Inspection on 14/10/05 for Seaway Nursing Home

This inspection was carried out on 14th October 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

Seaway Nursing Home 09/12/08

Seaway Nursing Home 10/01/08

Seaway Nursing Home 19/04/06

Seaway Nursing Home 05/05/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Seaway Nursing Home 33 Vallance Gardens Hove East Sussex BN3 2DB Lead Inspector Jennie Williams Unannounced Inspection 14th October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Seaway Nursing Home DS0000061313.V257592.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. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Seaway Nursing Home Address 33 Vallance Gardens Hove East Sussex BN3 2DB 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) 01273 730024 01273 730024 Seaway Nursing Home Ltd Dr Leckman Sumoreeah Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That service users are over 65 years of age on admission and that the numbers of service users accommodated in the home does not exceed 20 5th May 2005 Date of last inspection Brief Description of the Service: Seaway Nursing Home is a care home providing care for up to twenty (20) residents over the age of sixty five (65). It is located in a quiet residential area of Hove. Local amenities and the seafront are within walking distance of the home. There is nearby access to public bus routes. There is a small garden at the front of the home and a garden accessible to residents at the rear of the building. Rooms are located over three floors and are accessible by stairs or a passenger shaft lift is available for those unable to independently mobilise. Nursing care is offered at this establishment. There is no parking available at the home. Paid parking is available in adjacent streets and also at the nearby leisure centre. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Seaway Nursing Home will be referred to as ‘residents’. This report is based on the findings of the specified inspection date. This unannounced inspection took place over six and a half hours on the 14 October 2005. The Inspector toured the home and spot-checked some individual rooms. Staff files, some policies and procedures and care plans were randomly selected and inspected. This inspection involved discussions with the provider, staff and residents. The newly appointed acting manager was not working on this day. Information was obtained from the registered provider and observing practices with the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 6 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 Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5 & 6 The home has information available to prospective residents and their representatives to make an informed decision if the home is suitable for their needs. All prospective residents are assessed prior to moving into the home. Standard 6 is not applicable, as the home does not have dedicated accommodation to provide intermediate care. EVIDENCE: The Statement of Purpose and Service User Guide have been amended to reflect the recent changes in management. These documents provide clear information for prospective residents/representatives regarding the services/care to be expected at the home. A copy of these documents are available upon request at the home. Management or a registered nurse will undertake a pre assessment prior to anyone moving into the home. The home does not have facilities to provide adjustable beds for all residents requiring nursing care. It was confirmed that this is taken into account when assessing any new resident. A copy of social services’ care plan and information from other health professionals are obtained wherever applicable. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 8 Prospective residents/representatives are encouraged to visit the home prior to moving in. Some residents spoken to confirmed that they were unable to visit the home prior to moving in, but a relative did visit the home on their behalf. There is no dedicated accommodation at the home to provide intermediate care. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 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 & 10 Needs are being met at the home, but documentation in the care plans need to reflect actual current practice. Improving documentation of wounds will better monitor the effectiveness of treatments in use. Residents’ privacy and dignity are respected. EVIDENCE: Staff are advised to use the care plans in conjunction with the pre assessment information. This information is kept in separate folders. Care plans identify any changes in needs and any specialist needs an individual may have that differs from the pre assessment form. It was recommended at the previous inspection that all information relating to an individual be kept in the one folder. The home has decided to keep the same procedure. There is now a checklist kept in the office for the reviewing of care plans. Residents have a designated registered nurse responsible for the review of their care plan. There was evidence that care plans are regularly reviewed. Risk assessments are undertaken on all residents. Some residents said that staff do not discuss their care with them. It is required that evidence be provided of residents involvement in the reviewing of care plans, wherever applicable. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 10 Residents’ health needs are being met at the home. Two residents observed to be wearing glasses confirmed that their eyes/glasses were checked recently and regular check ups are provided if they choose. There is pressure-relieving equipment available at the home and a tissue viability nurse is accessible when needed. Documentation of wounds needs to be improved to monitor the effectiveness of treatment being used. The Inspector noted there were some containers in an individuals’ room, with a substance that is added to fluids/food to ensure they are the right consistency/texture for someone with a swallowing problem. The Inspector was informed that this is no longer required. There was no written information available to state that this formula is no longer used, nor who undertook an assessment to confirm it was no longer required. Social services care plan also demonstrated that thickened fluids are required. The home must ensure that clear guidance is provided to staff and documented in the care plans. Care plans need to reflect actual current practice. When speaking to residents the Inspector noted that some residents had not received thorough personal care. Faces had not been cleaned. Although the Inspector is sensitive to those residents wishing to remain independent, staff should still provide support/encouragement to ensure that residents appear clean. Particular attention needs to be paid to eye care. There are suitable procedures in place for the safe handling of medications. MAR charts inspected demonstrated that medication is being signed for at the time of administration. There were some prescribed creams found to be in a residents’ room for whom they had not been prescribed. There were also creams that were in communal areas/shared rooms that were not labelled for the resident they are being used for. Medication must only be used for whom they have been prescribed. This remains an outstanding poor practice issue. Written amendments on MAR charts are now being signed as recommended at the last inspection. Some residents spoken with informed the Inspector that they require night medication around 2100hrs. This was sometimes not being administered until quite late. It is required that management implement steps to ensure this practice is not occurring. Residents spoken with throughout the inspection stated that they felt their privacy and dignity is respected. Staff were observed to have a good professional rapport with the residents. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 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, 13, 14 & 15 Clear documentation of all activities provided to residents would evidence that all residents are provided with activities to suit their lifestyle and capabilities. Visitors are welcomed at the home. EVIDENCE: The residents spoken with during the inspection process had mixed feelings about the number of activities provided at the home. Some did not participate by choice, some felt there was enough on offer at the home to keep themselves occupied and some residents felt that there were not enough activities provided. The record of activities inspected demonstrated that no activity had been provided for over a period of 18 days. It was confirmed by the registered provider that this would not have been the case. It must be reiterated to staff the importance of clear documentation. The home has commenced finding out individuals preferences for activities. Visitors are welcomed at the home. There are no time restrictions imposed, but visitors are reminded to be considerate of residents if they visit during busy times or late evening. Residents may see visitors in their own rooms if they wish. There is a visitor’s book kept at the entrance of the home that all visitors must sign. Most residents confirmed that their lifestyle is their choice. They confirmed that they choose bedtimes, bathing times etc. There are information Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 12 pamphlets available near the main office regarding advocacy services that are available. Residents are able to bring in personal belongings with them with prior agreement with management. Residents were complimentary about the food provided and confirmed that there is always an alternative. The cook confirmed that she has been provided with a list of residents’ likes/dislikes/allergies as required at the previous inspection. However, it was noted that someone was served peas, when they had stipulated that they did not like these. These were removed for the resident. The Inspector observed residents enjoying their lunch. The mealtime was observed to be unhurried. One resident, that is nearly blind, was observed to be handed their meal without any clear direction from the staff where the food is located on the plate. Some residents were observed to have difficulty holding the cutlery. It is required that the home purchases specialist equipment to assist the residents to promote independence when eating. eg. grippers for handles. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Residents/representatives are provided with information on how to make a complaint. Staff are provided with sufficient information to inform them of the correct procedures if an allegation of abuse is made. EVIDENCE: The home has a suitable complaints procedure in place. The home has not received any complaints since the last inspection. No complaint has been made directly to CSCI since the last inspection. There are clear procedures for staff to follow if an allegation of abuse is made. There are pamphlets available near the main office providing people with information on elderly abuse issues and support networks that are available. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 14 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 & 26 Residents are happy living at the home and with their individual rooms. The cleanliness within the home is improving. EVIDENCE: The home is located in a quiet residential area of Hove. Local amenities and the seafront are within walking distance of the home. There is nearby access to public bus routes. Rooms are located over three floors and are accessible by stairs or a passenger shaft lift is available for those unable to independently mobilise. It remains an outstanding requirement that residents in receipt of nursing care are provided with adjustable beds. There are approximately ten available at the home at present. The lack of adjustable beds is taken into account when assessing any prospective resident. At the last inspection, it was noted that where staff smoke, it would often permeate into the residents’ communal areas. It was made a requirement that action is taken to address this. Staff are no longer permitted to smoke within Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 15 the home. Staff must go in the back garden if they wish to smoke during their break. Some individual rooms spot-checked were seen to be personalised to the individual’s preference. The cleanliness within the home is improving. Staff need to be encouraged to report when any maintenance work is required. There were naked light bulbs exposed and some bed headlights for individuals were not working. An extractor fan was observed to not be working. One communal bathroom was cluttered with personal toiletries for different individuals. This was addressed on the day. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 16 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 & 30 Resident’s needs are being met by the number and skill mix of staff on duty. The recruitment procedures need to be more robust. EVIDENCE: Residents were complimentary about the staff. Residents and staff spoken with felt that there were enough staff on duty at all times. There is always a registered nurse on duty. There were shortfalls noted in the information required to be kept on all staff. A full employment history and explanations for gaps in employment must be provided. Staff files must comply with Schedule 2. Ensuring application forms are fully completed will assist in the home tightening up on recruitment shortfalls. Shortfalls in the recruitment procedure were discussed with the registered provider. This remains an outstanding requirement. There were no interview notes recorded. There is one carer who has completed their NVQ level 2 training. There are some overseas trained nurses working as carers in the home. The home must continue to work towards the target of having 50 of care staff NVQ level 2 or equivalent qualified. It was discussed with the registered provider that the overseas trained nurses require to be assessed to ensure their training is equivalent to a NVQ qualification. Staff spoken with confirmed that they receive regular training relevant to their roles. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 17 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): 33, 35 & 38 Staff and residents benefit from clear leadership. Residents/representatives are provided with opportunities to air their views. EVIDENCE: The acting manager was not available on the day of the inspection. She previously worked at Seaway Nursing Home for 10 years. She returned to Seaway Nursing Home in June 2005. The registered provider confirmed that she is a trained nurse with current registration with the NMC and has the necessary skills and experience to manage the home. An application for a registered manager needs to be forwarded to CSCI. Staff are happy working at the home. There are clear roles and responsibilities within the home. A newly developed quality assurance and quality monitoring system has been implemented as required at the last inspection. Residents completed a questionnaire in July this year. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 18 The Inspector could not inspect individual personal allowance for residents due to a key not being available. It was discussed with the registered provider that action needs to be taken to ensure residents monies are accessible at all times. The registered provider did state that if anyone required money, petty cash was available. The home currently has one trustee bank account where all residents pension cheques and personal allowance is kept. Residents must be provided with individual bank accounts and records kept to clearly demonstrate how much money each individual has. It remains an outstanding requirement that individual bank accounts be provided. The registered provider confirmed that the same system for dealing with finances remains the same. The registered provider has been seeking advice on other bank/saving accounts for individuals. The records for health and safety checks were not inspected on this occasion. A pre inspection questionnaire will be sent to the registered provider to complete which will provide the most recent dates of checks for CSCI to keep on file. COSHH information is now stored with the hazardous substances as required from the last inspection. Laminated information sheets have been made for the hazardous substance used within the home. There were concerns noted at the last inspection that residents were being pushed in wheelchairs without any footplates. This practice was not observed at this inspection. The registered provider confirmed that information is currently being obtained for new wheelchairs. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 1 X X 3 Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 20 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 OP7 Regulation 15 Requirement That evidence be provided of service users involvement in the reviewing of care plans. That care plans reflect actual current practice. That the documentation of wounds is improved. That medication/creams is only used for whom they had been prescribed. (Timescale 05/05/05 not met) That management implement steps to ensure night medication is administered at the correct time. That service users are provided with suitable activities and clear records to be maintained. (Timescale 30/06/05 not met) That specialist equipment be provided to promote independence for service users when eating. That all service users receiving nursing care are provided with an adjustable bed. This is an ongoing programme. DS0000061313.V257592.R01.S.doc Timescale for action 31/12/05 2. 3. OP8 OP9 17 Schedule 3 13.2 30/11/05 30/11/05 4. OP9 13.2 30/11/05 5. OP12 16.2(m,n) 30/11/05 6. OP15 16.2(g) 31/12/05 7. OP24 16.2(c) 30/06/06 Seaway Nursing Home Version 5.0 Page 21 8. 9. OP25 OP28 23 18.1 10. 11. 12. OP29 OP31 OP35 Schedule 2 8&9 20.1 (Timescale 31/12/05 will not be met.) That the maintenance within the home is improved. That 50 of staff obtain NVQ level 2 or equivalent qualifications. (Ongoing requirement) That staff files comply with Schedule 2. (Timescale 30/06/05 not met) That an application is for a registered manager is forwarded to CSCI. That individual bank accounts be provided for individuals. (Timescale 31/08/05 not met) That service users monies is accessible at all times. 30/11/05 31/12/05 31/12/05 31/12/05 30/11/05 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. 2. Refer to Standard OP29 OP8 Good Practice Recommendations That interview notes are recorded. That particular attention is paid to eye care when providing personal care. Seaway Nursing Home DS0000061313.V257592.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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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