Inspection on 27/02/06 for Regents House Rest Home

This inspection was carried out on 27th February 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

Regents House Rest Home 12/08/09

Regents House Rest Home 15/08/08

Regents House Rest Home 22/03/08

Regents House Rest Home 28/09/07

Regents House Rest Home 01/02/07

Regents House Rest Home 12/12/05

Regents House Rest Home 16/02/05

Regents House Rest Home 18/10/04

Regents House Rest Home 09/03/04

Regents House Rest Home 16/01/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Regents House Rest Home 206 Regents Park Road Southampton Hampshire SO15 8NY Lead Inspector Mark Sims Unannounced Inspection 27th February 2006 13:00 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 Regents House Rest Home DS0000012319.V268703.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. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 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.V268703.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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 Not more than 3 service users in total may be accommodated under the age of 65 years 16th February 2005 Date of last inspection Brief Description of the Service: Regents House is a large period property that has been adapted for the purposes of providing residential care. Accommodation is single occupancy and available both on the ground and first floors, communal areas are only located on the ground floor and comprise of a large dining room and lounge, smoking is permitted in the lounge but not the dining room. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was undertaken unannounced and formed the second statutory inspection of the year for Regents House Residential Home. The inspection focused on those core standards not addressed at the 12th December 2005 inspection and various sources of evidence were considered in the formulation of judgements: records, observations and discussions with service users and staff/management. What the service does well: What has improved since the last inspection? What they could do better: The management team has made attempts to comply with the requirements of the previous inspection, 12th December 2005, however, some concerns or problems persist: Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 6 • The management was required to supply details and proposed timescales for the redecoration and repair of corridors and communal facilities. A plan has been submitted to the Commission, however the timescales and schedule are considered unreasonable. The management was required to supply details and proposed timescales for the redecoration and refurbishment of service users’ bedrooms. A plan has been submitted to the Commission, however the timescales and schedule are considered unreasonable. Whilst it was only a recommendation at the last inspection, 12th December 2005, that an alternative location for the manager’s office be sought as it is currently located in the dining room, no permanent changes to this practice have been introduced. • • In addition to the requirements and recommendations not addressed at the last inspection, 12th December 2005, the home was also noted to be performing below the National Minimum Standards in the following areas: • The home’s medication cabinets were unsafe and inadequate, which meant fellow service users and/or visitors, etc. could easily gain access to the residents’ medications. The moving and handling assessments in place required updating and clarifying for staff to ensure no confusion existed over numbers of staff and the equipment required to safely and effectively move clients. All communal bathrooms, toilets and food preparation areas should be fitted with liquid soaps and paper towels, it was obvious during the tour of the premises that these agents were not available. The home has no discernable Quality Auditing system and no formal way of ensuring the home is meeting the needs of the service users, or for the service users to influence the way the home runs and the services offered. • • • 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.V268703.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 Regents House Rest Home DS0000012319.V268703.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): Standard 6. The home does not provide an intermediate care facility. EVIDENCE: None. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 & 9. The home’s moving and handling assessments are poorly set out and do not provide staff with adequate direction to ensure safe and effective moves with clients. The home’s medication arrangements cannot be considered safe, as the cabinets used to house medicines cannot be properly or safely secured. EVIDENCE: During the tour of the premises the inspector observed a client being transferred from their chair by a staff member, the technique employed to achieve the move was clearly unsafe and raised with the manager during the inspection process. It was apparent on reviewing the moving and handling assessments for a number of clients, including the person involved in the move, that the assessments were neither sufficiently detailed nor sufficiently informative and that they did not comply with the guidance available within the Manual Handling Regulations 2002. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 10 In talking to the staff member involved in the move it was apparent that she felt able to safely assist the service user in this fashion, as the service user was light and small. She confirmed that she had not recently attended any moving and handling training and was clearly uncertain about the moving and handling instructions contained in the assessment. An issue effecting the service users’ medications came to light whist talking to staff in the kitchen, which is where the home’s medication cabinets are located. It was noticed during this interaction that the door to the medications cabinet was ajar and when this was raised with the staff member, it was established that this was normal, as the door would not lock any tighter. On inspection of the cabinet it was discovered that the doors were inappropriately secured and the locks inadequate to hold the doors closed, meaning the inspector was able to slip his hand inside the cabinet without unlocking it, as demonstrated to the manager. This issue is of concern, as it both breaches the Care Homes Regulations 2001 and Safe Storage of Drugs Regulations. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 & 14. The service users confirmed that they appreciate the freedom and support provided at Regents House and enjoyed the lifestyle provided, as it met their specific needs. EVIDENCE: During the tour of the premises the inspector had the opportunity to speak with several service users about their experiences of living at the home and the ability to participate in activities and leisure interests, the latter causing some amusement. Through discussions with the service users it was apparent that the home offered them the opportunity for both social interaction and stimulation if required, as well as more quiet, reflective periods when they could be alone. One gentleman discussed how he likes to vary his days, sometimes going to the lounge, sometimes spending time in his room reading, other days he will eat in the dining room or again he might decide to spend time alone and will ask to have his meal in his room. Another service user described similar experiences, although he also discussed visiting friends in their bedrooms for chats, etc., although often he preferred his own company, as this allowed him to do what he liked. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 12 People also discussed being able to go out, one person describing how they get out to the local library for books, as well as shopping trips and regular trips to a local church. Another person discussed how he gets out and about with a community driver and the services he accesses externally of the home. Whilst recently changes have been made with regards to the home’s smoking policy, smoking no longer permitted in the dining room, people are still allowed to smoke in the lounge, which one person mentioned put them off going into the lounge, although this practice obviously met the needs of the majority of residents. The continued presence of the manager’s desk, computer and files, etc. in the lounge is of concern, as this facility is supposed to be for the use of the service users and should be accessible at all times. This statement is not intended to imply that the manager deliberately restricts access to this area but her presence working or taking telephone calls, etc. is likely to discourage use other than at mealtimes. Whilst in discussion no service user considered this to be a problem, this is most likely because they are used to the situation and accept it as the norm, when the reality is that the manager’s office should be located in a quiet confidential location and the dining room accessible to clients. Regents House Rest Home DS0000012319.V268703.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): Standard 18. Efforts to comply with guidance around the protection of vulnerable adults from abuse are being made by the management. EVIDENCE: In discussion with the manager and staff it was established that both parties had undertaken National Vocational Qualification (NVQ) courses at various levels and that during each NVQ they had covered or addressed issues of adult protection. It was also established that the manager had attended a study day on the promotion of adult protection and that she had cascaded some of the knowledge gained down to staff, although it is unclear how this was achieved. On perusing the home’s policies file it was noted that the management provided access to ‘No Secrets’ documentation produced by the ‘Department of Health’, a whistle blowing policy and copies of the local authority adult protection procedure and strategy. It was also apparent in talking to the manager that she has had experience of using the procedure and working through the adult protection process with the Local Authority, which seemed to have progressed to a satisfactory conclusion. Regents House Rest Home DS0000012319.V268703.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): Standards 19, 21, 24 & 26. The premises is in a poor decorative state and requires remedial works, as identified at both this inspection and the 12th December 2005 inspection. Efforts to improve the toilet facilities have been made. The accommodation requires redecorating and refurbishing throughout, including both communal and private rooms. The home is not adequately taking precautions against the spread of infections. EVIDENCE: At the last inspection, 12th December 2005, the management was required to provide the Commission for Social Care Inspection with a plan and schedule for the redecorating of both the communal areas and private accommodation of the home (service users’ accommodation). Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 15 At this inspection a lack of progress in attending to the redecoration and remedial works required was noted and brought to the management’s attention, where limited resources were highlighted as a contributing factor. However, the premises continues to require attention, with a significant proportion of the work highlighted at the 12th December 2005 inspection remaining outstanding, as well as the additional issues identified at this inspection: • • • • • • • • • • • • Cracked tiles in downstairs bathroom. Kitchen units to be upgraded or replaced or repaired. Poor lighting in the upstairs corridors. Stretched, rucked and worn carpets along first floor corridors to be replaced or re-laid. Brown carpet first floor annex to be replaced due to staining and general wear and tear. Christmas decorations (awaiting storage) to be removed from first floor corridor. Bathrooms and toilets to be fitted with liquid soaps and paper towels. Medication cabinets to be made safe or replaced. The enlarged hole at the top of the stair to be filled. Corridors redecorated. Dining room redecorated. Manager’s office relocated. Of the environmental issues raised at the last inspection, 12th December 2005, the replacing of the toilet floor and redecoration of the area and the attention to the damp in Room 18 are the only noticeable improvements, although the downstairs corridor is understood to have received some attention. The tour of the premises highlighted that bedrooms are only being redecorated as vacated, which at least ensures people entering the home are being admitted to reasonably fresh feeling environments. However, a number of the rooms visited during the tour of the property were noted to be tired and stale looking and in need of redecoration and refurbishment, some items of furniture clearly having seen better days. However, it should be clarified that none of the people spoken to during the inspection had anything other than praise for the home and the care provided, it should also be noted that the client group possesses significant challenges, which most other homes or environments would find difficult to manage. Whilst completing the tour of the home it was noted that none of the communal bathrooms or toilets contain liquid soaps of paper towels, which are essential tools used to combat cross contamination and the spread of infectious agents / bodies. Regents House Rest Home DS0000012319.V268703.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): Standards 28 & 30. The number of staff presently possessing a National Vocational Qualification (NVQ) at level 2 or above is below the recommended level. The home has no structured training planning or system for monitoring the training completed by staff. EVIDENCE: In conversation with the manager it was established that 2 of the home’s 6 staff possesses a National Vocational Qualification (NVQ) at level 2 or above with a further 1 care staff in the process of completing their NVQ qualification. Currently this means that 33.3 of the staff team hold a NVQ qualification, which should rise to 50 during 2006 when the additional staff complete their course. The home has no formal structures for planning or monitoring staff training, although they operate an informal system whereby they retain copies of the certificates of achievement, this is classed as informal as the certificates are randomly filed. In discussion with staff it was ascertained that their access to training courses is limited, although the deputy or senior care confirmed having completed a medications course. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 17 However, as already identified, training around moving and handling has not been recently updated and the manager is the only staff member to attend adult protection training. The manager confirmed that she is in the process of seeking funding for staff training for this year but is unlikely to know how much she has available or secured until April. Regents House Rest Home DS0000012319.V268703.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): Standard 33. The home’s quality auditing programme lacks sufficient evidence that either the service user and/or their relative are involved in the process. EVIDENCE: The home is operating a mixed Quality Auditing (QA) system, which comprise both formal and informal agents for monitoring of the service. The formal processes witnessed in use during the inspection include practices such as: • • Monthly reviews of the care plans, although this is a little ad hoc at times. Individualised records of meetings with service users, five of these documents were reviewed, the content could be considered a little sparse on occasions. DS0000012319.V268703.R01.S.doc Version 5.1 Page 19 Regents House Rest Home • Annual review of the home’s policies and procedures The home also has more informal processes: • The unstructured maintenance of certificates of achievement for staff. However, neither of these processes formal or informal detail how the service users are actually asked to influence or rate the service being provided. It is important therefore that consideration be given to introducing a satisfaction survey, which can be tailored to gather information about the entire service or aspects of the service where problems might be perceived. Regents House Rest Home DS0000012319.V268703.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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X 2 X X 2 X 2 STAFFING Standard No Score 27 X 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X X Regents House Rest Home DS0000012319.V268703.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 Requirement Timescale for action 16/04/06 2 3 OP9 OP19 Regulation The manager must review all of 13 the moving and handling assessments for service users and consider purchasing a copy of the Manual Handling Regulations 2002. Regulation The manager must ensure the 13 medications cupboard is made safe and secure. Regulation The manager must attend to the 23 environmental items identified at this inspection and those raised during the previous inspection within 6 months, a plan on how this is to be achieved provided to the Commission. This requirement was raised at the 12th December 2005 visit. Regulation The manager must ensure all 13 bathrooms and toilets are fitted with liquid soaps and paper towels. Regulation The manager must ensure that 16 all service users’ rooms are redecorated and refurbished within the next 6mths, a plan on how this is to be achieved DS0000012319.V268703.R01.S.doc 16/04/06 16/04/06 4 OP26OP21 16/04/06 5 OP24 16/04/06 Regents House Rest Home Version 5.1 Page 22 provided to the Commission. This requirement was raised at the 12th December 2005 visit. Regulation The manager must ensure 50 19 of the staff employed possess an NVQ at level 2. Regulation The management must consider 12 how they can formally involve service users within the home’s Quality Auditing programme; and take steps to act upon the decision reached. 6 7 OP28 OP33 16/06/06 16/04/06 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 OP19 OP30 Good Practice Recommendations The manager should relocate her office away from service users’ communal areas. The manager should devise a more structured system for recording the training completed by staff. Regents House Rest Home DS0000012319.V268703.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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.V268703.R01.S.doc Version 5.1 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. 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