Inspection on 26/06/06 for Raymond House

This inspection was carried out on 26th June 2006.

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

Raymond House 13/04/07

Raymond House 31/01/06

Raymond House 06/06/05

Raymond House 25/11/04

Raymond House 28/07/04

Raymond House 13/02/04

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 Raymond House 7-9 Clifton Terrace Southend On Sea Essex SS1 1DT Lead Inspector Pauline Marshall Key Unannounced Inspection 26th June 2006 08:10 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 Raymond House DS0000015464.V290846.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. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Raymond House Address 7-9 Clifton Terrace Southend On Sea Essex SS1 1DT 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) 01702 352956 01702 435027 Jewish Care Jacqueline Michelle Shuttleworth Care Home 39 Category(ies) of Dementia - over 65 years of age (9), Old age, registration, with number not falling within any other category (39) of places Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Personal care to be provided to up to thirty-nine (39) older people. Old age not falling within any other category (OP) Care Home only Personal care to be provided to up to nine older people who have dementia. Dementia, over 65 years of age (DE(E)) The maximum number to be cared for shall not exceed thirty-nine (39). 31st January 2006 Date of last inspection Brief Description of the Service: Raymond House provides care and accommodation for thirty-nine older people of whom up to nine may have dementia. It is owned and managed by Jewish Care. It provides specialised care for people of the Jewish faith and caters for all their cultural, religious and dietary needs. The building consists of four floors, residents use the first three and each can be accessed by way of a passenger lift. Thirty-seven rooms are single and one double room is used as single occupancy. All the rooms have a wash hand basin. None of the rooms have en-suite facilities. There is a lounge and separate dining room on the ground floor and a lounge/diner on the first floor. Raymond House is a lively, active home with a large team of volunteers who support a range of activities. The home has access to three vehicles, which are shared with a nearby day centre, which is also run for people of the Jewish faith. The home is situated on the cliffs overlooking Southend sea front and has a large parking area to the rear of the property. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with up to date information on the home. Fees range from £652.00 to £694.00 and there are additional charges for hairdressing, chiropodist, taxi’s, toiletries and sundries. There is a decked area to the front of the home that provides seating with sea views. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that lasted for nine and fifty minutes. The process included a tour of the premises, a random selection of resident and staff files and discussions with residents, staff, and visiting relatives. As part of this inspection surveys were sent to eight residents, three relatives, three health care professionals, three social workers and three General Practitioners to obtain their views on the service the home provides. Four residents surveys were returned and all were positive in their comments, Residents say they are contented and the staff are very supportive. One General Practitioners’ survey was returned that highlighted a lack of carers to escort residents to the accident and emergency department of the hospital. All other aspects of this survey form were positive. The manager is considering the possibility of carrying out some building work and converting the whole of the first floor into a dementia unit. If this idea were taken forward the home would need to apply for a variation to its registration to increase its capacity and the number of residents with dementia. Twenty-eight of the thirty-eight standards were inspected. What the service does well: What has improved since the last inspection? Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 6 The home has began redecoration of the corridors and communal areas and the decorator is working from the top of the building down and plans to decorate the bedrooms when all communal areas are complete. 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. Raymond House DS0000015464.V290846.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 Raymond House DS0000015464.V290846.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): 1, 3, 4, 5, 6 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home carries out a thorough pre-admission assessment of needs and provides prospective residents with sufficient information to enable them to make an informed choice. EVIDENCE: The home provides prospective residents with a welcome pack; this provides information about Raymond House and the organisation Jewish Care. The manager stated that the organisation is in the process of reviewing its Statement of Purpose to ensure that it contains all the requirements under schedule 1. The Statement of Purpose must be updated to contain all the latest information. The home has its own pre-admission assessment form and the manager visits prospective residents as part of the assessment process. The manger said that Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 9 she also uses any assessment documentation received from the social work teams in conjunction with her own assessment. Staff have received training in dementia, challenging behaviour and the Jewish faith in addition to the relevant mandatory training enabling them to meet the needs of residents. The home offers trial visits and has guest days to enable prospective residents and their relatives to visit the home and ask any questions they wish to. Raymond House does not provide intermediate care. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 10 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, 10 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to the service. The homes care plans are not fully completed or signed by staff. Health care needs are fully met. Medication records are not fully completed and there are no protocols in place for the use of as and when medication. Residents are generally treated with respect and dignity. There was one instance where residents needs did not appear to be met. EVIDENCE: The care plans are in the process of being re-written and the new style provides clearer information for staff to meet the residents’ needs. Three care files were inspected and although the care plan system provides the opportunity to give clearer information, the forms were not fully completed. The daily care notes are now in the form of a tick chart that is completed on each shift and there is ample room for comments on the reverse of the form. Not all daily notes had a signature on them and it was difficult to determine who did what and when it was done. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 11 The care files examined showed evidence of multi disciplinary input and each file contained a record of any General Practitioner’s visits, including notes of the outcomes. All staff that administers medication has received medication training. The home has a copy of the Royal Pharmaceutical Society of Great Britain Administration of Medicines in care Homes guidance and encourages staff to read it. As and when (PRN) medication did not have clear guidelines of why, how, when, what dose and how often it should be administered. To ensure residents safety PRN protocols must be in place for all PRN medication that is prescribed. There were five occasions when the MARS (medication Administration Records were not signed. All medication must be signed for at the time it is administered and a record kept of any refused or spoilt medication. Residents spoken with said that they were treated well and that they were able to have their privacy when required and that staff always knocked on their doors before entering. One resident was wheeled into the dining area in her wheelchair and placed at the table by a member of staff one hour before the meal was due to be served; this appeared to upset her and she banged quite loudly on the table with her cutlery. In addition to banging on the table the lady was shouting and disturbing other residents and their visitors. Staff attended when they heard the lady arguing with another resident and moved her to the other side of the table. The home needs to review this practice as it appeared to cause distress to residents. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 12 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, 14, 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Residents experience a lifestyle that matches their needs, they are encouraged to maintain contact with family and friends and have as much choice and control over their lives as possible. Residents receive a wholesome appealing balanced diet in spacious pleasing surroundings. EVIDENCE: The home keeps a record of all activities undertaken in its activities book; these include quizzes, music therapy, reflexology, art & crafts, discussion groups and manicures. Residents spoken with said that they have the choice of joining in activities and sometimes chose not too. Religious services are offered in line with the Jewish faith and residents spoken with said that they could choose which activities they wished to participate in. The home encourages open visiting and residents confirmed that this is the practice of Raymond House and that they felt their visitors were made welcome at all times. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 13 Residents are registered for postal votes. Regular residents meetings take place, some have notes written up and others are more informal and the issues raised are dealt with at the time. Residents spoken with say they are happy with the way issues are addressed. A catering company supplies the homes catering services. The home operates a four-week rotating menu that offers a wide and varied choice of meals. The home promotes healthy eating with low salt and low fat options. Care staff ask residents each day for their choice of meal from the menus offered, an alternative is made available if they do not wish to have any of the foods on the menu. Residents spoken with had various opinions as to the quality of the food; most of the comments received were that the food was good, with plenty of choice. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 14 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, 18 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Complaints are generally acted upon swiftly and all issues are taken seriously by the home, however all complaints must be fully documented and the most recent one is not. Staff are well trained and residents are protected from abuse. EVIDENCE: The home provides all residents with a copy of their complaints procedure in the welcome pack. Their leaflet “Your view counts” contains a freepost card where residents or relatives can share any suggestions, complaints or compliments with the organisation. The home encourages residents and their relatives to raise any concerns with the manager initially; the complaints procedure has time limits that are adhered to. A relative spoken with stated that they had complained direct to social services and that the issues they had raised had now been dealt with by the home. One complaint made by a resident that had now moved on was not fully documented. All complaints should be fully investigated and the outcomes recorded. The home has a policy on adult abuse that works within the Southend Borough Council Procedure; all staff have received training on the protection of vulnerable adults and the manager said that staff will be receiving annual updates. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 15 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, 21, 24, 26 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The home is in the process of carrying out improvements to enable residents to live in a safe well-maintained environment and has sufficient communal facilities that are generally clean, pleasant and hygienic. EVIDENCE: The last inspection identified that some corridors had damaged wallpaper and that many of the bedroom doors were damaged by wheelchairs and required painting and protecting from further damage. Decorating of the corridors has begun and the manager said that she expects the full decoration and repair of the home to be completed within six months. The manager said that once areas are decorated, worn or damaged carpet would be replaced. Communal areas are pleasant and well furnished and there are quiet seating areas around the home, some with sea views. Residents’ bedrooms were well furnished with many personal items and decorated to their individual taste. Many bedrooms had specialist beds in them. Residents spoken with said they Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 16 were happy and satisfied with their bedrooms. Several of the bedrooms have non-slip flooring as opposed to carpet. The manager stated that she intended to keep the flooring where hoists are used and to introduce it to one bedroom where there were problems with odour control. The home has sufficient adapted bathrooms and toilets. One of the toilets had previously been a shower room and the sign had not been altered to reflect the change. The home was clean, tidy and hygienic on the day of the inspection with the exception of the bedroom where there was a problem with odour control. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 17 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, 28, 29, 30 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Staff are well trained, competent and supplied in sufficient quantities to meet residents needs. Some areas of the homes recruitment practice are not robust. EVIDENCE: The home currently has vacant bed spaces; staffing levels are adequate to meet the needs of the current residents. Domestic and catering staff are provided by an external contractor in addition to care staff. Each shift consists of a group leader and three care staff; on the day of the inspection both day shifts included two agency care staff. The homes manager and assistant head of homes hours of work are from 8.00 – 16.00 and the assistant head of home works alternative weekends. Eight staff has achieved NVQ training and one staff is in the process of it. The home meets the standards for the level of care staff that are NVQ trained. The home is using a high level of agency staff due to the vacant care posts; the manager said that there are currently ten vacancies for care workers and that Jewish Care are making every effort to fill them and that an advertisement for recruitment to these vacancies is due out again soon. The manager said Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 18 that most of the agency staff used are regular workers at Raymond House, therefore they are familiar with residents needs. Three staff files were examined and all contained the documents as required in Schedule 2. The home was not able to evidence that in the past it had explored and assessed the risk of an adverse Criminal Records Bureau check. The home was asked to address any potential risks that the lack of recording at that time may have highlighted in their recruitment practices and to ensure that they are robust for the future. Residents spoken with commented on how kind and nice the staff was to them. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 19 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, 33, 35, 36, 38 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The home is well managed and run in the best interests of the residents, the quality assurance system is not being fully utilised. Residents financial interests are safeguarded. Support and supervision for staff does not meet the National Minimum Standards. The health, safety and welfare of the residents is promoted and protected. EVIDENCE: The manager has more than eleven years experience in caring for older people and has achieved NVQ level 4 Registered Managers Award. Staff spoken with said they felt able to discuss issues with the manager. Some relatives spoken with during the inspection said they had raised some concerns with the manager and they did not feel that they had been dealt with effectively so Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 20 raised their issues with the social services department. All matters are now resolved. The home does have a quality assurance system and the last survey undertaken was on 26/8/04, no report was prepared from this and the manager said that she will undertake another survey and prepare a report for the residents, their relatives and the CSCI. The home now employs a quiet manager to assist in quality assurance issues. The home should undertake regular reviews of the quality of care that it provides. Three residents financial records were checked and all were in order. The manager stated that she felt that supervision records were private between the person and their supervisor and that these could not be inspected without permission of both the supervisor and supervisee. The manager supervises her head of home, administration staff and team leaders. Their individual team leader supervises care staff and they hold the records. Staff members spoken with agreed that their supervision files could be inspected. The home keeps a supervision calendar that showed that supervisions were infrequent. All staff should receive supervision six times per year and the outcomes should be recorded. All safety certificates were in place and there was evidence of regular checks on water temperatures and fire equipment. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 21 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 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X 3 X X 2 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 22 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(1) Requirement The Registered Person must prepare a written plan (service users plan) with consultation with the resident as to how their needs will be met. It must provide staff with guidance on how to meet the resident’s needs and must be regularly reviewed. This refers to the care plans that have not being fully completed or signed. Previous time scale of 14/02/04, 15/07/05 and 31/3/06 were not met. 2. OP9 13(2) The Registered Person must 20/09/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. Previous time scale of 31/3/06 was not met. 3. OP10 12 (4) (a) The registered person shall ensure that the care home is conducted in a manner, which DS0000015464.V290846.R01.S.doc Timescale for action 20/09/06 31/08/06 Raymond House Version 5.1 Page 23 respects the privacy and dignity of residents. This refers to the person being left at the meal table one hour prior to the meal being served. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated and recorded. This refers to the complaint that was investigated but was not fully documented. 5. OP24 16(2)(c) The Registered Person must provide suitable floor coverings in resident’s bedrooms. Previous timescales of 01/02/05, 15/07/05 and 31/3/06 were not met. 6. OP29 19 5d The registered person shall not employ a person to work at the care home unless they are satisfied that the person is fit to work there. This refers to the CRB return The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care. Provided at the care home. The registered person shall ensure that persons working at the care home are appropriately supervised. 20/09/06 31/01/07 4. OP16 22 (3) 20/09/06 7. OP33 24 (1) (a) (b) 20/09/06 8. OP36 18 (2) 20/09/06 Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 24 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 OP19 Good Practice Recommendations The home should continue with its repair and redecoration programme. Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Raymond House DS0000015464.V290846.R01.S.doc Version 5.1 Page 26 - 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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