Inspection on 07/03/07 for Regent Hotel

This inspection was carried out on 7th March 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Regent Hotel 15/03/10

Regent Hotel 04/03/09

Regent Hotel 04/01/06

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Regent Hotel 11 North Marine Drive Bridlington East Yorkshire YO15 2LT Lead Inspector Sarah Sadler Unannounced Inspection 7th March 2007 09:00 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 Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Regent Hotel Address 11 North Marine Drive Bridlington East Yorkshire YO15 2LT 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) 01262 673338 01262 403607 Sandylane Ltd Mrs Elizabeth Annie Finney Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Old age, registration, with number not falling within any other category (29) of places Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Regent Hotel is a large detached building situated close to Bridlingtons North Beach. It is part of a residential area away from the commercial aspects of the town. The local shops and amenities are only a short walk from the home. The home offers accommodation for up to 29 elderly male and female service users who may have conditions associated with old age. Regent Hotel has a range of room sizes available, the majority with ensuite facilities. Service users can enjoy the views from the lounge/dining room, which looks out over the bay. There is a garden area at the front of the home with seating and tables available. Fees to reside in the home vary from £370 to £430. Additional charges are made for the hairdresser of between £5 and £20 and the chiropodist of between £6 and £12. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report is based on information obtained from the pre-inspection questionnaire completed by the registered manager and information received by the Commission for Social Care Inspection (CSCI) since the last inspection of the home. This unannounced site visit was undertaken by one inspector over one day; the site visit commenced at 9.00 am and finished at 3.30 pm. The site visit consisted of a tour of the premises and examination of documentation, including three care plans. On the day of the site visit inspectors spoke on a one to one basis with the registered manager, two carers, a visiting relative and service users. Prior to the site visit surveys were sent to service users, relatives, staff and health and social care professionals. Nineteen were returned by staff, 8 by service users, fourteen by relatives/visitors, and 1 social care professional. Comments from service users in surveys were positive, for example,’ I came for respite and decided to stay’, I came here on respite, I stayed and I am very happy’. Comments from relatives included, ‘I think the Regent is fabulous it has done wonders for my relative. The staff are always helpful and friendly to me and the residents. I think the manager is just the best!’ And ‘All the staff have treated, my relative, with the utmost respect and for that I thank them.’ Comments received in surveys and from the visit will be included throughout the report. The inspector would like to thank the registered manager and staff for their assistance on the day of the site visit, as well as service users, staff and health and social care professionals that completed the surveys and service users who assisted with the visit. What the service does well: Service users were happy with the home and had positive interactions with both the registered manager and staff team. People reflected that they are happy that their health needs are met and have good access to a GP if this is needed. Health professional’s feedback reflected that people’s health needs are well met. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 6 People’s dietary needs are well met. They are offered a varied menu, which they are pleased with and are offered good support in the eating of their meals. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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 Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed prior to admission to ensure that these needs can be met by the home. EVIDENCE: Of the service user files examined all included an assessment undertaken by the home prior to the person being admitted. In addition to this there is a copy of the assessment undertaken by the Local Authority. The registered manager described how they always visit a service user and undertake the assessment to ensure that the home can meet the individuals’ needs and that they would be happy in the home. The assessments help to ensure that a full picture is gained of the individuals needs prior to them moving into the home, and that the home is able to meet these. The registered manager confirmed that intermediate care is not offered within the home. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health, medication and privacy needs are met. EVIDENCE: All of the service user files examined held a copy of their individual plan of care. This details the needs of the service user and how the home will support this person with the meeting of these. The care plans are regularly reviewed within the home and a formal review is held annually with care management. By having an up to date plan of care service users can be assured that staff are aware of their latest needs and how these are to be met. Service users confirmed in surveys that they felt that they received the care and support they needed either usually or always and one person commented ‘outstanding’. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 10 Service users files included details of any health appointments or visits and what these were for including the details of any follow up information. There were risk assessments in relation to the risk of falls and pressures sores and weight monitoring charts to help maintain peoples’ health needs. Discussion with the visiting district nurse reflected that the home act appropriately in order to meet peoples health needs and that they are pro active and professional in dealing with any issues. Responses in the service user surveys reflected that people always receive the medical support they need, with one person commenting ‘ the manager always makes sure we have a doctor when we need one.’ Health and social care surveys received reflected that all were happy that the home follows specialist instructions and that they are satisfied with the overall care in the home. The service user spoken with confirmed that they felt their privacy was respected as staff always knocked on their door prior to entering. Staff responses to the question of maintaining privacy and dignity of service users was positive and included comments for example, ‘complete personal care discreetly’ and ‘knock on the door prior to entering’. Medication is stored in a lockable medication trolley, which is when not in use also locked securely. Records are kept of the receipt administration and disposal of all medicines. From the health care surveys received all were happy that medication is appropriately managed within the home. However, on the day of the visit none of the medicines administered that morning had been signed for. The carer in charge explained that, as she was busy supporting service users she checks and administers medication but goes back to sign for these later in the day. This has the potential for errors to occur and should not take place, medicines must be signed for at the time of administration and the registered manager spoke with the staff member at the time regarding this. One prescribed tablet is broken in half by the staff and labelled, to be administered later in the day. This has the potential for an error to occur and it would be recommended to the home that this be discussed further with the pharmacist. All medicines stored as ‘controlled’ were stored appropriately with up to date records being kept. However other items were also stored in the same facility and although only the senior person on duty has access to this it is not usually considered best practice to store different items with controlled medicines and it would be advisable for the registered person to seek an alternative storage for the other items. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled to make choices, partake in activities, maintain relationships and receive a good diet. EVIDENCE: The registered manager confirmed in the pre- inspection material that activities offered within the home include; moving to music, a visiting artist, darts, dominoes, and flower arranging. Service users were observed to participate in the movement to music session and appeared to be relaxed and enjoy this. Responses in the service users surveys reflected that people felt that there were always activities that they could take part in and one confirmed that they may undertake, bingo, keep fit and going to the hairdresser. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 12 Visitors were observed during the visit and discussions with a relative and a service user reflected that people are welcomed into the home, and can visit as they wish. Discussions with staff reflected that service users may make choices in their lives, and the comments included, ‘ What they say goes.’ And ‘ whatever they say we have to go by’. One service user commented ‘ I make my own choices and my room is how I want it’. Service users were observed to choose whether to spend time alone in their room or with others. Menus have been developed to provide a variety of meals for the service users. People are provided a hot lunch daily and a lighter evening meal. Discussions with the chef reflected that there are a number of alternative dishes people may request should they not like the meal of the day. The meal served at the time of the visit was of a good quality and service users commented that they liked the food provided. Responses in service user surveys reflected that people were either usually or always happy with the food provided. With staff surveys reflecting that they felt service users received a varied menu, which is well presented. Mealtime was a relaxed time with service users with additional needs being well supported by the staff and the staff joining service users to eat their lunch, making it a social event. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are aware of the complaints system feel enable to raise concerns and have systems in place to support them in the case of any allegations of harm. EVIDENCE: The registered manager confirmed in the pre -inspection material that there had been 5 complaints to the home in the last 12 months, with two being substantiated. Records for these complaints are kept. Service user responses in surveys reflected that all but one person always knew who to complain to and how to make a complaint. The one other person stated that they usually knew who to talk to and how to make a complaint. All but three of the fourteen relatives surveys returned reflected that people knew how to complain. In the staff surveys all but three were clear on the complaints process, with some answers being very detailed. The registered manager confirmed in the pre-inspection material that no incidents or allegations of adult protection have been referred in the last twelve months. However one concern of this nature had been referred to and dealt with by the local Authority. All of the staff surveys and the staff interviews reflected that people had a good understanding of the Protection of Vulnerable Adults. This would help support service users and staff should any allegation of harm be raised. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users continue to live in a comfortable and clean home, which continues to be re-furbished. EVIDENCE: There is an ongoing programme of refurbishment within the home and decorating was taking place at the time of the visit. The home continues to be comfortable throughout and service users comments from surveys were that the home is fresh and clean. There is now an air filter in place, to accommodate people who wish to smoke, to ensure that this does not upset other non smokers. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 15 Staff feedback included that they wished for more or better bathing facilities for service users, including a disabled downstairs toilet and upon inspection it was found that some of the bathrooms did not allow for space to assist in moving and handling procedures, for example a hoist would not fit in a bathroom. It would be recommended that the registered person address this issue with a view to both the ongoing meeting of service users needs and to moving and handling procedures. On initial testing it was found that some of the hot water exceeded the recommended 43 ° centigrade and actually registered at 52°. The registered manager addressed this at the time of the visit and the ‘whole’ hot water system was adjusted to ensure the correct temperatures. The registered manager was advised that if there is stored hot water this must be at temperatures close to 60° centigrade with an outlet of temperatures close to 43 ° centigrade. There is a separate laundry area that allows for laundry to be managed away from food areas. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are adequate staff who may not always be well deployed but who are well recruited and trained. EVIDENCE: There are planned rotas for the support within the home. These include seniors, carers, the cook and cleaner, including day and night shifts. Some of the comments received were that at certain times it is more difficult to meet service users needs than others, and that more staff may be necessary. In addition the senior carer was unable to correctly complete the records for the administration of medicines due to being busy. However, in all but one of the service user surveys returned, people confirmed that there are always staff available when they are needed and the other person commented that there are usually people available when they are needed. All but three of the relative’s surveys confirmed that in their opinion there were enough staff on duty. It would be advisable that the registered manager look at the deployment of staff to ensure that service users needs can be met at all times. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 17 Recruitment documents were kept in staff files, which, reflected that staff complete an application form and provide two written references prior to the commencement of employment within the home. The original evidence that staff have completed a criminal Records Bureau check (CRB) and are suitable to be employed within the home was not available. Although there is matrix of staff CRB checks, which includes the CRB number. The manager receives confirmation once a satisfactory CRB check is received for each staff member. Good recruitment processes ensure that only staff who are suitable to do so, work with vulnerable people are employed within the home. The registered manager confirmed in the pre-inspection material that staff had undertaken a variety of training in the last 12 months. This included; dementia, infection control, equality and diversity, the safe handling of medicines, managing behaviour, the Protection of Vulnerable Adults (POVA) and moving and handling. Further training is planned in; fire, first aid, infection control, moving and handling and health and safety. Staff surveys reflected that staff had completed a variety of training, which included these. Staff files included a training plan. This reflects that the staff training is planned and provided to ensure a well trained staff team to meet service users needs. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is well managed, enables them to participate in its development and protects them from financial harm. They are protected by the homes policies and procedures on Health and Safety. EVIDENCE: The registered manager has managed the home for a number of years and has continued with their professional development. Over the last year they have undertaken training in equality and diversity, Moving and Handling, Dementia and infection Control. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 19 Staff surveys reflected that all staff felt that they got support and direction from the management of the home and included comments for example, ‘ I was listened to and my problems I had were sorted out’. The registered manager forwarded a copy of the quality assurance and business plan report 2007 to the CSCI. This report included the results of service users and relatives or advocates surveys, reflecting that people who are stakeholders in the home are involved in its ongoing development. Records are kept for any service user monies handled within the home. These were found to be up to date and correct. The registered manager confirmed in the pre-inspections material that there are ongoing maintenance checks within the home. Records were examined for example, for, Fire checks and Health and safety policies and procedures within the home. A certificate to confirm that the electrical wiring in the home is safe was not available and the registered manager forwarded this to the CSCI the next day. However this was not of a good quality and although a further copy was requested, this was not received. It was found that products, for example cleaning products, were not securely stored. As these products may be harmful to health and would come within the remit of the Control of substances Hazardous to Health (COSHH) legislation, it was recommended to the registered manager to address this. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 3 17 X 18 3 3 3 2 X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 2 Standard OP9 OP27 Regulation 13 18 Requirement The registered person must ensure that any as medication is administered it is signed for. The registered person should address the deployment of staff to ensure that peoples needs continue to be fully met. The registered person must ensure that any COSHH products are safely stored. Timescale for action 15/04/07 30/04/07 3 OP38 13 15/04/07 Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 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 3 Refer to Standard OP9 OP9 OP38 Good Practice Recommendations The registered person should gain advice from the prescribing pharmacist regarding the cutting and storing of tablets. The registered person should address the storage of none medication items with prescribed medications. The registered person should provide the CSCI with a clear certificate detailing that the electrical wiring in the home is safe. Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Regent Hotel DS0000064420.V328790.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!