CARE HOMES FOR OLDER PEOPLE
Seaswift House Sea Hill Seaton Devon EX12 2QT Lead Inspector
Teresa Anderson Unannounced Inspection 24th January 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Seaswift House Address Sea Hill Seaton Devon EX12 2QT 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) 01297 24493 01297 21149 Mrs Kathryn Sara Jackson Ms Carole Rundle-Drew Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2nd August 2005 Brief Description of the Service: Seaswift is made up of 3 houses converted into one care home. The home provides accommodation and personal care for up to 14 service users who have needs associated with old age. Accommodation is provided over three floors and are linked by stair lifts. All bedrooms are single occupancy and 10 have en-suite facilities. There is a communal lounge/conservatory and two dining rooms, all situated on the ground floor. The home is close to the centre of Seaton and the seafront. The front aspect overlooks a bowling green and gardens. The rear of the home has a small patio style garden. Seaswift does not have dedicated parking. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. It is the second inspection to take place since April 2005 and as such this report should be read in conjunction with report dated August 2006. This inspection took place over 3 and a half hours, during which seven residents, two members of staff, the manager and the owner were spoken with. All communal areas and some bedrooms were seen. Records in relation to fire and medication were inspected. What the service does well: What has improved since the last inspection? What they could do better:
The care plan of one resident should be reviewed to ensure that all needs are identified and that there is a clear plan, balancing safety with other needs, to ensure those needs are being met. The book containing details of Controlled Drugs should have numbered pages and an index page.
Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 6 Although changes to management systems have been made, improvements should continue to ensure that the home is run efficiently and safely at all times. Quality monitoring should be introduced to ensure the home continues to be run in the best interests of residents. Fire training and fire drill records should clearly demonstrate who has and who has not had this training. Systems for ensuring maintenance and checks are carried out should be improved. 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. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Relevant standards were inspected and met at the inspection in August. EVIDENCE: Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (7, 8, 9) Residents’ healthcare needs are well met. Not all residents’ benefit from care planning that takes into account and meets all their needs. A minor addition to the medication recording system would ensure this system is safe and clearly auditable. EVIDENCE: The general system for care planning is satisfactory and since the last inspection the manager has ensured that care plans demonstrate that healthcare needs are being met and risk assessments have been updated. However, the care plan of one resident who is challenging the service at night when there are no waking night staff requires reviewing. For safety reasons, a door gate is being used to prevent this resident from wandering and coming to harm. During discussions with the owner and manager about this practice, they identified that this may be causing distress to the resident and that there may be more suitable means of ensuring this resident stays safe at night. The manager has agreed to discuss other measures with this resident, her family and with the local Community Psychiatric Nurse (CPN); to document the outcome of these discussions and to put in place a plan which balances and meets this residents needs.
Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 10 Since the last inspection many changes have been made to the system for managing medication. This has included the purchase of a medication fridge and providing residents who self-medicate with lockable storage. No Controlled Drugs are currently kept in the home but the manager should ensure that the recording book has numbered pages and an index to ensure this system is easily and clearly auditable. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (12, 14) Residents who live at Seaswift are provided with activities that suit their social preferences and are supported and encouraged to make choices in their everyday lives. EVIDENCE: Residents at Seaswift are largely independent. They say they prefer their own company on the whole but enjoy socialising when sherry is served and at meal times. The home does provide organised activities such as quizzes and bingo and some residents choose to attend these when they feel like it. Until recently the home commissioned poetry and music sessions but the numbers attending have declined significantly and this is currently under review. Some residents take advantage of the homes close proximity to the town and sea, going out for walks alone, with staff or family. Most residents have their own TV’s in their bedrooms and some enjoy reading and listening to music. Residents told the inspector they spend their days how they like, choosing what they wear, when to get up and go to bed, how their rooms are arranged and what they do generally. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 12 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): The relevant standards were inspected and met at the inspection in August. EVIDENCE: Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (19, 22, 25) The home is maintained and adaptations are provided for the safety and comfort of residents. This could be further improved through the development of a programme of routine maintenance. Residents comfort could be further enhanced through the addition of central heating in one room. EVIDENCE: These standards were followed up from the last inspection when an area of loose paving stones on the patio required attention, chairs required leg raisers (so that residents can rise from low chairs without assistance); the home had three unprotected radiators and baths did not have thermostatic valves fitted. These have now been dealt with. Some progress has been made in relation to ensuring that there is a programme of routine maintenance in place. This could be further improved to help the owner identify what checks are due or are necessary. It was noted during this inspection that the lounge/conservatory does not have a central heating radiator and that a freestanding electric heater is used to heat the room. The owner has agreed to install a radiator for the comfort of residents and to risk assess and wall mount the freestanding radiator to reduce
Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 14 the risk of fire until a radiator has been installed. It was agreed that the free standing electric heater in the dining room would be removed on the day of inspection as this room does have a working central heating radiator. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (27, 28, 29) Residents can be assured that they are in the safe hands of well qualified and skilled staff. EVIDENCE: Since the last inspection the duty rota has been amended to ensure that it is clear who is working at night and Criminal Bureau Record (CRB) checks have been carried out. Staff are well liked and appreciated by residents who describe them as ‘lovely’, ‘kind’ and ‘helpful’. 50 of the care staff are trained to NVQ Level 2 or above to help ensure they have the necessary skills to care for older people. Four members of staff will soon be attending a 12-week course in Infection Control. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (31, 32, 33, 38) Residents benefit from an open and accessible management style. Management systems could be further improved to ensure that residents are safe and the home runs efficiently. The planned introduction of Quality Assurance systems would ensure that residents are included in the running of and decision-making in the home to a degree that suits them. EVIDENCE: The Registered Manager, Carole Rundle-Drew, has many years experience in the care industry and has achieved NVQ level 4 in Care. She is currently undertaking her Registered Managers Award and plans to finish this in the short term. Residents and staff expressed confidence in and like the manager. Her time is split between managing for 2 days a week and providing care on the other 3 days. During the two days she manages the home she has full responsibility for the running of the home and for setting up and monitoring systems of management. There is evidence that this delegation of responsibility is not benefiting residents fully. The owner and manager have
Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 17 discussed this and, as the owner intends to expand the home by 5 or 6 residents, they have decided that when this happens the position of manager will be full time. Quality assurance systems have not yet been fully implemented. The manager intends to link this to the next learning module of the Registered Managers Award training. As residents are ‘very happy’ with Seaswift and could not currently think of anything that would improve the home, this is acceptable and it has been agreed that this should be completed by 30th July 2006. Fire training is carried out but documentation is not sufficient to identify who has not received training and/or fire drills. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 18 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 x x 3 x x 2 x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 x x x x 2 Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Requirement The registered person must ensure that written care plans show how service users needs are to be met. (This relates to one resident whose need for safety is not being balanced against other needs). The registered person must ensure that no service user is subject to physical restraint unless restraint of the kind employed is the only practicable means of securing the welfare of the that or any other service user and there is exceptional circumstances. (This relates to one resident who wanders at night). The registered person must make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. (This relates to the need to have a Controlled Drugs Register which has numbered pages and an index). The registered person must
DS0000022024.V271961.R01.S.doc Timescale for action 20/03/06 2. OP7 13 (7) 20/03/06 3. OP9 13 (2) 20/02/06 4. OP25 23 (2) (p) 30/03/06
Page 20 Seaswift House Version 5.1 5. OP25 13 (4) 6. OP25 13 (4) 7. OP38 23 (4) ensure that heating for service users is provided in all parts of the care home which service users use. (This relates to the lounge/conservatory that does not have central heating). The registered person must ensure that all parts of the home to which service users have access are, so far as reasonably practical, free from hazards to their safety. (This relates to the use of a freestanding electric heater in the dining room.) The registered person must ensure that all parts of the home to which service users have access are, so far as reasonably practical, free from hazards to their safety. (This relates to the use of a freestanding electric heater in the lounge/conservatory that will be used until a central heating radiator is installed). The registered person must make arrangements for persons working at the care home to receive suitable training in fire prevention and ensure that by means of fire drills that persons working at the care home are aware of the procedures to be followed in case of fire. (This relates to the need to ensure that records clearly document who has and who has not received training and attended fire drills). 24/01/06 30/03/06 30/01/06 Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 21 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. Refer to Standard OP19 OP32 OP33 Good Practice Recommendations A programme of routine maintenance should be produced and implemented and clear records kept. The registered person should ensure that the systems for managing the home benefit the health and safety of service users. Effective quality assurance and quality monitoring systems, based on residents views, should be in place to measure success in meeting the aims, objectives and statement of purpose of the home. Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Seaswift House DS0000022024.V271961.R01.S.doc Version 5.1 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
