Inspection on 31/01/06 for Raymond House

This inspection was carried out on 31st January 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 26/06/06

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 Ron Reeves Unannounced Inspection 31st January 2006 10:00 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.V280617.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.V280617.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.V280617.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). 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, the first three are used by residents 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 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 also for people of the Jewish faith. The home is situated on the cliffs overlooking Southend sea front Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which lasted seven hours. There was a tour of the premises and inspection of a random sample of bedrooms. Various records, policies and procedures were looked at. Discussions took place with the manager, care manager and time was spent talking to four residents about their life in Raymond House. In addition three care staff and the home’s administrator were spoken with. What the service does well: 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. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Raymond House DS0000015464.V280617.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.V280617.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): 1-5 The admission process is well managed and prospective residents and their families are given sufficient verbal and written information and the opportunity to visit the home in order to make informed choices. EVIDENCE: The home has a statement of purpose and service users’ guide. Minor amendments to the Statement of Purpose were discussed with the manager. The home’s welcoming pack for service users contained comprehensive information about the home for prospective residents. The manager informed that she endeavours to visit all prospective residents and carry out a comprehensive assessment to ensure that the home can meet individual needs. Residents and their families are invited to visit the home before making any decisions. Every resident is provided with a comprehensive terms and conditions of residence. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 9 Raymond House specialises in care for older people of the Jewish faith. Staff are inducted into the religious, social and cultural requirements of the residents. The home is registered to accommodate nine residents who have a diagnosis of dementia. Dementia and challenging behaviour training has been introduced for all staff. Raymond House DS0000015464.V280617.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): 7-9 & 11 Shortfalls on the care planning system have been outstanding for some time and need to be addressed. Resident’s healthcare needs are generally being met although the medication administration system requires careful monitoring. EVIDENCE: The manager is aware that the home’s care planning system needs improving. She informed that the proprietors are in the process of designing care plans that can be introduced for all their homes. This was discussed at the previous inspection some eight months ago. It was disappointing to note that there is no information available as when the new care plan format will be introduced. The present system is confusing and does not contain sufficient information for staff to meet resident’s needs. However staff spoken with demonstrated a good understanding of the residents care needs. Records evidenced that resident’s health care needs are being met including regular visits by opticians, district nurses and continual advisor. The home uses a pre-dispensed system for all administration of tablet medication. Examination of the home’s medicine administration records (MAR) revealed that on some occasions medication was not booked in or signed for. The Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 11 manager informed she will be introducing daily audit checks to ensure MAR sheets are appropriately completed. Medication storage was appropriate however some bottled medication was not marked with the date of opening. The home does not have a policy on caring for people who are terminally ill. However the manager informed that the majority of staff have attended training for care of people who are terminally ill. Raymond House DS0000015464.V280617.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): 15 Dietary needs of the residents were well catered for with a balanced and varied selection of food. EVIDENCE: The home operates a four week rotating menu, which is based on residents likes and dislikes and regularly reviewed in the residents’ meeting. Healthy eating with low salt and low fat meals are promoted. Menus seen were wide and varied and contained many choices for the residents to choose from. Care ask residents every day what they would like to choose from the menus. It was noted that alternatives can be provided if residents did not wish to choose anything from the menus. Residents spoken with described the food as “great” “very nice indeed”. Residents can choose to eat in the dining room or in their own rooms. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 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): 16-18 Arrangements for dealing with residents concerns were appropriate. Staff have the training and understanding to protect residents from abuse and to manage challenging behaviour. EVIDENCE: The home has a comprehensive complaints procedure which is displayed in the home and contained in the service users’ guide. The last complaint received by the home was in July 2005 and resolved satisfactory. All residents where possible are included in the local voters’ register and those residents wishing to vote generally opt for a postal vote. There was no evidence of a proprietors’ policy on abuse. However, the home has a copy of the local authority’s protection of Vulnerable Adult procedure and all staff have received training in the protection of vulnerable residents from abuse and to manage challenging behaviour. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 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): 19,21,23-26 The home provides adequate accommodation for the residents, however these are areas that would benefit from redecoration and refurbishment. EVIDENCE: Raymond House is located on the cliff tops and provides the residents with commanding views over Southend seafront. The home is generally well maintained and furnished, however, some corridors had damaged wallpaper. Many of the bedrooms doors were damaged by wheelchairs and need protection and re-painting. This was reported at the previous inspection. The manager informed she had obtained quotations for the carpeting of several bedrooms, which were reported at the previous inspection, but felt the quotations were too high and is investigating other providers. Communal areas were pleasant and well furnished and there were small areas where residents could sit quietly. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 15 Those residents bedrooms seen were generally well furnished, decorated and personalised to individual residents tastes, many had new specialist beds and some had been recently redecorated. There were sufficient adapted bathrooms and many communal toilets located throughout the building. Residents spoken with were very satisfied with their bedrooms. The home on the day of the inspection was clean and tidy throughout and odour free. The home’s laundry was found to be adequate to meet the resident’s laundry requirements. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 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): 27,28,30 Staff at the home were well trained to meet residents needs. The home needs to pursue employing more staff. EVIDENCE: At the time of the inspection there were only 28 residents in the home and the manager had reduced the agreed staffing levels by one care staff during the morning shift. She was reminded that the commission must be consulted before staffing levels are reduced. However, with eleven vacancies staffing levels were appropriate to meet resident’s needs. In addition to care staff, domestic and cooking staff are provided by an external contractor. The manager felt that the arrangements were working well. The home has ten care staff vacancies. The manager informed that recruitment of permanent is becoming increasingly difficult. Vacancies are being covered by agency staff and staff working additional hours. Where possible the same agency staff are employed to ensure a consistency of care. Staff training is promoted by the home and NVQ training encouraged. At the time of the inspection, one staff was qualified at NVQ level 2 and a further 6 staff training to achieve NVQ level 2. In addition one member of staff is studying at NVQ level 3. There was evidence that most staff have received dementia and challenging behaviour training together with the basic foundation training. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 17 Residents spoken with were very complimentary regarding the staff. Comments included “staff are wonderful” “staff are very helpful and caring”. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 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): 31,32, 34-38 The home is well managed by an experienced and qualified manager who provides good guidance and direction for the staff. The manager is aware of the areas in which the home needs to improve and must continue to press the proprietors to achieve these improvements. EVIDENCE: The manager has over eleven years experience in caring for older people. She has recently achieved NVQ level 4 and now undertaking the Registered Managers Award. Staff spoken with felt the manager was easy to approach and very supportive and Raymond House was a nice place to work in. The home looks after small amounts of resident’s personal money for day to day expenses. Examination of records and money revealed an excellent recording system that is regularly audited. Records indicated staff receive regular supervision on a two monthly basis. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 19 Policies, procedures and records were generally well kept and securely stored. Some have been commented on in this report. The manager is aware of her duties under Health and Safety. Safety certificates were seen for services and equipment and regular checks are made of the fire prevention practices and equipment. However, the emergency lighting should be checked on a more frequent basis. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 X 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 2 X 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 3 3 3 3 Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 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 OP7 Regulation 15(1) Requirement Timescale for action 31/03/06 2. OP9 13(2) 3. 4. OP19 OP24 16(2)(c) 16(2)(c) 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 Care plans must be regularly reviewed. (Previous time scale of 14.02.04 AND 15/07/05 were not met The Registered Person must 31/03/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. The Registered Person must 31/03/06 ensure that the premises are kept in a good state of repair The Registered Person must 31/03/06 provide suitable floor coverings in resident’s bedrooms. (Previous timescales of 01.02.05 15/07/05) Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 22 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. 2. Refer to Standard OP11 OP18 Good Practice Recommendations The home should produce policies, practices and procedures for staff to manage people who are terminally ill. The home should develop a policy for the protection of residents from abuse. Raymond House DS0000015464.V280617.R01.S.doc Version 5.1 Page 23 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. 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