of which have en suite facilities There is one double room with en suite facilities. There is a car park at the front of the home.The home is situated in a residential street in the market town of Watton in Norfolk, and is within walking distance of the main street which has shops and other facilities.The home receives it medical nursing, and other professional services via the local Health Centre Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over three hours with the new Manager. Long discussions were held over the way forward for the care of the residents in Quinton House. Some records were inspected. A tour of the building took place. Some residents and staff were spoken to. What the service does well: What has improved since the last inspection? What they could do better: The Home must ensure that fire door closures work correctly so corridor fire doors are not wedged open with chairs and large bottles. The Home needs to look at person centred care for the residents and build care plans and information that is relevant for the individual. Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 6 The recruitment of new staff must have correct procedures in place to safeguard the residents. 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. Quinton House DS0000027480.V261985.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 Quinton House DS0000027480.V261985.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): EVIDENCE: These standards were not inspected on this occasion. Quinton House DS0000027480.V261985.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 and 9 The Home needs to rethink the format it uses to write and record care for the individual person with more information about the social support required. The Home is supported well by the team of health workers to ensure resident’s health needs are met. Medication administration procedures are safe and will be even safer when the photographs are in place for each person and the trolley arrives within the Home. EVIDENCE: The Home has recently taken residents in to Quinton House who are requiring special support for their own protection. One person had improved significantly. This progression from admission to date was not recorded in detail to evidence the change and no care plan had been reviewed to show the ongoing updated needs. (Requirement) Other care plans seen did not show clear personal, social and healthcare needs to be able to individualise the resident’s requirements. Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 10 The health care needs are supported by the local GP practice with ongoing support from the community nurse team. Specialist support for individuals such as the psycho geriatrician is seen within the care plan recordings. On talking to one lady she was able to talk about the support she gets from the nurse and her “nice GP”. The administration of medication has improved with all medication signed for on seeing the resident ingesting the pills or liquids. The Home has ordered a drugs trolley which will safe guard even further the residents, with staff able to watch the medication at all times when not locked away. (At present the medication is taken from the office cabinet to the dining room by hand with staff travelling backwards and forwards with each residents medication). Photographs of all residents are to be placed on the file, which will ensure the correct care and medication is offered to the right individual. Quinton House DS0000027480.V261985.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 lifestyle in the Home is seen as kind and caring, but tends to be rather institutionalised with expectations and preferences not taken into account for the individual person. Residents maintain contact with family and friends who are made to feel welcome when they visit. Meals are enjoyed and the menu well balanced but more choice needs to be available. EVIDENCE: Residents are not given clear choices to match their need. At least four residents are helped to get bathed and into their dressing gowns before tea. (One resident was seen bathed and in her dressing gown at 4pm).This is due, according to the Manager, to the staff having to help too many people at the same time to all retire before the night staff come on duty, or busy in the kitchen getting teas as the Cook only works until 2 pm. This is seen as institutionalised practise and the staff rota’s must be adjusted to ensure that people have choice that matches the expectations prior to arriving at the Home. On talking to one person they said they didn’t mind as “it helps the Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 12 busy staff but I would prefer not to be ready for bed quite so early”. (Requirement) Visitors were seen coming and going throughout the afternoon with a tray of tea and biscuits offered. One gentleman was given the handset phone to talk to his sister in private and another lady talked about all her local friends who were her “club companions” visiting regularly. The residents spoken to, were all pleased with the meals and that they were of good quality. “We have a really good cook” stated one resident. “The only problem is we can not always have a choice”. One resident would like a boiled egg but this was not deemed possible due to the cook not on duty until 8 am in the kitchen and “if one was offered cooked breakfast choice then everyone would need to be offered that choice”. (Requirement). As mentioned previously in this report the way staff are deployed needs to be reviewed. Quinton House DS0000027480.V261985.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): EVIDENCE: These standards were not inspected on this occasion. Quinton House DS0000027480.V261985.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, 20 and 21 The Home is working on improving the environment but is seen as not safe with fire doors wedged open. The lounge and dining room are comfortable and fit for purpose. The bathroom facilities downstairs are not fit and suitable at present but are to be improved shortly. EVIDENCE: There is a plan in action of ways to change the upstairs lounge which at present is a location for all furniture and items that need storing. The decoration and curtains were discussed with the use of the room to become a meeting/training room. The Home did not have clear records of weekly fire alarm checks. Dates were recorded inconsistently and this must change to weekly tests and recording. (Requirement). The Home had at least two corridor fire doors that were Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 15 wedged open with a chair and bottle. (These were issued as an immediate requirement). The doors did have fire closures on them but did not work. While waiting for replacement fire guards the doors are to be kept closed. The lounge downstairs has improved since the last inspection with all new chairs in situ and a new television, video and DVD about to be placed in the room. (Present television is of poor sound and not visible to all in the room). The dining room is in two areas allowing residents space to eat and enjoy their meals. The one bathroom on the ground floor is still unusable due to the delay in repairing the bath hoist. This has now been completed, with a new bathroom suite about to be purchased. The whole of the bathroom needs redecorating and floor covering replaced once the suite is fitted. (Requirement). Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 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 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 skill of the staff seen was appropriate but there was a lack of numbers to cover all areas of the care required. The correct paperwork is not in place in personnel files to ensure residents are cared for and protected by clear policies and procedures of recruitment. The Home is using all avenues to ensure the staff are trained and competent to do the job correctly. EVIDENCE: The Home runs with 3 care staff in the morning, 2 and a part time care staff in the afternoon and one sleeping in, one awake overnight. (A senior is on call through the night for emergencies). The Home needs to look at the way staff are deployed to ensure they can meet the individual needs of each resident. For example residents were in the lounge in their dressing gown at 4pm to allow care staff to then prepare tea as mentioned in standard 12. The home needs more hours in the kitchen to ensure care staff can cover their designated roles and offer more time to residents that is appropriate to their care needs. (Requirement) The recruitment of new staff had recently taken place with concerns shared with the Manager of staff in the building without all the relevant paperwork being in place. One person had lost all personal records due to unforeseen circumstances and only had references from the family. Another had only one reference on file. POVA checks were carried out but all procedures must be in Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 17 place and all forms of identification copied and held on file with a recent photograph as stated in Schedule 2 of the National Minimum Standards. (Requirement). The Home had a notice displayed of the forthcoming training on Adult Abuse with most of the staff signed up to attend. This will be the first time the Home has run this course. It will take place on a few dates to ensure all staff have the opportunity to pick a date to attend. The Homes moving and handling co-ordinator has just completed an update course and is cascading the information to the staff. Dates of this were seen on record and on talking to one staff member she had just completed her update and felt competent in the task. Eight staff have just completed the distance learning course on safe handling of medicines and as a result are updating the way medication is administered to ensure even safer practise is taking place. (Training pack and names of candidates seen). Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 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 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): EVIDENCE: Due to the Manager only being in post for three weeks these standards were not inspected on this occasion although many issues were discussed and will be fully inspected on the next inspection. Quinton House DS0000027480.V261985.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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 1 3 2 x x x x x STAFFING Standard No Score 27 2 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x x x Quinton House DS0000027480.V261985.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 OP7 Regulation 15 and 17 Requirement It is a requirement that all care plans are clear and current with all updates recorded and reviewed, dated and signed by the people involved. It is a requirement that the Home meets the needs of the individual person to match their expectations. It is a requirement that residents are able to have choice in the type of meal they prefer and that the choice is clear It is a requirement that all the fire doors in the communal areas are made safe with the correct equipment in place for closing in the event of the alarm being triggered. (THIS IS AN IMMEDIATE REQUIREMENT) It is a requirement that the downstairs bathroom be completed and made fit for residents to use in comfort. (THIS IS AN OUTSTANDING REQUIREMENT) It is a requirement that the Manager looks at the way hours for staff rota’s are deployed DS0000027480.V261985.R01.S.doc Timescale for action 30/11/05 2 OP12 15 and 18 31/12/05 3 OP15 16 2 i 31/12/05 4 OP19 23.4 c 25/10/05 5 OP21 23.2 j 31/12/05 6 OP27 18 31/12/05 Quinton House Version 5.0 Page 21 7 OP29 19 within the Home to ensure the care for residents is carried out correctly and at appropriate times. It is a requirement that all staff employed have all the relevant records in place as stated in Schedule 2 of the National Minimum Standards. 30/11/05 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 Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Quinton House DS0000027480.V261985.R01.S.doc Version 5.0 Page 23 - 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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