Inspection on 05/12/05 for Seabrooke Manor Nursing Home

This inspection was carried out on 5th December 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 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

Seabrooke Manor Nursing Home 08/06/06

Seabrooke Manor Nursing Home 30/06/05

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 Ms Gwen Lording Unannounced Inspection 5th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Seabrooke Manor Nursing Home Address Lavender Place Ilford Essex IG1 2BJ 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) 0208 553 5538 0208 514 2283 maherb@bupa.com BUPA Care Homes (CFH Care) Limited No. 2741070 Mr Brent Jonathan Maher Care Home 120 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (90) Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 60 nursing care beds in two units for elderly people, including 4 named beds for under 65s 30 beds for elderly people with mental health problems, including 5 beds for age 50 30 beds for elderly people requiring personal care only Date of last inspection 30th June 2005 Brief Description of the Service: Seabrooke Manor is a 120-bed home owned and operated by BUPA Care Homes Ltd. The home is purpose built and is divided into four separately staffed units. These provide care for specific client groups: people over sixtyfive years requiring nursing care and personal care due to frailty/ illness and people with dementia, 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 main road and public transport. The external grounds and building are well maintained and secure. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 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 10am and lasted six and a half hours. The inspection was undertaken by two inspectors and focused on the care of residents requiring nursing and personal care due to frailty/ illness. The two units providing this care are Norman House and Belgae House. The two units inspected at the previous inspection undertaken on 30th June 2005, Roman House and Saxon House, were also visited to discuss the action taken to address the requirements made at that inspection. Discussions took place with the Deputy Manager, the senior sister on Belgae House, nurse in charge of Norman House and several members of nursing and care staff in both units. The Inspectors also had the opportunity to visit the main kitchen and laundry and speak to the Head Chef and Laundry manager. The Inspectors spoke to several residents in the large and small lounges, and to a number of residents who were in their bedrooms, on both of the units visited. In addition the relatives of residents visiting the home were interviewed to get their views and comments about the care in the home. A tour of both units was made and a number of staff and care records were looked at. This was the second statutory inspection visit in the inspection programme for 2005/2006. The Inspectors would like to thank the residents, their relatives/ visitors and staff for their input during the visit. What the service does well: Those residents spoken to, who were able to express a view, were very happy with the quality of care they were receiving in the home. During the inspection, staff on both units, were seen to be providing good personal care and residents appeared well groomed. There is a relaxed atmosphere throughout the home. Residents appear unhurried and are given sufficient time and support in their everyday activities. The manager and staff are committed to improving the standard of care people receive in the home and to make sure that the residents are “well looked after”. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 6 Both residents and relatives spoken to said that they felt able to talk to a member of staff if they had any concerns or worries and that all staff are approachable. What has improved since the last inspection? What they could do better: The care plans on Belgae and Norman House must be further developed to make sure that they show how all the health, personal and social care needs of individual residents are to be met. Daily recordings and actions must relate to and follow the areas of need identified in the individual care plan. The registered providers must ensure that their recruitment procedures are operated robustly and followed consistently for all staff recruited to work in the home. The registered providers must ensure that there are a sufficient number of hoists provided to meet the assessed needs of all residents on Belgae House. Please contact the provider for advice of actions taken in response to this Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 7 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 DS0000025961.V271000.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 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 the following standard(s): Standard 3 Appropriate pre-admission assessments are carried out for all residents prior to them moving into the home. Care plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified understood and met. The home does not offer intermediate care. EVIDENCE: Individual records are kept for each resident. Six files were examined on Norman House and five files examined on Belgae House. All records inspected have assessment information recorded and the information had been used to continue assessment following admission to the home and develop written care plans. The records showed that residents, where capable and their relatives/ representatives are involved in the assessment process. Where appropriate, information provided by the placing authority was also on file. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 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): Standards 7, 8, 9 and 10 Residents’ health and personal care needs are set out in individual care plans but not all care plans accurately reflected the current needs and did not always 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. However, there are some inconsistencies in the recording of medication, which may result in unsafe practices. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. EVIDENCE: Norman 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. However, there were inconsistencies in Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 11 the practice and standard of some care plans and the following was discussed with the nurse in charge and the home’s deputy manager: • One examination of one care plan it was noted that the resident is recorded as having a significant weight loss over a period of time. The care plan indicated that the resident had been seen by the GP and appropriately referred to a specialist service. The care plan directed that his weight be monitored and recorded on a weekly basis. However, the last weight recorded in his care plan was for the month of August 05. On examination of the care plan of another resident it was noted that the care plan had not been reviewed since May 05. • Belgae House Individual care plans were available for each resident and the records of five residents were examined. The records for these residents were found to be generally detailed and comprehensive. However, there were inconsistencies in the practice and standard of some care plans and the following was discussed with the senior sister in charge of the unit and the home’s deputy manager. On examination of one care plan it directed that the resident “ Be toileted regularly and as required”. In discussion with the resident and her visiting relative, the Inspector was told she is sometimes asked to wait when she requests to use the toilet, as she requires the use of a hoist and there is only one hoist on the unit. This was checked with the senior sister and she confirmed that there is only one hoist. The promotion of continence must be supported by the provision of suitable and sufficient equipment. • On the examination of the care plan of another resident, admitted to the home on 14/11/05, it was noted that no routine nutritional screening had been undertaken, there was no risk assessment undertaken for manual handling and the use of cot sides, which had been indicated in her care plan. • One resident with a sacral pressure sore had been referred to and seen by the Tissue Viability Nurse on an ongoing basis. Whilst the frequency of renewal of dressings was being undertaken as prescribed; and recorded in the daily records, this information was not being maintained on the wound management records. General All the care plans examined indicated that residents are seen by other health care professionals such as dentist, chiropodists, specialist nurses and doctors. Where indicated, fluid intake/ output monitoring charts and turning charts were being accurately maintained by staff. • Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 12 An audit was undertaken of the management of medications on both Norman and Belgae House. The following issue was noted and discussed with the nurses in charge: • Handwritten entries on Medication Administration Record (MAR) charts must be signed and dated by the person making the entry i.e. registered nurse. The entry must also include the source of the information e.g. GP, relative. Staff talked about and were observed to treat residents in a respectful and sensitive manner. They understood the need to respect an individual’s dignity through practices such as in the way they addressed residents and when entering bedrooms, bathrooms and toilets. Residents spoken to said that all staff were respectful and thoughtful when attending to their personal care. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 13 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): Standards 12, 13, 14 and 15 There is a varied programme of activities available, which suit individual needs, preferences and capacities. The meals in the home are well-presented and individual preferences and specialist dietary needs are catered for. 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. EVIDENCE: There is a general programme of activities for the home, which includes both small and large group activities; visiting professional entertainers; and outings. Since the last inspection one of the small lounges on Saxon House has been converted for us as a “cinema” for the use of all residents at Seabrooke Manor. There is a library of films, to suit all tastes, and includes old films as well as more recently released films. The room has been decorated and fitted as a proper cinema and can be easily modified and used for other activities, or as a quiet lounge for residents and their visitors. In discussion with staff it was apparent that many of the residents make regular use of the cinema, are involved in the choice of films being shown and have had a lot of enjoyment from this venture. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 14 Visiting times are flexible and residents are able to receive visitors in one of the lounges or in their own rooms. Those visitors spoken to during the visit said, “staff always make them feel very welcome”. However, one visitor on Belgae House stated that she is not always offered a cup of tea/ coffee when she visits. The meals in the home are well presented and there is always a choice of meal. The head chef has been at the home for a number of years and regularly visits each of the units when meals are being served, as he is able to receive feedback/ comments from staff and residents. Meals are served in the dining room or residents may choose to eat in their rooms. A number of residents remain in their lounge chairs and eat from small tables placed in from of them, though it is not clear if this is through choice. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 15 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): Standards 16 and 18 The home’s complaints policy/ procedure provides residents and their relatives with the appropriate information to ensure that their complaints are dealt with promptly, effectively and to their satisfaction. However, not all of the residents would be able to use a formal, written process. 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: There is a written policy and procedure for dealing with allegations of abuse and whistle blowing. There is an ongoing programme of training in Adult Protection/ Abuse Awareness for all staff, 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. The home has a written complaints policy and procedure and the records indicate the number of complaints received and includes details of investigation and any action taken. However, some of the residents would not have the capacity to use a written, formal process. Those residents spoken to, who were able to express a view said that they felt able to make complaints and raise issues if they needed to and would speak to “one of the nurses”. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 16 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): Standards 19, 20 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 the dementia units has improved considerably in meeting the needs of people living with dementia EVIDENCE: General All four units in the home were toured, accompanied by the deputy manager at the start of the visit, and Norman and Belgae House were visited unaccompanied later during the visit. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or rooms being cleaned. All areas of the home were clean, tidy and free from odour throughout. The standard of the décor, furnishings and fittings are generally being maintained to a good standard. There is an ongoing programme of Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 17 refurbishment and re-decoration. The home employs a full time maintenance person and there is a system in place for staff to report items requiring minor repair or attention. A requirement was made at the previous inspection relating to the design and layout of the environment of the two dementia units Saxon and Roman House. A visit was made to both these units during the inspection. The environment has improved considerably in helping to meet the needs of people living with dementia. This included new signage and décor; improved lighting and the addition of “memory boxes” fitted to bedroom doors, reflecting good practice within care homes. Belgae House The lounge previously used a lounge for those residents who smoke has been re-furbished and provides a very comfortable small lounge for residents to use as a quiet area or to receive visitors. A smaller room is now provided for the very few residents who smoke. Norman House The microwave in the small kitchen/ servery was noted to have some small internal areas, which were rusty. The Inspector brought this to the attention of the nurse in charge and was later advised that the microwave had been removed and replaced. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 18 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): Standards 27, 29 and 30 Staffing levels are satisfactory and there are sufficient staff on duty to meet the individual assessed needs of the residents. The care staff on both Roman and Saxon House are receiving training in understanding and meeting the needs of people living with dementia. The home in conjunction with the organisation’s Human Resources Department, have a robust recruitment policy. However, these recruitment policies have not been consistently followed and may result in residents receiving care from staff members who have not been properly vetted. EVIDENCE: Both Belgae and Norman House have relatively stable staff teams. The staffing levels of qualified nurses and care staff were sufficient to meet the nursing needs and personal care needs of residents. In addition to qualified nurses and care staff Seabrooke Manor employs an activity co-ordinator, catering, laundry, housekeeping, maintenance and administrative staff. In discussion with staff it was evident that they understand and fully support the main aims and values of the home. A number of requirements were made at the previous inspection around staffing issues including, additional staffing at peak periods such as mealtimes; and care staff undertaking portering duties such as collecting hot food trolleys Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 19 form the main kitchen. Through discussion with staff and the deputy manager there was evidence to show that these requirements have now been met. A three-day dementia course has been developed and is being cascaded to all staff through an in house training programme. Other staff have completed training on “Managing Challenging Behaviour” and staff have found this to be most helpful in responding to and understanding individual’s behaviour and needs. An examination of six personnel records identified that four carers had significant gaps in their employment history; and one medical health declaration had not been fully completed or signed. Criminal Records Bureau (CRB) checks had been obtained for all staff. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 20 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): Standards 33 and 36 Resident’s benefit from a committed staff team who have the skills and training to meet their needs. Monitoring visits are undertaken regularly by the responsible individual to monitor and report on the quality of the service provided in the home. EVIDENCE: A requirement was made at the previous inspection around the need for staff to receive regular formal supervision. Through discussion with both care staff and nursing staff there was evidence to demonstrate that this requirement has been met. Regulation 26 visits are undertaken by the responsible individual on a regular basis, to check the quality of care being provided and ensure that care is being Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 21 delivered in accordance with the individual care plans and wishes of residents. It also includes asking residents and their relatives, and staff what they think about the service the home offers. A copy of the report is submitted to the Commission. The majority of residents’ financial affairs are managed by their relatives/ representatives. It was not possible to test Standard 35 at this inspection as the administrator with responsibility for recording/ maintaining the computerised system was not available. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 3 X X Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 23 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 OP7OP8 Regulation 12 & 15 Requirement Timescale for action 31/01/06 2 OP9 13 3 OP29OP37 17 & 19 4 OP22 23 All residents must have individual plans of care, which show how all their health, personal and social care needs are to be met. Care plans must be regularly reviewed and updated to reflect changing needs. All handwritten entries on 31/01/06 Medication Administration records (MAR) charts must be signed and dated by the person making the entry and include the source of the information. The registered providers must 31/01/06 ensure that their recruitment procedures are operated robustly and in line with regulation. Sufficient and suitable hoists 28/02/06 must be provided to meet the assessed needs of all residents. Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Seabrooke Manor Nursing Home DS0000025961.V271000.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford 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. 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