Inspection on 16/09/05 for Royal Bay Residential Home

This inspection was carried out on 16th September 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

Royal Bay Residential Home 04/01/07

Royal Bay Residential Home 06/02/06

Royal Bay Residential Home 23/02/05

Royal Bay Residential Home 24/06/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Royal Bay Residential Home 86 Barrack Road Aldwick, Bognor Regis West Sussex PO21 2PE Lead Inspector Mrs J Farrell Announced Friday, 16 September 2005, 09.30am,V241527 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Royal Bay Residential Home Address 86 Barrack Road, Aldwick, Bognor Regis, West Sussex, PO21 2PE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 864086 RBCH Limited Mrs Beverley Annita Treble Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (OP) - 42 Both of places Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24/02/05 Brief Description of the Service: The Royal Bay Residential Home can accommodate up to forty two residents in the category of Older Person. The property is a detached three-storey building in Bognor Regis, close to the town centre and all amenities. Accommodation is provided in thirty-five rooms, seven of which are double sizes. there are two lounges and a conservatory. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 16th September 2005 and lasted six hours. There were 35 residents living at the home at the time of inspection. During the inspection the inspector spoke with 10 residents in private and 5 in the communal lounge. The overall impression of this home is that there is clear strong leadership, which is consistently looking to improve the high quality of care already received by the residents at Royal Bay. Two inspectors were involved in the inspection. Mrs Farrell who was the lead Inspector and Mrs Datoo was the second inspector. This is the first statutory inspection of this year. Mrs Datoo is a pharmacy inspector. She spent 3 hours examining medication procedures. A tour of the premises took place, rotas and care records were inspected. Records were examined at random and 8 staff members were spoken with, to gain a sense of what it was like to live in the Royal bay Residential Care home. The majority of residents spoke highly of the establishment comments included “that staff are very helpful and kind. The home is comfortable and clean, the food is varied and well presented, the managers are very efficient and caring “ Prior to the inspection the Inspector received 22 relatives comment cards from residents, which had very positive comments about the home. What the service does well: The home has an experienced team of staff who enjoy their work and have a good understanding of the needs of the people living at the home. Residents spoke highly of the support received by staff and positive relationships were observed. The environment is relaxed and friendly and residents have use of a range of communal areas in addition to their individual rooms. Meals are varied, balanced and well presented, offering both choice and variety. All residents spoken with described the food as very good or excellent. Residents are supported with their personal routines and this support was seen to be offered and carried out with dignity and respect. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 6 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. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Prospective service users have the opportunity to see if the home will be able to meet their needs before they accept a permanent placement. Arrangements are in place to ensure that the health care needs of residents are identified and recorded. Staff have sufficient abilities to meet the current needs of the residents admitted. However staff would like to have more training on dementia, this would enhance the ongoing care needs of the residents. EVIDENCE: Nine residents spoken with in private were able to provide a copy of the Service Users Guide. They said they had been able to visit the home if they wished prior to being admitted. A review of their care needs was discussed with them either before or during the first week of their stay. One resident said she thought her health had considerably improved since entering the home. Assessments could not be found in relation to one new resident. Inadequate assessment information puts staff and service users at risk of inappropriate care. Through sampling resident records it was evident that two residents have been admitted to the home although they have a possible diagnosis of dementia. Royal bay Residential Home is not registered to accommodate residents with Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 9 dementia and this impacts significantly on training for staff and staffing levels to meet these needs. It is recommended that Community Mental Health Team input is sought in relation to residents with possible dementia and training and staffing levels be reviewed to meet these needs if the Royal bay Residential Home remains a suitable placement. The Statement of Purpose states the qualification details of the staff. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Care plans set out the health, personal and social care needs of residents. Health care input is good, monitoring of nutirion could be improved. It was not clear, which of medication policy and procedures available to staff, were applicable to the home. EVIDENCE: Resident care plans were sampled, they contain information about the needs of residents. Responses from health and social care worker comment cards indicate that staff demonstrate a good understanding of the care needs of residents and that nay specialist advice that is given is incorporated into the care plan. Care plans include disclaimers which residents have signed to say they do not want to be consulted about their care plan, however three residents who spoke with the inspector did not know about their care plan. One resident was very well informed about his care plan. Residents said they could see their doctor when they wanted and one resident said that nurses visit her regularly. Responses from GP comment cards indicated that both were satisfied overall with the care provided, that senior staff are available to confer with and that the home communicates clearly and works in partnership. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 11 Although residents records included an eating and drinking plan, nutritional assessments had not been undertaken for any of the residents whose records were sampled and weight monitoring is not done monthly as recommended in the National Minimum Standards for Care Homes. This is because the weighing scales are shared with the sister nursing home and needs to be transported when required. The homes policy and procedure file was easily available to staff. Some medication policies and procedures, referred to nurses being responsible for medication. Resident’s have the choice to retain responsibility for some or all of their medicines. On admission risk assessments for self-administration are written, but those examined had not been updated. Resident’s are able to purchase over the counter medicines from a local pharmacy. Records of receipt, administration and disposal of prescribed medicines were clearly maintained and medicines for self-administration were identified. Medicines storage was in a lockable room with cupboards, refrigerator and trolley. The trolley was not suitably adapted, in order that medicines transported around the home, could be quickly locked away, in an emergency. An oxygen flowmeter did not have an expiry date. Ten care staff had received safe handling of medication training. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Opportunities are offered for residents to be involved in activities and for contact with family, friends and the local community. Residents are offered a choice of food and refreshment throughout the day. EVIDENCE: Residents told inspectors that they are able to handle their own finances if they wish. They are also able to bring in personal possessions with them to the home if these can be accommodated. Residents have access to personal records if requested, but the manager told the Inspector that the current group of people living at the home have not requested to do so. Currently all the residents, have family or friends to assist them, but if advocacy assistance was required this would be sought from an external agency. Six residents informed one of the Inspectors that an activity programme was not to their likeing, but staff confirmed that other activities were organised It was evident from the comments received that residents would benefit from an audit of activities –which take place both inside and outside the home. Most residents said that the food is very good and there is plenty of it, comments included, “..food is very good.. home made..very good chef” “the food is very good, 2-3 choices” “the food is very good, plenty of choice and lots of it”. A drink is served to residents in the evening. Feedback indicated that biscuits are not always offered with this drink, when an evening snack is not provided, the time without food exceeds twelve hours. Good practice was Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 13 noted in that the chef has a very positive approach to complaints. Residents informed the Inspector that if they have a complaint that he always comes to see them and ‘tries to sort it out’ .One resident discussed their special diet and how the chef accommodates this. The Inspector interviewed the chef and was very I, pressed with his proactive approach and knowledge of nutritional values. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The home has a positive approach to the management of complaints and staff understand the vulnerability of residents. The recruitment process does protect residents from abuse. EVIDENCE: The complaints book was viewed and this indicated that complaints are recorded, alongside outcomes and actions taken to resolve the complaint. During the inspection, one resident repeated a previous complaint to a senior carer, who responded with knowledge and sensitivity – reminding the resident of the choices available to them. It was apparent that any sign of dissatisfaction is taken seriously and acted on. A resident at the home said she could not imagine ever having cause to complain, but that she would not hesitate if the need arose. Robust procedures are in place for responding to any allegations or suspicions of abuse. Staff members told the inspector that they had received training in recognising the different forms of abuse. The staff interviewed were knowledgeable about the vulnerability of residents and the systems in place to protect them. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,25,26 Some improvements to the décor have been made and this provides comfortable surroundings for the people living at the home. However the outstanding matters may constitute a potential risk to the safety for the residents. EVIDENCE: The home is situated on a busy road on the outskirts of Bognor town centre close to local shops, post office and public houses. It is well maintained and a programme of regular maintenance is undertaken. It is comfortably furnished and has a homely atmosphere. The garden is well kept with an abundance of flowering baskets. The home meets the requirements of the Environmental Health Department and local Fire Service. The premises were clean and tidy on the day of the inspection. It was noted and brought to the registered manager’s attention that cleaning products are being stored in a bathroom and are not secured to ensure the health and safety of residents and staff. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 16 The Inspector noted that some of the hot water outlets were delivering water well above 430C this was pointed out to the manager. The Inspector observed staff taking a resident to the only communal toilet on the ground floor. Staff were clearly having difficulty in helping the resident to use this facility due to lack of space. Staff informed the Inspector that it was impossible to ‘get a hoist or a wheelchair into the space’. There was a curtain over the door but this is insufficient to provide privacy. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The procedures for the recruitment of staff are robust and ensure that sufficient staff are on duty throughout the day and night. Staff are trained and competent to provide care for the current residents needs. EVIDENCE: On the day of inspection, there were sufficient staff to support the needs of residents as detailed in the care plans. Staff spoken with confirmed that staffing levels were adequate at this time. The five relatives who provided feedback about the home, said they were happy with the number of staff at the home and found them to be kind and knowledgeable. Recruitment records were sampled for two recently employed staff all necessary checks are made prior to employment commencing including a POVA First check if the applicant is to begin work supervised before receipt of the full CRB disclosure. The residents who spoke with the Inspector commented how nice staff were and how they felt relaxed and happy to ask for help. The Inspectors observed lots of positive interaction between residents and staff. Staff training is ongoing, with over 50 of staff having completed National Vocational Qualifications. New staff undertake an induction in line with the National Training Organisation. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,35,36,38 Residents 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 her responsibilities fully. Service users are protected by the management systems in the home. However hot water may constitute a potential risk to the safety for the residents. EVIDENCE: The manager has been in post since 1999. She has an NVQ level 4 and has completed the Registered Manager’s Award. Evidence was seen that this manager has kept herself updated with current good practice. Four staff files randomly selected gave indications of induction, supervision, training and development staff had received. Most staff interviewed reported to the Inspectors that they had had regular supervision and their entire mandatory training. Policies and procedures are in place to ensure the smooth running of the home. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 19 The staff on duty demonstrated that they were aware of their responsibilities under Health & Safety. A maintenance person is employed to undertake a variety of checks and audits and to keep the home in a good state of repair. During a tour of the building, it was noted that some hot water taps were running at above 430C. Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 2 x x 2 3 STAFFING Standard No Score 27 3 28 4 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 4 4 x x 3 4 x 2 Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 21 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 OP8, Op10, Regulation 12(1)(a) Requirement Timescale for action 01/12/05 2. OP9 13(2) 3. 4. OP22 OP25, OP38 23(2)(A) 12(1)(a) That a suitable weighing machine is provided for the homes uses as and when required. Medication policy and procedures 01/11/05 must be reviewed to ensure that these are clear and relevant to the home. That the home provide a suitable 01/12/05 toilet facility on the ground floor for the current service users. Unnecessary risks to the health 01/12/05 and safety of service users are identified, and as far as possible eliminated. This includes scalding and burns from hot water. this is an outstanding requirement. 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 OP4 Good Practice Recommendations Staff should receive training on dementia training Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Royal Bay Residential Home H60-H11 S14696 Royal Bay V241527 160905 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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