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Inspection on 12/12/05 for Regents House Rest Home

Also see our care home review for Regents House Rest Home for more information

This inspection was carried out on 12th December 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good written and verbal information to residents to ensure that they are aware of their rights` and to help them decide whether the home will be right for them. Residents receive adequate and appropriate support with their personal and health care needs. Staff are aware of residents` support needs and provide care in a private and caring manner. Residents receive a varied and balanced diet and are able to keep in contact with family and friends. Staffing levels are maintained and responsive team. The home`s recruitment procedures provide protection to residents.

What has improved since the last inspection?

What the care home could do better:

There remains plenty of scope for improvement to the physical environment and priority will need to be given to those areas most in need of attention. Whilst record keeping is generally satisfactory there is room for improvement to ensure that residents` best interests are safeguarded.

CARE HOMES FOR OLDER PEOPLE Regents House Rest Home 206 Regents Park Road Southampton Hampshire SO15 8NY Lead Inspector Chris Johnson Unannounced Inspection 12th December 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Regents House Rest Home Address 206 Regents Park Road Southampton Hampshire SO15 8NY 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) 02380 322 101 Mr Ian Newson Mrs Jean Newson Mrs Sandra Pearl Anaszko Care Home 17 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (17), Mental disorder, excluding learning of places disability or dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (17), Old age, not falling within any other category (17), Physical disability (3), Physical disability over 65 years of age (7) Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Not more than 3 service users in total may be accommodated under the age of 65 years Service users in the DE, MD or PD categories may not be accommodated under the age of 55 years A total of not more than 7 service users may be accommodated in the PD and PD (E) categories 16th February 2005 Date of last inspection Brief Description of the Service: Regents House provides accommodation with care for up to seventeen service users who have needs associated with old age, dementia, mental disorder and physical disability. The home is located close to the shops and facilities in Shirley, and a number of service users are able to access the community independently. The home is set out on three levels. The laundry is located in the basement. Communal areas are on the ground floor, and comprise a lounge and dining room. Service users are able to smoke in the lounge. There are bedrooms, bathrooms and toilets on the ground and first floors. There has been a change in registered manager since the last inspection. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over one day on the 12th December 2005. The registered manager assisted the inspector throughout the inspection. Written and verbal feedback was supplied to the manager at the end of the visit. The findings of this report are based on a number of different sources of evidence including; a pre inspection questionnaire completed by the manager prior to the inspection, a tour of the premises that included looking at residents’ bedrooms and communal areas. Staff and care records were inspected. A group discussion was held with several residents other residents and members of staff were spoken with individually. At the time of this inspection there were seventeen residents living at the home. What the service does well: What has improved since the last inspection? What they could do better: There remains plenty of scope for improvement to the physical environment and priority will need to be given to those areas most in need of attention. Whilst record keeping is generally satisfactory there is room for improvement to ensure that residents’ best interests are safeguarded. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 6 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. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4 and 5 The home operates a thorough admission and assessment procedure ensuring that they can meet peoples’ needs prior to them moving in. EVIDENCE: The home carries out thorough and comprehensive assessments prior to offering a resident a place at the home and all relevant information is sought from professionals such as care managers to ascertain whether the home can meet the person’s needs. As part of the admission process to the home all prospective residents are assessed to determine whether the home can meet their needs. As part of this procedure prospective residents and or their representative have the opportunity to visit the home, look at the type of accommodation on offer and find out about day-to-day life in the home. Residents confirmed that they had been given this opportunity and that this assisted them in making their choice of home. Individual records are kept for each resident and from inspection of the records for two people admitted to the home since the last inspection, full assessment information had been recorded, that included the homes’ own assessment and that of placing agencies such as social services. This demonstrated that the Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 9 home had ensured that they were able to meet the resident’s needs prior to offering them accommodation. Records were also available to demonstrate that residents are issued with a copy of the home’s Statement of Purpose and had been given the opportunity to read the most recent inspection report and complaints procedure before making a decision whether to move in. All residents spoken with said that they considered that their needs were being met and that they received the appropriate level of support. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 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 and 10 Residents receive adequate and appropriate support with their personal and health care needs. EVIDENCE: Each resident has an individual plan of care detailing their care needs and these provide some guidance as to how these needs are to be met. The care plans of several residents were looked at during the inspection. Some care plans were quite brief, however the manager had started to review them and expand on the information within them. Several examples of the revised format were seen and were much more detailed and provided sufficient information. Staff are made familiar with the details and care needs of residents. Staff reported that they had access to the care plans and demonstrated that they were aware of residents support needs. All staff had signed the care plans to confirm that they had read the plan. Wherever possible residents are encouraged to be involved in their care planning to ensure that their wishes are taken into consideration and to promote their independence. Residents told the inspector that they had access to a range of healthcare support as and when necessary and written documentation supported this. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 11 Residents also confirmed that they were happy with the way that their medication was managed and that they received them regularly and at the correct time of the day. Medication is safely and appropriately managed in line with written procedures. Stock records were checked against administration records for several residents and all were found to be correct. The previous requirement regarding the medication cabinet being stored in the kitchen had been addressed and regular temperature checks are undertaken to make sure that the medication is not subject to fluctuations in temperature. Residents told the inspector that staff respected their privacy and that assistance with personal care was carried out in private. This was supported by observations during the inspection and through discussion with staff. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 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): 13 and 15 Residents receive a varied and balanced diet and are able to keep in contact with family and friends. EVIDENCE: All residents spoken with confirmed that they were free to receive visitors as and when they pleased. This was substantiated from inspection of the visitor’s book whereby a written record of all visitors to the home is maintained. There were not any reported restrictions on visiting times. Menus are planned in advance and discussed with residents. Records had been satisfactorily maintained of all food provided and all cooked meat temperatures are monitored, as are fridge and freezer temperatures to minimise any associated risks. Residents reported that they were happy with the quantity and quality of the food provided. All staff involved in food preparation are trained in food hygiene practices and kitchen hygiene standards are maintained. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Satisfactory systems are in place for service users to address any concerns or complaints that they may have. EVIDENCE: The Commission for Social Care Inspection had not received any complaints about the home since the last inspection. The home has a complaints procedure and this is explained and issued to residents prior to them moving into the home. Residents commented that if they were unhappy with anything they would inform the manager and that they felt confident that she would deal with it. Staff reiterated this and said that they felt comfortable approaching the manager and had been instructed to report any concerns directly to her. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24,25 and 26 Improvements to the physical environment have made the home a more homely place to live in. However, further improvements are needed to provide more comfort. EVIDENCE: Several improvements had been made to the physical environment since the last inspection including, the redecoration of some bedrooms and the redecoration of the main lounge. The dining room has since been made a nonsmoking area and should therefore provide residents with an alternative smoke free area. There remains plenty of scope for improvement to living areas and several bedrooms. The carpet on the upstairs landing is very worn and needs to be replaced, as do some bedroom carpets. An upstairs toilet was in a poor state of repair and requires redecoration, new flooring and better lighting. The dining room needs to be redecorated, as do some bedrooms. The bedrooms that have been done so far do provide more comfort. Priority will need to be given to Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 15 those in most need of redecoration to bring them up to this standard. Two bedrooms in particular need attention. One shared room especially needs to be redecorated and the furnishings need to be replaced. Another single bedroom has a persistent dampness problem and although attempts have been made to address this the problem has not been rectified. Whilst the resident of this room did not see it as a problem, it is not acceptable and could present a health and safety issue. Residents are given the freedom to personalise their rooms with their own belongings and within reason can exercise their own lifestyle choices. Residents reported that they were happy with the standard of cleanliness within the home that their rooms were kept clean, that their bedding was changed regularly and clothing laundered and returned immediately. Generally standards are maintained. The only exception to this was that some unpleasant odours were apparent in one bedroom and some bedroom carpets were quite stained. Currently the home does not have office facilities. All administrative work undertaken by the manager including updating residents’ files is done so in the dining area. This means that outside of meal times the dining area is often in use. To ensure confidentiality the manager and staff have to put away all documents and close any programmes on the home’s computer system when leaving the area. During the inspection it was noted that the manager frequently had to pack work away to attend to other issues or to enable residents to use the room. Whilst the home is limited for office space consideration should be made to relocating the workstation and filing cabinets to another area. This would prove both more efficient and mean that resident’s communal space is no longer encroached upon. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 29 Staffing levels are maintained and care is delivered by a caring and responsive team. The home’s recruitment procedures provide protection to residents. EVIDENCE: The home has a well-planned rota and provides a sufficient level of staffing to meet the needs of the current residents. All residents spoken with or who returned a questionnaire were complimentary about the staff attitude and commitment to their jobs and spoke highly of them. Comments included “They are amiable” and “ If you ask for something, they will get it”. The inspector observed this to be the case throughout the inspection. The rota is structured to ensure that staff are aware of their delegated duties and responsibilities on a given day. Staff reported that they were happy with the staffing levels and that they considered them to be sufficient and that they were properly maintained. The staff files of several members of staff recruited since the last inspection demonstrated that the manager had undertaken all necessary checks prior to employing them to safeguard the residents. Criminal Records Bureau certificates, and checks against the Protection of Vulnerable Adults list had been obtained, as had all necessary references. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 17 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): 31,32,35,36,37 and 38 The home is well and safely managed. Generally records are well maintained. However there are some improvements needed to ensure residents best interests are safeguarded at all times. EVIDENCE: Since the last inspection there has been a change of registered manager. The current manager has worked at the home for several years, previously as head of care. The manager demonstrated a caring and sensitive approach to the needs of the residents. The manager is open and staff and residents reported that she was approachable and accessible. The manager is currently undertaking an NVQ level 4 qualification. There was plenty of evidence to demonstrate that the home was being managed appropriately. In general records were well-maintained and promoted residents’ best interests. The only exceptions to this being some omissions in the home’s Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 18 accident book. Whilst it was evident that all appropriate action had been taken to deal with falls not all incidents had been recorded satisfactorily. There is also a need to keep a record of any valuables looked after on residents’ behalf. There were not any concerns as a result of this inspection as to the health safety or welfare of service users. Regular testing of the fire alarms had taken place and service contracts were available to demonstrate that the home’s fire fighting and detection equipment is regularly serviced. Certificates were available to show that the lift, portable electrical appliances and the gas system had all been regularly inspected and maintained. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 3 2 X X 2 3 3 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 3 3 X X 3 3 2 3 Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 20 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 Standard OP19 Regulation 23 (2) Requirement An action plan must be submitted detailing the plans and timescales to make good repairs to the upstairs landing and hallway walls and redecoration of the dining area. The upstairs toilet must be redecorated and the flooring must be replaced. An action plan must be submitted detailing the plans to decorate and furnish all bedrooms to an acceptable standard. The Commission for Social Care Inspection must be informed of the plans to address the damp in bedroom 18. A record of all accidents and valuables looked after is to be maintained. Timescale for action 20/02/06 2 3 OP21 OP24 23 (2) 16 (2) (c) 12/04/06 20/02/06 4 OP24 13 (4) 20/02/06 5 OP37 17 (1) 12/01/06 Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 21 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 Consideration should be given to locate the filing cabinets and workstation to an alternative more appropriate area of the home. Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Regents House Rest Home DS0000012319.V270271.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!