Inspection on 10/10/05 for Remyck House

This inspection was carried out on 10th October 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

Remyck House 15/07/09

Remyck House 25/07/07

Remyck House 28/09/06

Remyck House 18/05/06

Remyck House 28/09/04

Remyck House 22/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Remyck House 5 Eggars Hill Aldershot Hampshire GU11 3NQ Lead Inspector Beverley Rand Unannounced Inspection 10th October 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Remyck House DS0000012099.V257165.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. Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Remyck House Address 5 Eggars Hill Aldershot Hampshire GU11 3NQ 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) 01252 310411 Mr Thedchanamoorthy Kandiah Mrs Shanthini Kandiah Mrs Peggy Hilton Care Home 29 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (29) of places Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th July 2005 Brief Description of the Service: Remyck House is a care home providing personal care and accommodation for up to twenty nine service users, seven of whom may be admitted with dementia. Mr & Mrs Kandiah own the home and Mrs P Hilton is the registered manager. The home is located on the outskirts of Aldershot town centre and is close to local amenities and bus route. The home has three communal lounges and a communal dinning room. Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Remyck House DS0000012099.V257165.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. Remyck House DS0000012099.V257165.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 Remyck House DS0000012099.V257165.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): Standard 6 does not apply. These standards were not assessed. EVIDENCE: Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 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): 8&9 The manager ensures that residents’ health care needs are met but residents’ are not protected by the home’s medication procedures. EVIDENCE: A resident said that the district nurse visits the home every week and the manager confirmed this. Staff said that senior staff would call the doctor if someone asked or was looking unwell. A dentist has not visited since the new manager has been at the home and he is looking into this. An optician has seen individual residents, but there has not been a general visit by an optician yet and the manager has identified a company who may undertake eye tests for those residents without an optician. The chiropodist visits every six weeks. The home uses a dossette box system for medication and this is stored in a locked cupboard. However, one person administers the drugs, which means that as they take the medication to one person in a communal area, such as the dining room, the boxes are left unattended. The manager has already identified this as a concern and a medicines trolley is on order. The manager agreed that a short term measure should be taken to minimise the risk whilst waiting for the trolley to arrive, and decided that two staff should administer Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 10 the medication. Staff sign the records after the resident has taken their medication, however, records did show some gaps which were generally attributable to certain shifts. The medicine cupboard contained medication for two residents who had left the home in August and September: this should have gone with them at the time. A complaint was previously made to the Commission, which alleged, (and was substantiated by the manager) that a staff member had opened a medication capsule for a resident and put the contents into a cup of tea. This was in response to the resident having difficulty in swallowing. However, this is not a safe practice as some drugs only work if they remain intact, and are released slowly. Additionally, damage can be done to the throat through swallowing the content without the coating. The manager dealt with this issue at the time of the complaint. Staff have not received any formal training and were not aware regarding what drugs are used for, how they work, side effects to look for, etc. The manager has recently undertaken a ‘Train the Trainer’ course regarding medication and plans to give all staff a training pack which he will use to provide training. He plans to start this within the ‘next week or so’. Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 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): 12, 14 & 15 The home ensures that residents can bring their own possessions into the home, and make choices about meals. The home does not ensure that adequate activities and stimulation are available for residents. EVIDENCE: At the last two inspections, the inspectors found that there was a lack of activities for residents. When the home applied to be registered to admit people with dementia, the inspector was assured by the manager and the provider, that activities would both increase, and be of relevance to people with different stages of dementia. The staff and manager told the inspector during this inspection that the singer is now visiting the home fortnightly instead of monthly. Staff also said that residents who previously did not join in with the singer, are now enjoying this more. There are more staff on the rota which means that they can set up games, such as cards and draughts, spontaneously. The manager has implemented a key worker system, and part of their role is to work with residents to identify ways they might be involved in the running of the home, for example, by making sandwiches. The gardener has been asked to source some window boxes and trestles so that residents could be involved in planting them. However, the progress is not adequate for the amount of time that has elapsed since this issue was first raised, i.e. a year, and the rapidly changing needs of the resident group. The inspector Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 12 suggested that the manager seek activities advice based on current good practice and research. The inspector saw that residents had brought personal possessions into the home and the manager said he encouraged this. Residents can look after their money if they are able to. One resident who was asked said that the food was good, and staff said that the cook speaks to residents in the morning and offers them a choice of food for lunch. The cook records the food provided on a daily basis, but records should show specifically who has eaten what, to ensure diet monitoring. Support is given to those residents’ who need assistance with eating. Some residents choose to eat in their rooms. The inspector observed a resident asking for a glass of water, which staff got immediately. The staff member giving out tea and coffee had previously asked everyone what they would like to drink and had made the drinks to order. Remyck House DS0000012099.V257165.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 & 18 The manager ensures that there are procedures in place to enable residents to complain, and to protect residents from abuse, although the written policy regarding the latter would benefit from being clearer. EVIDENCE: Residents have a copy of the complaints procedure in the Service User Guide which residents have in their bedrooms. A copy of the procedure was seen, and it includes the appropriate timescale. Staff told the inspector that they do keep a book, to record any complaints. A complaint was made to the Commission, which was referred to Social Services under the Protection of Vulnerable Adults procedures. The complaint focussed on care practice within the home, (including the medication issue detailed in standard 9), regarding a specific staff member and resident. Social Services visited the home and spoke with the resident. The manager of Remyck House, after liaison with Social Services, investigated the allegations. The matter was unresolved, but a plan of action was agreed by all parties involved. Staff who were asked by the inspector about the procedure they should follow if they suspected abuse within the home, were aware of the role of Social Services. However, the home’s written procedure was confusing and incorrect and should be amended. Remyck House DS0000012099.V257165.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 & 26 The manager does not ensure that all residents live in a well maintained and clean environment. EVIDENCE: Since this standard was last assessed an extension has been built, which enabled the home to accommodate 29 residents in total. The inspector toured the building and looked at the communal rooms, kitchen, bathrooms/toilets and some bedrooms. The bedrooms in the new extension have new, matching furniture and are in a good state of decoration. In the original building, one vacant bedroom had a stained carpet, the en-suite floor was stained and the walls would have benefited from being painted. The manager said that the room would be decorated ‘when someone moved in’. In another vacant room the walls needed repainting and the chest of drawers was worn. The armchair had dust in the arm creases and there was a slight tear in one of the arms. A further room had a stained carpet and another had worn furniture. The bathroom in the extension is in everyday use as it was purpose built, however, Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 15 it would benefit from being more homely in appearance, as there are not any pictures, plants, ornaments, etc. A tall bin was found in front of a fire exit door on the ground floor and although the inspector told the staff member it should not be there, it was still there when the manager arrived about an hour later. An agency worker who had begun their first shift at the home that morning, was not told where the fire exits were, or the procedure to follow if the alarms went off, until the afternoon. Two rooms smelt of urine, and the inspector was told that the cleaner had not yet been to those rooms. The inspector went back later in the day, and although the smell was less, it was still evident. The manager told the inspector that staff use gloves when undertaking personal care with residents and the inspector saw staff wearing gloves. Improvements had been made in the kitchen regarding food storage, but the cupboard doors and the wall by the cooker hood were not clean and had evidence of tea/coffee drips and food splashes/grease marks. The inspector looked at the kitchen in the afternoon when the kitchen was clear of lunch preparations, etc. Remyck House DS0000012099.V257165.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): 29 The home ensures that residents are protected by consistent recruitment procedures. EVIDENCE: The inspector looked at recruitment files for three new staff. The files contained the appropriate pre-employment checks, references and proof of identity. All necessary checks had been completed before the staff started working at the home. Remyck House DS0000012099.V257165.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, 33 & 35 The home does not ensure that it is run in the best interests of the residents and their financial interests are not safeguarded. EVIDENCE: The registered manager of Remyck House has retired and left the home two weeks ago. The new manager, Derek McCarthy has been in post approximately five months and has applied to the Commission to become the registered manager. Mr McCarthy has been previously registered as a manager within the field of domiciliary care in the community. The new manager has been able to undertake management tasks whilst the registered manager was in place, and has ensured that the majority of the requirements made at the last report, have been met. The manager has arranged for the first residents’ meeting to be held this week. An audit of interest in activities was recently undertaken, but there has Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 18 not been a formal quality assurance survey. Since the last inspection, the home has been able to admit people with dementia: this along with the management and building changes has meant that the home has been in a transition period whereby a quality assurance tool would have been beneficial. The manager had delegated the task of distributing pre-inspection comment cards from the Commission, to the residents. These were subsequently returned directly to the inspector, but none of them had been completed. It was clear from a letter from the manager to the residents that was included, that the cards had not been given to residents. The manager had not been aware of this, and acknowledged that a mistake had been made. Additionally, the pre-inspection questionnaire which must be completed by the home, prior to inspection, was not completed or returned to the inspector. The home looks after the personal allowance for two residents who are unable to manage money themselves. One account matched the records, but the other amount of money did not match the records which also did not match receipts. It was not possible to see how by how much the records did not match. Remyck House DS0000012099.V257165.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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 x x x x x x 2 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 2 x x x Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13 (2) Requirement All staff who administer medication must have training, which includes basic knowledge of how medicines are used and how to recognise problems in use, record keeping, the home’s policies etc. All medication records must be accurate. A plan of activities must be devised that reflects the interests and needs of residents. (Repeated requirement of 6/7/05 and 23/11/04) Fire exits must be kept clear at all times. The home must have a formal quality assurance system in place. Residents’ money must be properly accounted for, and records must match the amount of money held on behalf of residents. The worktops and kitchen cupboard doors must be kept clean Timescale for action 10/12/05 2 3 OP9 OP12 13 (2) 16 (2)(m)(n) 10/11/05 10/12/05 4 5 6 OP19 OP33 OP35 23 (4)(b) 24 (1)(3) 13 (6) 10/11/05 10/01/06 10/11/05 7 OP38 23 (2)(d) 10/11/05 Remyck House DS0000012099.V257165.R01.S.doc Version 5.0 Page 21 (Repeated requirement of 6/7/05) 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 OP9 OP18 Good Practice Recommendations Medication belonging to individuals should go with them when they leave the home. The manager should amend the home’s Adult Protection Procedure to include the role of Social Services, to ensure that staff can access the correct information when looking at the policy. There should be an ongoing maintenance plan in place regarding the re-decoration and re-furnishing of the building. 3 OP19 Remyck House DS0000012099.V257165.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 Remyck House DS0000012099.V257165.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. 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