Inspection on 06/06/05 for Raymond House

This inspection was carried out on 6th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Raymond House 13/04/07

Raymond House 26/06/06

Raymond House 31/01/06

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 Nikki Gibson Unannounced 6th June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 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 Raymondhouse@care.org Jewish Care Jacqueline Michelle Shuttleworth CRH 39 Category(ies) of OP Old Age 39, DE(E) Dementia-over 65 9 registration, with number of places Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25th November 2004 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 pasenger 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 I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which lasted six and a half hours. During the inspection there was a tour of the premises and records and documents were looked at. Time was spent in one of the lounges and with residents in their own rooms. Three residents were spoken in depth about life at Raymond House and the care of other residents was observed and they were chatted with. The manager and five members of staff were also spoken with. The manager, staff, and residents were most helpful and this was greatly appreciated. Discussion of the inspection findings took place with the manager throughout the inspection and guidance was given. What the service does well: What has improved since the last inspection? What they could do better: Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 6 The owners and manager at Raymond House are aware that they need to review the information they have about the residents and provide clear instructions to staff so that they know the best way to help them. Staff need training in the new way that medicines are received so that errors do not occur. To provide a homely environment and in keeping with a residential setting carpets or equivalent should be fitted in residents’ bedrooms. 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 I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 4 6 The home provides a good standard of care specific to meeting the needs of the residents. EVIDENCE: The manager said that prospective residents were visited and assessed by her unless they live some distance from the home. In that case they were assessed by someone else trained and competent to do so. A tick box format was used plus other information including a medical report and information from the prospective resident and their supporters/family. Sufficient information was gathered to enable the home to make the decision whether their needs could be met by the home. Raymond House specialises in caring for older people of the Jewish faith. Staff were inducted into the religious, social and cultural requirements of the Jewish residents. Dementia care training has been introduced for all staff. Staff were observed interacting with residents with dementia in a supportive and understanding manner. Raymond House does not provide intermediate care. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 9 Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 standard(s) 7 8.9 10 Shortfalls in the care planning system and medication administration put residents welfare at risk. Other health needs are appropriately addressed with evidence of multi disciplinary working taking place. Positive relationships between staff and residents have been formed which made them feel safe and well cared for. EVIDENCE: The manager was aware that the care planning system in the home needs improving and new formats were being considered. The present system was complex yet did not provide the information staff required to meet all the needs of the residents. Staff spoken to showed a good understanding of the residents, gained from experience or passed on verbally. However, there was the risk that information would be missed and care would not be provided in a consistent manner. Some risk assessments were displayed on the back of residents’ bedroom doors. Those studied were incomplete or out of date. A resident said, ‘when you are ill the staff are there for you’. Records showed that residents’ medical needs were addressed and they had access to relevant professionals such as the continence advisor, optician, dentist and district nurse. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 11 A new system of delivering medication was started on the day of inspection. It was of concern that staff were inadequately trained and there was a high level of uncertainty and anxiety. It was unreasonable to expect staff to make the change over without training or time for the conversion. Staff said that some errors were due to lack of time and the change in system i.e. not checking and signing in the new medication. However, other shortfalls in the medication system were ongoing, for example out of date medication in use and medication inappropriately stored. The staff spoken to were not aware of the Royal Pharmaceutical Society of Great Britain guidelines for ‘The Administration and Control of Medicines in Care Homes and Children’s Services’. Further copies can be obtained by contacting 0207 572 2409 or e-mailing: ifearon@rpsgb.org.uk. Staff need to be fully aware of the guidance and coached in it and trained in the specifics of the new blister pack system to ensure the health and safety of the residents. Residents said that staff treated them with dignity and respect. Bedroom doors and bathroom doors had appropriate locks and residents who are able hold their own key. Two residents said that that they regretted that there were no en-suite facilities, but acknowledged that there were bathrooms close to their bedrooms. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 standard(s) 12 13 14 15 The relaxed and varied lifestyle in the home was its particular strength. Activities and good food were an important aspect of the home which clearly improved the quality of life of the residents. EVIDENCE: Raymond House was commended on the level of leisure, social and cultural activities that took place. The home had a large volunteer group who were very active in the home. A large display board in the hallway advertised future events such as the ‘Wild West Theme day’, armchair exercises, and clothes shop. A number of photographs depicting parties and other celebrations were displayed. Some residents said they went regularly to a Day Centre, which they thoroughly enjoyed. One resident said the entertainment in the home was very good. From discussion with residents and from observation it was evident that residents were able to follow their own routines. It was noted that one resident had an electric kettle and refrigerator in her room and following a risk assessment there was talk that a microwave could be added. Residents were able to bring their own possessions into the home and to personalise their rooms. The manager said that food was frequently discussed at residents’ meetings and that it was not always easy to please everyone. A choice was provided at Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 13 each meal and individual likes, dislikes and diets were catered for within Jewish dietary laws. Residents spoken to described the food as, ‘good’ and ‘excellent’. Mealtimes could be flexible, tables were attractively laid in the dining room or residents could eat in their own rooms. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 standard(s) 18 Staff have the training and understanding to protect residents from abuse and to manage challenging behaviours. EVIDENCE: The manager said that all the staff have received training in the protection of vulnerable adults and in managing challenging behaviours. The homes policies and procedures on Adult protection and dealing with complaints were not studied at this inspection. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 standard(s) 19, 20, 22, 24, The premises were clean, but would benefit with further refurbishment, which would promote a more homely atmosphere. EVIDENCE: Raymond House provided the residents with commanding views over Southend seafront. The home was generally adequately maintained, however some corridors had very damaged wallpaper and were in need of redecoration. Some bedrooms were also in need of redecoration and most needed new floor coverings which was in keeping with a residential setting. This has been raised at previous inspections and has yet to be addressed. Communal areas in the home were pleasant and in addition to the two main seating areas there were small seating areas on corridors which residents enjoy using. Two residents said they liked the quiet and peace of a small seated area overlooking the estuary. Raymond House does not have any garden as such and this needs to be born in mind when assessing new residents with dementia as they would need to be very closely supervised if they wanted to go outside. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 16 The home had hoists and other moving and handling equipment available. There were assisted bathrooms with grab rails and there were handrails in corridors. The home complains of a lack of storage space, however they generally managed to keep corridors and bathrooms clear so they were safe to use. There were call bells throughout the home and the time it takes for calls to be answered was recorded in the main office. The manager said that there was an expectation of staff that they answer call bells with in four minutes. One resident said she was very happy with her room and asked that it be inspected. It was clean and bright and had been personalised with the resident’s own possessions. As in most of the bedrooms it had a vinyl floor which detracted from the homely feel. The resident said she was looking forward to having carpet. However, she would like some additional protection round her hand bowl so the carpet did not get wet. The home provided different styles of adjustable beds according to the needs of the person. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 There were adequate numbers of staff with the skills and knowledge to care for the residents well. Staff demonstrated an awarness of their roles and responsibilities. EVIDENCE: At the time of the inspection adequate numbers of staff were being deployed. The staff rota was studied and although generally clear the manager was advised that full names should be recorded, as first names only could be confusing over the course of time. Generally care staff cover for each other or the manager or her deputy work on the floor if they are short staffed. This was not always appropriate and the manager should have the authority to deploy agency staff that can attend quickly when necessary. Minimum staff levels agreed were: Six care staff in the morning Five care staff in the afternoon Three awake staff at night The manager and deputy manager are supernumerary. Ancillary staff were provided by an external contractor. A white board was used to ensure that staff were aware of their roles and responsibilities and to foster accountability. This helped the home maintain a consistent level of care. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 18 Staff files were inspected at random. The home had a robust recruitment procedure that was followed and all staff had police references before taking up employment. The procedures in place protected the residents. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 The home was managed in a way, which provides staff with leadership. The manager has a good understanding of the areas in which the home needs to improve EVIDENCE: The manager was advised that in order to keep abreast of any new guidance and support that she and the staff retain and refer to the newsletters sent by the CSCI. Further copies can be obtained by contacting the CSCI office. Staff spoken to on the subject said that they were happy working in the home and felt supported by the manager. Staff morale was good and staff turnover was relatively low. Staff and resident meetings have taken place regularly and minutes were maintained. This gave them all the opportunity for their views to be heard. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 20 Questionnaires have been used to obtain stakeholders views on the home, as part of the homes Quality Assurance system. Results of the survey have been published. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 x 3 x 2 x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x 3 3 x x x x x Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? 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 7 Regulation 15(1) Requirement The Registered Person must prepare a written plan (“service user’s plan”) with consultation with the resident as to how their needs will be met. It must provide staff with guidence on how to meet the residents needs Care plans must be regularly reviewed. (Previous time scale of 14.02.04 was not met The Registered Person must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the home. (Previous time scale of 01.09.04 not met) The Registered Person must ensure that the premises are kept in a good state of repair The Registered Person must provide suitable floor coverings in residents bedrooms. (Previous timescale of 01.02.05 not met) Timescale for action 15 July 2005 2. 9 13(2) 15 July 2005 3. 4. 19 24 16(2)(c) 16(2)(c) 15 July 2005 15 July 2005 Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 23 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 27 Good Practice Recommendations Staff rotas should include surnames so the staff can easily be identified. Raymond House I56-I06-S15464-Raymond House-V231322060605-Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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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