Inspection on 13/02/06 for Scarborough House

This inspection was carried out on 13th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Scarborough House 22/11/07

Scarborough House 09/01/07

Scarborough House 09/05/05

Scarborough House 07/02/05

Scarborough House 17/08/04

Scarborough House 26/01/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Scarborough House Clubbs Lane Wells Next The Sea Norfolk NR23 1DP Lead Inspector Ann Catterick Unannounced Inspection 13th 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 Scarborough House DS0000027502.V275409.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. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Scarborough House Address Clubbs Lane Wells Next The Sea Norfolk NR23 1DP 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) 01328 710309 NO FAX # Imperial Care Homes Limited Position Vacant Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2005 Brief Description of the Service: Scarborough House is a care home providing personal care and accommodation for 17 older people. There were 17 service users accommodated on the day of inspection. The home is owned by Imperial Care Homes and at present there is no registered manager. The acting manager is Christine Hodnett. The home is located in the coastal town of Wells and is located close to shops, public transport and other local amenities. The home is a two storey detached property with a single extension attached to the side of the original building. The home offers bedroom accommodation on the ground and first floor. The home has a variety of communal areas throughout the home. A new kitchen has recently been installed. There are patio and garden areas that are accessible to service users and these are well tended with attractive potting and planting. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 13th of February and lasted 6 ½ hours. The inspector was able to speak to many of the service users; staff and management as well as look at care plans and files and have a tour of the building. Since the last inspection the registered manager has left the home and Christine Hodnett is the acting manager. All comments received about Christine from staff and residents were positive. A pre inspection questionnaire, completed by the manager and comment cards from service users and relatives were received prior to the inspection. All written and verbal comment received were positive about the staff, food and environment. Visitors were always made welcome and service users said they would feel comfortable sharing any concerns they may have with staff. Some service users felt that they would like opportunity to be taken out of the home more and some felt that activities were limited. Overall the home offers a good service. What the service does well: The environment is comfortable and well furnished offering good quality accommodation. All service users spoke very positively about the staff. For example “Staff very good and very understanding.” “Girls are marvellous.” “Looked after very well” All service users offered positive comments about the food. “Food good, plenty of it.” “Food very nice.” All staff receive formal supervision that is recorded. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 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. Scarborough House DS0000027502.V275409.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 Scarborough House DS0000027502.V275409.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): 1, 3 and 6 Prospective service users can have all relevant information to enable them and their families to make an informed choice on whether or not they wish to move into the home. Prior to admission a prospective service user has their needs assessed to ensure that these needs can be met within the home. The home does not provide intermediate care. EVIDENCE: The home has a copy of the home’s Statement of Purpose and Service User Guide in the front of the home. These contain all of the information needed for prospective service users to be able to make an informed decision on whether or not they would like to move into the home. Within the service User Guide there are positive comments from service users. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 9 Care plans were inspected and at the front of these is the original assessment completed by the home prior to admission. If social services or health are involved in the placement the home would ask for an assessment from the lead worker. The home does not provide intermediate care. Scarborough House DS0000027502.V275409.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, 8, 9 and 10 Service users’ needs were set out in a care plan. There is opportunity for further development in this area. Service users are protected by the home’s policy and procedure relating to medication. Service users said that staff upheld their right to privacy and that they were treated with respect. EVIDENCE: Several care plans were seen and they included relevant and useful information. Within some care plans the information was limited and more detail could have been included. The social history and health information of service users was limited in some of the care plans seen. Care plans had been reviewed but not always adequately. One service user appeared to have needs that were outside the registration of the home. There had been no recent re assessment with regard her significant change in health although a referral to a consultant had been made. This person’s behaviour was having an Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 11 impact on the privacy and personal space of others but this was not identified in the care plan and no risk assessment regarding this matter was in place. The administration of lunchtime medication was observed and good practice took place. Medication was stored appropriately and mostly all written records seen were in order. Staff need to ensure that they complete the medication administration record at all times. The medication is stored in a medication trolley on the ground floor and as the home does not have a lift staff take the medication containers out of the trolley and upstairs by hand as they cannot transfer the trolley upstairs. The staff said that if there were a reason for them to leave the task of administering medication to attend to an emergency they would always return the medication downstairs to the medication trolley first to ensure safety. This issue has been discussed with the pharmacy inspector who has advised if medication has to be taken upstairs and cannot be done by using the trolley this should be done on an individual basis to minimise the risk of error. He suggested that individual medication is placed in a medication pot taken upstairs to the individual, signed for and then this practice repeated for all individuals. A requirement has been made in this area. Service users all spoke very positively about the care they received from staff and felt that there privacy was being upheld and they were treated in a respectful way. Staff were on one occasion observed entering a room without knocking and they need to ensure that they knock and await an answer at all times. However, the relationship between staff and service users appeared to be very good. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13, 14 and 15 Service users were satisfied with the general lifestyle experiences they had within the home although comment was made that it would be nice to have more opportunity to be taken outside of the home. Links with family and friends are maintained and some service users still maintained links with clubs or churches in the local community. Service users and/or their families are encouraged to exercise choice and control over their finances. Meals are taken in the dining area, lounge or bedrooms and service users all spoke positively about the food they received. EVIDENCE: Generally service users appear satisfied with the lifestyle experiences that they have within the home. Service users spoke of watching TV and reading books with some opportunity for bingo, crosswords and movement to music. Many of the service users at Scarborough House are very able and there is opportunity for further activities or occupation after tea. One service user said that they liked to go into the fresh air but there were not enough staff to do this. There are two staff on at any one time and the home could consider having additional Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 13 staff on duty to specifically be involved in social activities to ensure service users’ needs are met in this area. There appears to be a preference of having tea in the bedrooms. The outcome of this being there is little socialisation after that time. A recommendation has been made in this area. Service users are encouraged and enabled to keep contact with family and friends and these are always welcomed into the home. Some service users have contact with local churches and communion is offered in the home once a month. Another service user continues to use a club that meets with one of her specific needs. Service users are encouraged to take responsibility for their finances and information about advocates is offered to service users and/or their families. Service users spoke very positively about the meals provided within the home. Saying that food was good and plentiful. Service users tend to only use the dining room for lunch having breakfast in their rooms and supper in their rooms or the lounge. The cook is in the home between 9.30am and 13.30pm with care staff serving breakfast and tea. Service users were offered cooked teas on some occasions. Hot and cold drinks and fruit were available throughout the day. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 The home has a clear policy and procedures to deal with complaints to ensure that all complaints are listened to and taken seriously. The home has a policy and procedure for protecting service users from abuse. EVIDENCE: There have been no complaints received since the last inspection. The home has a policy and procedure relating to complaints and a copy of this is displayed in the front of the home and in the Service Users Guide. Service users spoken to said that if they had any concerns, which they did not, they would feel comfortable taken them to the management. The home has a policy and procedure to protect vulnerable adults from abuse. There have been no concerns regarding adult protection since the last inspection. Several staff have had training in this area and it is covered in their NVQ level 2. Two staff were spoken to and both were clear about the whistleblowing policy and would always refer any concerns to the management. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 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 the following standard(s): 19, 22 and 26 Service users live in a comfortable, safe environment that meets with their needs. Service users now have the specialist equipment that they need to maximise their independence. On the day of inspection the home was clean and tidy with no offensive odours. EVIDENCE: The home is well maintained and furnished. Bedrooms are varied and individual in character, reflecting the personality of the occupier. Communal areas are well furnished warm and comfortable. There is an attractive hard surfaced corridor that could be a risk to service users and a recommendation to carpet this area has been made. The manager said that she walks around the building on a regular basis and identifies any work, repair or maintenance Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 16 that needs doing. She then reports this to the proprietor keeping a record of when reported and when completed. Since the last inspection a stand aid hoist has been purchased and now the mobility needs of all service users are being met. On the day of inspection most parts of the home were seen and all area were clean and tidy free from any offensive odour. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 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 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, 28 and 29 There are some times within the day that there does not appear to be sufficient staff on duty to meet all of the needs of the service users. The home is aiming to ensure that all staff who work within the home have the training to ensure that they provide safe working practices. Staff are protected by the homes recruitment and selection policy but this did not appear to have been thoroughly followed with one member of staff. EVIDENCE: The home has 17 service users and two care staff on duty at all times. However at breakfast time and teatime there is no cook on duty and one of the care staff have to assist with breakfast and tea. This leaves only one care assistant to care for the needs of the service users. One of these staff is also responsible for the administration of medication. The addition of a kitchen assistant may resolve this situation. Also some service users spoke of the lack of opportunity for staff to take them outside of the home, for example out in a wheelchair or short walk. Activities are planned take place on a weekly basis but they do not always take place if staff or the manager have other tasks to do at this time. There was also a comment received from a relative saying that service users would benefit from more one to one contact. They stated that staff were very good but did not have much time for this. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 18 The proprietor needs to ensure that there are sufficient numbers of staff on duty at all times to meet the needs of service users. A requirement has been made in this area. Since the last inspection the Proprietor has arranged that a senior member of staff from the company is a dedicated worker who is qualified and involved in supporting all of those who are completing their NVQ. The home has a recruitment and selection process and when looking at staff files all of the information needed was available for all but one member of staff. Application forms, job descriptions and references were seen on the files. A CRB had not been received for this one member of staff and a requirement has been made in this area. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 19 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, 35, 36 and 38 The home does not have a registered manager. The home is being managed by an acting manager who may make application to become the registered manager. The feedback from staff and service users about her leadership style was positive. Service users’ financial interests are protected within the home. All staff are offered informal and formal supervision. The home aims to ensure that the health, welfare and safety of service users are being protected. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 20 EVIDENCE: Since the last inspection the registered manager has left the home and Christine Hodnett is the acting manager. She is now enjoying the role and is developing more administration skills. She has NVQ level 3 in care and would need to complete further qualifications if she were to make application for the post. She is receiving support and guidance from the proprietors. Staff and service users spoke positively about her management skills. Service users and/or their families or advocates take responsibility for any finances. Three service users have a small amount of personal allowance looked after by the home. This is kept individually in the safe and all transactions are recorded and countersigned. This was fully checked on the day of inspection and all was in order. All staff received informal and formal supervision. Formal supervision is recorded and evidence of this was seen on the day of inspection. All staff complete induction, foundation and mandatory training. All staff are encouraged to complete NVQ training. Chemicals are kept in a locked cupboard and staff are aware of safe practice in this area. Radiators are covered and water outlets are of the correct temperature. Window restrictors are on all upstairs windows. On the day of inspection the front door was unlocked and a resident who was confused walked out of the home and had to be assisted back by staff. A risk assessment needs to be completed to ensure that the home is secure and service users are safe and protected from harm. A requirement has been made in this area. Individual and environmental risk assessments were seen. Incident and accidents were recorded and were appropriate reported. The inspector does not feel competent to inspect against standard 38.4 but the acting manager believed that the home worked in a way that was compliant with the relevant legislation. Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 21 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 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 3 x x x 3 STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 x x 3 x x 2 Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement Timescale for action 01/04/06 2. OP27 18 (1) a 3. 4 OP29 OP38 19 (1) 13 (4) c The Registered Provider must ensure that they make arrangements for the safe recording, handling, safekeeping and administration of medication. This relates to the way administration is administered to service users when they are situated on the 1st floor. The Registered Provider must 01/04/06 ensure that there are enough staff on duty at any one time to meet all the needs of the service users. This relates to breakfast and tea times. It also relates to ensuring there are enough staff on duty to meet the social needs of service users. The Registered Provider must 01/04/06 ensure that a CRB is obtained for all staff. The Registered Provider must 01/04/06 ensure that all unnecessary risks to service users are identified and eliminated. This relates specifically to the security of the building as on the day of inspection a vulnerable service DS0000027502.V275409.R01.S.doc Version 5.1 Scarborough House Page 23 user left the building without the immediate knowledge of staff. 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 OP7 OP15 Good Practice Recommendations It would be good practice to develop the care plans to include more detailed information. There is a culture in the home, not to use the dining area for tea time and it would be good practice to encourage this, which may encourage more socialization during the evening. It would be good practice to consider having the tiled hallway carpeted to minimise the risk of injury if a service user fell in this area. 3. OP19 Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Scarborough House DS0000027502.V275409.R01.S.doc Version 5.1 Page 25 - 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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