Inspection on 16/08/05 for Seahorses

This inspection was carried out on 16th August 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Seahorses 04/11/09

Seahorses 09/09/09

Seahorses 03/03/09

Seahorses 22/02/08

Seahorses 30/04/07

Seahorses 17/10/06

Seahorses 13/01/06

Seahorses 19/01/05

Seahorses 03/08/04

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

CARE HOME ADULTS 18-65 Seahorses 8 Park Road Gorleston Norfolk NR31 6EJ Lead Inspector Linda Wells Unannounced 16 August 2005 at 12.00 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Seahorses Address 8 Park Road, Gorleston, Great Yarmouth. Norfolk. NR31 6EJ. 01493 655731 01493 655731 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) Mr John Hallam Mrs Wendy Bain Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Huntingtons disease and other Neurological Disorders. Date of last inspection 19th January 2005 Brief Description of the Service: Seahorses is an older style, chalet bungalow that is run as a residential care home providing twenty-four hour nursing care to six adults with Huntingdon’s Disease. All bedrooms are single, on the ground floor and contain a washbasin. Residents have communal use of a bathroom, a toilet, lounge and a conservatory that contains the dining area. There is a well kept garden to the rear of the property and road side parking to the front. Qualified nurses are part of the staff team and the manager is a qualified nurse. The Home is within walking distance of the sea front, close to healthcare facilities, local shops, hotels and pubs and has its own mini-bus. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over three and one half hours and was carried out as part of a routine inspection plan. On the day of inspection six residents were living at the home but only one resident was at home because five residents and two staff had gone to the beach for the day. The manager and the proprietor were not present and therefore the staff records and some servicing records were not available and will be looked at during the next inspection. The two visiting professionals, spoken to individually, both said that the home provided a homely, friendly environment, that the routine of the home was flexible, staff liaised with them on the specialist needs of each resident and that they were “totally satisfied” with the standard of care provided. The visiting Regional Care Advisor from the Huntington Disease Association said that she thought that one of the “strengths” of the home was the effort made to include residents in community activities and outings. The inspection took the form of a tour of the premises, individual discussion with one resident, three staff members and two visiting professionals, examination of care plans, the available records, certificates and compliance of requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection? The home has been made more attractive and residents have benefited from the conservatory on the front of the home being extended, the windows being double glazed, new flooring fitted in the conservatory and hall, ramps being fitted to outside doors, bedroom furniture being replaced and the redecoration of the lounge, conservatory and bedrooms. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 6 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. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 5 The admission procedure and written information available is satisfactory and enables residents and staff to make a decision on whether the home will meet the needs of anyone wishing to live there. EVIDENCE: The homes Statement of Purpose, Service User Guide and Terms and Conditions contract were seen and found to contain relevant information. The staff members spoken to said that prior to admission as much information as possible was collected from a prospective resident, their family and other professionals. They said residents, their family and/or friends visited the home, that the manager often visited residents in their own home and that residents were admitted on a one-month trial basis. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9, 10 The health, social and personal care needs of residents were met, they were consulted but records were not all fully up to date. EVIDENCE: The resident spoken to indicated that he was well looked after and six individual plans of care were examined and found to contain relevant health, social and personal care information, a statement of need, daily records, risk assessments, communication needs, swallowing reviews, preferences, reviews, history, weight records and visiting professionals. However, they did not contain a photograph of the resident and a requirement was made that a photograph be held in the plan of care and/or medication records of each resident to aid agency and bank staff in the identification of each resident. Residents were not protected by the storage of information held on each resident. The plans of care were kept on a shelf in the conservatory offering open access to everyone and a requirement was made that they are stored securely to ensure the confidentiality of residents is assured. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 , 14, 17 There are social and leisure activities that residents take part in, the meals meet the dietary needs of residents but are not freshly cooked and served. EVIDENCE: The resident spoken to said that he sometimes enjoyed the outings and records were seen to demonstrate that activities were provided every Tuesday and Thursday and as arranged. A record was held in the plan of care of each resident of the activities offered and taken part in but had not been completed for some residents for more than a year. A recommendation was made that this record is kept up to date to show that residents are offered and take part in activities that they are interested in and find stimulating. Residents enjoyed meals that were balanced and varied and the meals eaten by the residents were recorded in a diary. The records held in the kitchen on the dietary need of each resident showed that meals were offered to residents in the consistency and manner required. However, the meals are cooked by the night staff for consumption on the following day and then reheated when required, and a requirement was made that this practise is ceased. All meals should be cooked daily from fresh just prior to being served to avoid any potential nutritional loss or contamination caused by storing and reheating. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 20, 21 Personal support is given to residents in the way they prefer, their needs are met but they are not fully protected by the homes medication procedures. EVIDENCE: The information seen held in the plans of care informs staff and enables them to support residents in the manner they prefer whilst meeting their needs. The staff spoken to said that it was an ongoing process that when with or assisting resident they talked to and observed residents and agreed with them those actions or routines that did not work or could be improved upon. Medication was seen to be administered by the Nurse on duty, was stored correctly but the records of the administration of medication was incomplete and on more than four occasions had not been signed for or a code used to indicate why the medication had not been given. A requirement was made that all medication administration records are completed to protect the health and safety of residents. Records showed that residents were not all consulted on their arrangements at death and a requirement was made that the wishes of each resident are recorded to show that they are known. Repeated requirement. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. EVIDENCE: No complaints have been received by the home and the resident spoken to indicated that if he had reason to complain he would speak to staff and that he was confident that the problem would be resolved quickly and to the satisfaction of all involved. Residents were protected from abuse, neglect and self-harm by the objectives, policies and procedures seen of the home and the staff spoken to said that they had undertaken training in Adult Abuse to help them recognise, prevent and deal with any potential abuse. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27, 29, 30 The standard of the environment within this home is mainly good providing residents with an attractive, safe and homely place to live. EVIDENCE: A tour of the building revealed that residents benefit from a home that is decorated and furnished to a good standard. It contained some specialist equipment such as a hoist and ramps and the resident spoken to said that the home was comfortable, clean, tidy and odour free. This was found during the tour of the building and residents were seen to have personalised their bedrooms. A requirement was made that the carpet in the bedroom next to the kitchen, that was stained and not secured to the floor at the join across the room, be replaced to protected the health and safety of the resident and staff from trips and falls. Residents had the use of a communal bathroom and a toilet but to fully protect the health and safety of residents and to make both the toilet and the bathroom more attractive two requirements were made that the cracked tiles in the bathroom and the flooring in the toilet be replaced and a further recommendation was made that the damaged and repaired bath is replaced. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36 The needs of residents are met, staff members are competent, but the supervision of staff does not fully provide safeguards to offer protection for the people living at the home. EVIDENCE: The resident spoken to said that he was well cared for and the staff spoken to said that there were enough staff on duty to meet the needs of each resident if all shifts were covered in times of sickness and annual leave. The staff spoken to had a mix of experience and demonstrated that they were aware of their role and responsibilities. The two nurse staff members spoken to said that they were supported by the manager, proprietor and daily handover and that they supported care staff throughout their shift. The care staff member spoken to said that she discussed problems as they occurred with the duty nurse who supported her and kept her informed of any changes to the needs of each resident. Staff training will be looked at during the next inspection because staff records were not available but two of the staff spoken to were trained nurses and one was a care staff member who said that she had completed induction and foundation training and was about to commence NVQ2 in September 05. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 15 All of the staff spoken to said that they did not received supervision and a requirement was made that all staff receive regular supervision and that records are kept to ensure the needs of residents are known and met, review work practise and to plan training. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 40, 42 The manager is supported by the nursing staff in providing leadership, guidance and direction to staff to ensure that residents receive a good standard of care. EVIDENCE: The resident spoken to said that the home was well run and records demonstrated that residents are protected by the management and administration procedures carried out in the home. Policies and procedures have been produced and were seen on all aspects of the home and service provided. The records held were found to promote and protect the rights and best interests of each service user. The servicing and testing of equipment records were not all available and will be looked at during the next inspection. Those seen for fire safety, emergency lighting and risk assessments on the building showed that checks had been carried out and relevant and timely certificates were held to ensure that the health and safety of residents is protected. There was no insurance certificate Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 17 displayed in the home and a recommendation was made that a current certificate be displayed to show that the residents and staff are protected. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 x 3 3 Standard No 11 12 13 14 15 16 17 x 2 x 3 x x 2 Standard No 31 32 33 34 35 36 Score 3 3 x x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Seahorses Score 3 x 2 2 Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 2 x I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 19 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 YA6 Regulation 17.1-3 schedule 3 17.1.b Requirement The registered person must ensure that each plan of care contains a photograph of the resident. The registered person must ensure that all information held on each resident is stored securely and in line with the Data Protection Act. The registered person must cease to cook meals at night and reheat them the next day. The registered person must ensure that records are completed for all medication administered or not administered. The registered person must ensure that the wishes at death of each resident is recorded in their plan of care. The registered person must ensure that the carpet in the bedroom next to the kitchen is replaced. The registered person must ensure that the flooring in the toilet is replaced. The registered person must ensure that the cracked tiles in the bathroom are replaced. Timescale for action 31st October 2005 1st November 2005 31st October 2005 1st October 2005 and ongoing 31st October 2005 30th November 2005 30th November 2005 30th November 2005 Page 20 2. YA10 3. 4. YA17 YA20 16.2.1 13.2 5. YA21 12.2 6. YA24 23.2.b 7. 8. YA24 YA24 23.2.b 23.2.b Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 9. YA36 18.2 The registered person must ensure that all staff receive regular supervision and that records are kept. 30th October and ongoing 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. 3. 4. Refer to Standard YA12 YA27 YA42 Good Practice Recommendations It is recommended that a list of activities offered and undertaken is maintained in the plan of care of each resident. It is recommended that the bath be replaced to make the bathroom more attractive. It is recommended that a current insurance certificate is displayed in the home. Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 Seahorses I55 s32541 Seahorses v243587 UN 160805 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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