Inspection on 30/06/05 for Seabrooke Manor Nursing Home

This inspection was carried out on 30th June 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

Seabrooke Manor Nursing Home 08/06/06

Seabrooke Manor Nursing Home 05/12/05

Seabrooke Manor Nursing Home 24/08/04

Seabrooke Manor Nursing Home 29/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Seabrooke Manor Nursing Home Lavender Place Ilford Essex IG1 2BJ Lead Inspector Gwen Lording Unannounced Inspection 30 June 2005 09:30 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. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Seabrooke Manor Nursing Home Address Lavender Place, Ilford, Essex IG1 2BJ 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) 020 8553 5538 020 8514 2283 BUPA Care Homes (CFH Care) Limited Mr Brent Jonathan Maher CRH Care Home 120 Category(ies) of DE(E) Dementia - over 65 (30) registration, with number MD(E) Mental Disorder - over 65 (30) of places OP Old Age (90) Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 60 nursing care beds in two units for elderly people, including 4 named beds for under 65s 2. 30 beds for elderly people with mental health problems, including 5 beds for age 50 3. 30 beds for elderly people requiring personal care only Date of last inspection 24 August 2004 Brief Description of the Service: Seabrooke Manor is a 120 bedded home owned and operated by BUPA Care Homes Ltd. The home is purpose built and is divided into four seperately staffed units. These provide care for specific client groups: people over sixtyfive years requiring nursing and personal care due to fraility/ illness and people with dementia, some of whom require nursing care and some of whom require assistance with personal care. The home is situated in a residential area of Ilford in the London Borough of Redbridge; approximately 10-15 minutes walk from the mainroad and public transport. The external grounds and building are well maintained and secure. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day, commenced at 9.30am and lasted 6 hours. The inspection was undertaken by two inspectors focusing on the care of residents with a diagnosis of dementia. The two units providing this care are Saxon House (residential care) and Roman House (nursing care). The inspectors looked at the same standards in both units, one inspector looking at Roman House and the other at Saxon House. Discussions took place with the registered manager, deputy manager, the senior sister on Roman House and the senior carer in charge on the day at Saxon House. The requirements and recommendations made at the previous inspection were discussed with the registered manager. There are two unmet requirements around care plans and training in dementia care that have been repeated in the previous two inspection reports and one unmet requirement around formal supervision of staff from the last inspection report. A variety of resource materials specifically related to the care of the people living with dementia were left on both units. Roman House The inspector spoke to five residents and the relatives of two of these residents. A tour of the unit took place and a number of care and health records were inspected. Discussions took place with nursing and care staff and also ancillary staff. Saxon House The inspector spoke to five residents and the friend of one of these residents. A tour of the unit took place and a number of care records were inspected. Discussions took place with care staff and also ancillary staff. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Roman House Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 7 Although the qualified nursing staff are receiving training in the care of people living with dementia, this must also be a priority training need for care staff and ancillary staff must have awareness training in this area. The unit only currently completes an accident/incident form for what staff considered being major accidents and incidents i.e. following a fall or large skin tears. In all cases there is a detailed body map recording all injuries, bruises etc. that is dated and signed. However, it is necessary that an accident/incident form be completed in every case. The complaints record must reflect all complaints, concerns and issues of dissatisfaction whether verbal or written and whether these are viewed as of a serious or non-serious nature. Saxon House It was evident from discussions with some staff that they had not received comprehensive training in caring for people living with dementia. Some staff had received a short awareness course in this area. However, to effectively care for people living with dementia it is essential that staff are equipped with the correct training to understand behaviours, and to allow residents to continue to exercise choice in their daily lives. The care plans identified some areas of need, but did not describe in sufficient detail how these needs would be met. Daily recordings and reviews did not always relate to the areas of need identified in the care plan, i.e. there were no records of nutrition, no continence care programmes etc. The care plan should aim to enable the resident to be able to take as full a part as possible in their daily living routines and so allow them to maintain a degree of independence. General Consideration must be given to the environment on both units to best use the lay out and design to meet the specialist needs of people living with dementia. For example through the use of décor, visual clues such as colour, signage and the use of familiar things from a person’s previous setting such as photographs etc. There are two activity co-ordinators employed at Seabrook Manor. However, those residents living with dementia would benefit from a wider programme of activities to ensure that they have a more varied and stimulating activity programme to take part in. 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. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 8 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 Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 9 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) 3 and 4. A pre-admission assessment is undertaken for all prospective residents and care plans are drawn up using this assessment. However, more detail needs to be obtained around a person’s existing abilities, such as making a cup of tea, washing up and other ordinary activities of daily life. This should then enable the staff to provide the right level of care to assist the resident to continue to live as full a life as is possible, and for as long as possible. EVIDENCE: Individual records are kept for each resident and a number of records were inspected on each of the two units. Roman House All records inspected had full assessment information recorded around the physical nursing care needs of the residents. However, there was limited information recorded as to the social care needs of each resident. The inspector was satisfied that the personal care and physical nursing care needs of residents were being adequately met and understood. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 10 Saxon House All records inspected had some details of social care needs but no information was recorded as to the dementia care needs of each resident. The inspector was satisfied that the personal care needs of residents were being adequately met. General Whilst the qualified nursing staff on Roman House are developing the skills to meet the needs of people living with dementia, the care staff on both units have not received adequate and appropriate training to meet and understand the social care needs of people living with dementia. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 11 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 and 10 Residents’ health and personal care needs are set out in individual care plans but not all plans accurately reflected the current needs and did not provide staff with sufficient information to ensure that care needs were being met on a daily basis. There are clear medication policies and procedures for staff to follow, and discussions with staff and the review of medication records show that staff are following the policies and procedures. The inspectors were satisfied that residents were safeguarded with regard to their medication. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. EVIDENCE: Roman House Individual care plans were available for each resident and the records of six residents were examined. The records for these residents were found to be generally detailed and comprehensive around the social, nursing and personal Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 12 care needs, and followed on from a full assessment. The records indicated that relatives were involved in both the initial care planning and the reviews. However, there was limited information on meeting the dementia care needs of residents. There was evidence that care plans are reviewed on a monthly basis and updated to reflect changing needs, and the records indicated that residents are seen by other health care professionals. Risk assessments are routinely undertaken for all residents. The accident/ incident records were examined. Roman House only currently completes an accident/ incident form for what staff consider to be major accidents and incidents for example, following a fall or large skin tears. Body maps are routinely completed following all accidents or incidents. However, an accident/ incident form must be completed in all cases. Saxon House Individual care plans are available for each resident and the records of seven residents were examined. Because the care plans did not show evidence of a person’s current ability and level of functioning, staff were not able to ensure that the correct care was being given to residents. The quality of care, which is experienced by someone with dementia, can be improved by the way staff use and understand care plans. A comprehensive care plan can only enhance the care experience of a resident living with dementia. Because the label of “dementia” tends to prompt very negative responses care plans tend to be couched in terms of risk, dependency or disability. The assumption that people with dementia cannot do much leads to dependence on care staff to do tasks that they could actually be doing themselves. It is therefore, essential that comprehensive care plans are compiled, with the assistance of relatives and friends of the resident, to ensure that staff provide the correct level of care. There was no evidence that body maps are routinely completed following an accident or incident. Although there was evidence that the care plans were reviewed monthly, there was little evidence that the reviews were meaningful as they did not always reflect changes to the care required or detail the progress of an individual. There was some evidence that some background history regarding previous activities enjoyed by residents was recorded, there was no evidence that such information is used in a meaningful way in the delivery of social care. For Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 13 example discussions with a visitor indicated that a resident used to enjoy playing the piano, but when discussing this with a member of staff she expressed surprise since she was not aware of this. There are pianos available at Seabrooke Manor. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 14 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, 14 and 15 There is a varied programme of activities available for large groups. More consideration needs to be given to planning individual and small group activities which are suitable for those residents with specialist needs such as dementia to ensure that all residents have a sufficiently stimulating and varied choice of activities. Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends as they wish. The meals in the home are well presented and there is always a choice of meal. Residents on the dementia units may benefit from the use of, for example picture menus, finger foods, small nutritious snacks and more flexible eating times to maintain independence, exercise choice around food and eating and still provide a healthy balanced diet. EVIDENCE: Roman House Visiting times are flexible and visitors commented that staff “ make them feel welcome, at any time”. Residents are able to receive visitors in one of the Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 15 lounges or in their own rooms. The husband of one resident spoken to chooses to visit and spend most of the day with his wife. This is well accommodated by staff and arrangements can be made for the provision of a meal. He particularly appreciated this arrangement on the day of the inspection as it was his wife’s birthday and he was able to join her for lunch. Staff had arranged with the chef for a birthday cake to be provided and staff and other visitors confirmed that a cake is always provided when a resident celebrates a birthday in the home. Meals are served in the dining room or residents may choose to eat in their rooms. A small number of residents remain in the lounge chairs and eat off small tables placed in front of them, though it is not clear if this is through choice. Menus were inspected and found to be balanced and a choice is offered each day. As well as the two choices of hot meal, two residents had chosen a cold meat salad. Staff are on hand to assist individuals with eating when necessary. The majority of the thirty residents need either supervision by staff or assistance with eating. Staff where observed to be offering assistance appropriately and residents were not being rushed. However, staff also had to attend to residents who had lost interest in their food, offer encouragement and reminders to eat and attend to residents who were wandering from the dining table. Staffing levels at mealtimes must be sufficient for service users to be assisted where necessary, whilst encouraging independent eating for as long as is possible. Saxon House Visiting times are flexible and visitors commented that staff “ make them feel welcome, at any time”. Residents are able to receive visitors in one of the lounges or in their own rooms. Meals are served in the dining room or residents may choose to eat in their rooms. A small number of residents remain in the lounge chairs and eat off small tables placed in front of them, though it is not clear if this is through choice. Menus were inspected and found to be balanced and a choice is offered each day. Staff are on hand to assist individuals with eating when necessary. The majority of the thirty residents need either supervision by staff or assistance with eating. Staff where observed to be offering assistance appropriately and residents were not being rushed. However, staff also had to attend to residents who had lost interest in their food, offer encouragement and reminders to eat and attend to residents who were wandering from the dining table. Staffing levels at mealtimes must be sufficient for service users to be assisted where necessary, whilst encouraging independent eating for as long as is possible. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 16 The majority of bedroom doors were locked. The inspector was informed that this because a resident was either in hospital or where a relative had requested the door to be locked for a particular reason for example, other confused residents entering the room and interfering with or removing personal possessions. On inspecting records there was no evidence that the resident was either in hospital or of a relative’s request. If there is such a request from a relative, the request must be in writing and the reasons for this must be fully recorded. Staff must explain to relatives making such a request that it has significant implications for the individual resident since it restricts any access they may wish to have to their own room during the day. The lack of appropriate signage on bedroom doors, for example there were no names or other identifying methods such as pictures, restricts the ability of residents to locate their bedroom thus restricting choice. General There is a general programme of activities for the home, but there does need to be more consideration given to the specialist needs of people living with dementia. For instance more individual activities and small group activities focusing on the individual’s needs and cognitive functioning, and adapting activities to relate the individuals likes and dislikes, past and present. The current practice of compiling life history profiles as used on Roman House must be extended to Saxon House. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 17 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 and 18 All complaints made whether verbal or written must be recorded to ensure that any trends are identified and that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a written complaints policy and procedure and the records inspected indicate the number of complaints received and includes details of investigation and any action taken. In discussion with the senior sister on Roman House and the senior carer on Saxon House, and inspection of the complaint record maintained, it was evident that only formal written, or serious complaints are being logged. However, all complaints however, small are acted upon. The inspector had a discussion with the senior sister as to what constituted a “complaint” to be logged. This must include verbal complaints via telephone or face to face and expressions of concern and dissatisfaction with any element of the service in line with BUPA’s complaint policy. Those relatives spoken to considered that the staff were always very responsive to any concerns or issues of dissatisfaction raised. There is a written policy and procedure for dealing with allegations of abuse and whistle blowing. Here is an ongoing programme of training in Adult Protection/ Abuse Awareness and this is now extended to all staff working in Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 18 the home including administrative and ancillary staff. Those staff spoken to during the inspection were aware of the action to be taken if there were concerns about the welfare and safety of residents. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 19 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 and 26 Generally the standard of the environment within the home provides residents with an attractive, safe and comfortable place in which to live. The environment on both of the dementia units must be improved to meet the specialist needs of people living with dementia. EVIDENCE: The standard of the décor, furnishings and fittings are generally being maintained to a good standard. There is an ongoing programme of refurbishment and re decoration. The home employs a full time maintenance person and there is an effective system in place for staff to report items requiring repair or attention. As the ability of people with dementia to communicate with words decreases, the use of non-verbal cues and the environment is important in enabling them to cope better with daily life. The general environment on the dementia units must reflect good practice guidance on dementia care within care homes. A Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 20 copy of the Commission’s “Dementia Care Within Care Homes Guidance” has previously been given to the registered manager, and additional copies were left on both units. Consideration must be given to utilising the existing design and layout of both units to meet the specialist needs of people living with dementia. For example, through the use of visual cues such as colour and signage. Staff must also be aware of factors such as noise. On the day of the inspection of Saxon House noise from the television was competing with music being played on an audio tape. This can be very distracting for residents and have a direct impact on their behaviour. On the day of the inspection both units were found to be clean and free from offensive odours throughout. Saxon House On Saxon House although there are two lounges, the very large lounge/dining room and a smaller lounge used for those residents who smoke, the smaller lounge was in a poor decorative condition. The current use of this lounge is being reviewed to make it into a “cinema” for the use of all residents at Seabrooke Manor. The inspector is concerned that this has the potential to reduce the communal facilities available to residents in Saxon House. Much more thought must be given to the use of communal space, with a designated area for those few residents who smoke. Consideration must be given to the layout of seating areas in the large lounge as relatively few residents could actually see the television, and could be distracted by activities being undertaken in other areas of the lounge. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 21 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 and 30 Both units employ staff in sufficient numbers to meet primarily the personal and nursing needs of the residents. The increased needs of residents living with dementia at peak periods, such as mealtimes and social activities, may mean staffing levels being increased at these times. The care staff on both Roman and Saxon House are not sufficiently trained or skilled to understand and effectively meet the needs of people living with dementia. EVIDENCE: Both units have relatively stable staff teams. The staffing levels of qualified nurses and care staff on Roman House and the levels of care staff on Saxon House were sufficient to meet the nursing needs and personal care needs of residents. With the exception of mealtimes on Roman House which has already been commented on earlier in this report. In addition to qualified nurses and care staff Seabrooke Manor employs two activity co-ordinators, catering, laundry, housekeeping, maintenance and administrative staff. In addition to serving meals, two members of care staff from each unit have to go to the main kitchen at each mealtime to collect the hot trolley. Whilst the kitchen is in close proximity to both units, this effectively means that the staffing numbers are depleted by two on each occasion. Care staff should be wholly engaged in undertaking tasks around meeting residents personal and social care needs and it is strongly recommended that ancillary staff undertakes these portering duties. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 22 Whilst the qualified nursing staff on Roman House are receiving training in the care of people living with dementia, this must be a priority training need for all care staff on both Roman House and Saxon House. Care staff must be supported and enabled to develop the skills, knowledge and abilities required to successfully enable residents to continue to exercise choice in their daily lives and reach their full potential. All care staff must receive comprehensive and certificated training in caring for people living with dementia. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 23 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 & 36 The manager is a very experienced and well-qualified person. However, because of the size of the establishment it is essential that the lines of accountability within the home are robust enough to ensure that the manager is, at all times, fully appraised of any issues relating to the day to day management of the home, and of the specialist needs of residents. EVIDENCE: Although the manager stated that he had redirected resources from Roman House to Saxon House to review care plans and working practices, this was not evidenced in the care plans examined on Saxon House. This is an unmet requirement from the last two inspections of Seabrooke Manor. The inspectors understand that the responsibility for training has been devolved to the deputy manager. However, the requirement for care staff to receive training in the care of people living with dementia was a requirement in the previous two inspection reports for Seabrooke Manor. Care staff had not Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 24 received this training and the deputy care manager on Saxon House had withdrawn from a training course on dementia care From discussions with staff on both units it was evident that there are regular opportunities for ad hoc individual supervision and staff meetings, but there was no evidence that staff, both nursing and care staff, receive regular formal supervision. This is also an unmet requirement from the last inspection visit. Supervision should cover all aspects of practice; philosophy of care in the home and career development needs, and all staff should be supervised as part of the normal management process on a continuous basis. The manager must put in place effective quality assurance and quality monitoring systems to enable him to maintain informed day-to-day control of the delivery of care in this very large establishment. Regulation 26 reports are undertaken regularly by a representative of the registered providers and a copy of the report is sent to the commission. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 25 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 x x 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 2 x x x x 2 x x Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 26 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 3 Regulation 14 Requirement All pre-admission assessments must include a detailed assessment of the persons dementia care needs and their social care needs. Staff individually and collectively must have the required skills, experience and training to deliver the service and care which the home offers to provide on the dementia units. (Timescale of 31/12/04 not met) All residents must have individual plans of care, which show how all their health, personal and social care needs are to be met.(Timescale of 30/11/04 not met) A record must be maintained of all accidents/ incidents occuring to residents. The home must provide a more varied programme of activities for those residents with a specialist need such as dementia. Where relatives have requested the door of a residents bedroom to be locked, this request must be put in writing and the reasons for this must be fully recorded. Timescale for action 31/08/05 2. 4 12 & 18 31/08/05 3. 7&8 12 &15 31/08/05 4. 5. 8 12 17 Schedule 3 - 3(l) 16 30/06/05 and ongoing 31/08/05 6. 14 12 31/07/05 Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 27 7. 15 & 27 18 8. 16 22 9. 19 23 10. 30 18 11. 31 9 & 24 12. 36 18 Staffing levels at meal times must be sufficient for residents to be assisted where necessary, whilst encouraging independent eating for as long as possible. All complaints made whether verbal or written must be recorded and include details of investigation, any action taken and the outcome for the complainant. The existing layout and design of the environment on the dementia units must reflect good practice guidance on dementia care within care homes, to ensure that the specialist needs of residents on these units are met. All care staff on the dementia units must receive comprehensive and certificated training in caring for people living with dementia. The manager must put in place effective quality assurance and quality monitoring systems to enable him to maintain informed day to day control of the delivery of care in the home. Formal supervision systems must be fully implemented in accordance with Regulation 18 and Standard 36.3 of the National Minimum Standards. (Timescale of 31/12/04 not met) 31/07/05 31/07/05 31/08/05 31/08/05 31/08/05 31/08/05 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. Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 28 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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 Seabrooke Manor Nursing Home G55_S0000025961_Seabrooke Manor_V235583_300605_Stage 4.doc Version 1.40 Page 29 - 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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