CARE HOMES FOR OLDER PEOPLE
Royal Bay Residential Home 86 Barrack Lane Aldwick Bognor Regis West Sussex PO21 2PE Lead Inspector
Mrs J Farrell Unannounced Inspection 6th February 2006 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 Royal Bay Residential Home DS0000014696.V281757.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. Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Royal Bay Residential Home Address 86 Barrack Lane Aldwick Bognor Regis West Sussex PO21 2PE 01243 864086 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) royalbay@btopenworld.com RBCH Limited Mrs Beverley Annita Treble Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th September 2005 Brief Description of the Service: The Royal Bay Residential Home is a privately owned care home registered with the Commission for Social Care Inspection to accommodate up to forty two service users in the category of Older Persons. 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 sized. There are two lounges, a dining room and a conservatory. The registered provider is Royal Bay Care Homes Ltd and the registered manager is Mrs Beverley Treble. Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours on 6th February 2006. This is the second statutory inspection of this year. The purpose of this inspection was to inspect standards that were not assessed on the announced inspection and to generally monitor care practices. This report must be seen in light of the previous inspection report, which was carried out in September 2005. Miss Hunt was in charge of the home while Mrs Treble was away on annual leave. This is a consistently high achieving home, which responds to any constructive criticism actively and is proactive in improving the services for the residents. The inspection in September 2005 highlighted practices above the minimum standards in 4 areas and the inspector scored these areas at a 4, which is commendable. The Inspector saw nothing, which would change her mind regarding this good practice. The Inspector would like to thank the management, staff and residents for their hospitality and cooperation throughout the inspection. No requirements were made following this inspection. What the service does well:
The ongoing environmental improvements to the home have created a homely and relaxed atmosphere, whereby residents take ownership of their surroundings. At the time of this inspection the home was being efficiently managed. Systems are in place to ensure residents are safeguarded and their health and social care needs are being met. 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. 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. Mealtimes are flexible, particularly supper, which was noticed to cater to individual needs. Residents are supported with their personal routines and this support was seen to be offered and carried out with dignity and respect. All records and files were found to be neat and easily assessable. Residents and relatives spoke highly about the services offered at the home and described the staff as friendly and caring. One relative said staff are always so polite. Another relative stated that she was so relieved when her relative was placed at Royal Bay and she could not fault any of the care. Comments from residents included that staff were ‘fantastic ‘ ‘so caring’ ‘always there for you’ ‘I could not want for better care’ Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 6 The manager and her team respond quickly to any requirements and recommendations made by the Commission. 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 DS0000014696.V281757.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 Royal Bay Residential Home DS0000014696.V281757.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): 3,6 There are systems in place to ensure residents and their representatives’ make an informed choice about the Home. No resident moves into the home without having had a thorough assessment of their needs discussed with them. Residents confirmed that their varying care needs were being met. The home does not provide intermediate care. EVIDENCE: Four residents spoken with in private were able to confirm that they had been provided a copy of the Service Users Guide. They said they had visited the home prior to being admitted on a trial short stay. A review of their care needs was discussed with them during the first two weeks of their stay. One resident said she thought her health had considerably improved since entering the home. Residents said they found it particularly helpful to have met with the manager prior to entering the home. Four pre-admission assessment documents were looked at and they clearly showed that the admission procedure was thorough and well recorded. This procedure ensures that new resident’s needs are properly assessed and planned for.
Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 9 Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 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): 7,11 Arrangements are in place to ensure that the health care needs of residents are identified and met. 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 specialist advice that is given is incorporated into the care plan. In discussion with some of the staff it was concluded that they would benefit from some support or training to improve their confidence in discussing and helping residents to express what they would like to have happen to them at the end stages of their life. Most staff have had practical training on what to do after the death of a resident and there are clear policies to guide staff on what to do. The inspector was impressed with the staff knowledge and their sensitive approach to this difficult subject. Royal Bay Residential Home DS0000014696.V281757.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): Residents said that their social needs were met as far as possible taking into account their increased physical frailty. Residents receive a wholesome appealing diet in pleasant surroundings at times convenient to them. EVIDENCE: Residents spoken with said that they were encouraged to maintain their chosen hobbies in and out of the home. Notices of forthcoming residents meetings are displayed and items for the agenda are requested. Several residents told the inspector that they often attended these meetings. Individual care plans clearly state the social and recreational preferences of the resident. The record of food provided was varied and interesting. There was clear evidence that fresh produce is used daily. The home employs a qualified chef who consults daily with the resident. Residents said that meal times were always a pleasure. One resident said he preferred his main meal in the evening and the staff on duty provided this. The lunchtime meal was taken with all of the residents and found to be appetising and well presented. Menus viewed were varied and most residents spoke positively about the food they received. One resident told the Inspector he regularly had his favourite meal cooked for him. Five out of ten residents spoken with said they had never heard any complaints about the food at Royal Bay and that personal choices and
Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 12 preferences were always respected. However a small number of residents did say they would like to have more of a variety of vegetables and one resident commented that though they can have a cooked breakfast sometimes the person cooking it does not have cooking skills. Royal Bay Residential Home DS0000014696.V281757.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): 17 Service users rights are protected by means of accessing and participating in the civic process if they wish. EVIDENCE: Residents are encouraged to vote and postal votes are provided. Royal Bay Residential Home DS0000014696.V281757.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): 22,25 Service users benefit from a clean, comfortable and well-maintained home. 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 home meets the requirements of the Environmental Health Department and local Fire Service. At the time of the inspection, all communal areas and the ten bedrooms seen by the Inspector were found to be clean, tidy and well maintained. All residents and relatives spoken with confirmed that the home was always clean and free from odour. The staff interviewed stated that they take pride in maintaining a very clean environment and all were very clear regarding the issues of infection control. A Legionella policy is in place, and regular health and safety checks are carried out. Water temperature checks are regularly recorded. It was noted that the home is managing with two washing machines only. This presents a problem according to the laundry assistant when the demand
Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 15 becomes high and residents clothes cannot be turned around in reasonable time. Royal Bay Residential Home DS0000014696.V281757.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): 27 The deployment and number of staff is sufficient to meet the needs of the residents. 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 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. Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 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): 33,34,37 The homes management are approachable and staff feel they are supported. Service users are protected by the management systems in the home. EVIDENCE: Visitors made positive comments about the management and staff gave good examples of best practice. Policies and procedures are in place to ensure the smooth running of the home. Staff confirmed that regular meetings were held where the manager informed them of any changes in legislation. Regulation 26 reports need to be sent to the Commission for Social Care Inspection as required. The home undertook an audit last year, which included outside professionals. This produced an action plan, which identified that residents would like to have more activities. The process will be ongoing. Residents spoken with confirmed that there were asked their opinion about the running of the home.
Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 18 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. Access to individual training records and audits were available at this inspection and found to be satisfactory. Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x x x x 3 x x 3 x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 3 x x 3 x Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action 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 OP26 Good Practice Recommendations The home may wish to purchase a third washing machine. Royal Bay Residential Home DS0000014696.V281757.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, 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
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