Inspection on 25/07/05 for Shalom

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Shalom 29/05/07

Shalom 03/10/06

Shalom 16/05/06

Shalom 07/12/05

Shalom 31/08/04

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 Shalom 8 Carew Road Eastbourne East Sussex BN21 2BE Lead Inspector Jon Wheeler Announced 25 July 2005 9.30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Shalom Address 8 Carew Road Eastbourne East Sussex BN21 2BE 01323 410926 01323 504324 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 David McMeekin Mr David McMeekin Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (OP) 18 of places Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of residents to be accommodated is eighteen (18). Date of last inspection 31 August 2004 Brief Description of the Service: Shalom is a three storey detached property in a quiet residential area of Eastbourne. It is situated close to the town centre and is within walking distance of the shops, train station and local bus routes. There is an attractive, well-maintained garden around the home. The home is registered to provide care and accommodation to eighteen older people and is an established family run business. There are eighteen single bedrooms, all with en-suite facilities. There is a communal lounge and dining area on the ground and first floors, in addition to communal bath and toilet facilities. As the home is on three floors and there is no lift in the building, service users on the upper floors need to be able to use the stairs. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on 25 July 2005 and lasted for five and a half hours. The process included speaking to the owner/manager and another director of the company; to all the service users in the home and to three staff members. It also included a tour of the premises; reading care plans, records, policies; checking the administration and recording of medication and observing staff providing direct care to the service users. What the service does well: What has improved since the last inspection? What they could do better: Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 6 The service must address a number of the requirements that have been made in the previous two inspections, particularly those concerning health and safety of service users and the planning and reviewing of their care. The service should arrange comprehensive reassessments for three specified service users to ensure their needs can be met in the home. Care plans and risk assessments should be reviewed and updated as necessary to ensure the safety of the services users and to ensure their needs are consistently met. The service should consider installing a lift to enable easy access to all areas of the home. Staff should receive formal supervision as well as training in moving and handling, first aid, food hygiene and fire safety. Fire doors should not be wedged, and if they need to be open, should only be done so having been fitted with approved automatic closing devices. The hole in the floor of the ensuite bathroom of a service user, specified during the inspection, should be mended. 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. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5. The home provides suitable information and has a robust pre-admission process to ensure the staff can meet the needs of prospective service users. The home generally meets the needs of the service users in the home, although changes of needs of some service users have not been comprehensively identified and met. EVIDENCE: There was an up to date and accurate Statement of Purpose and Service User Guide, which outlined the range of services offered in the home. There was documentary evidence of the owner undertaking pre-admission assessments to ensure the home is able to meet the needs of any prospective new service users. The owner reported that he had assessed people and decided that their needs could not be met fully in the home. Service users spoken with reported that they and their families had been given the opportunity to visit the home prior to moving in. One service user said she had visited the home, met the staff and had a coffee with the service users as Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 9 a way of getting to the know the home before deciding whether or not to move in. Whilst the home provides a caring and friendly environment, there was evidence that the service was beginning to struggle to meet the needs of some of the service users, whose needs have significantly changed. Whilst the owner has helped some service users to move on to services able to meet their needs, three of the current service users were in need of a re-assessment to ensure their needs were best met at Shalom. The staff in the service were able to demonstrate that they were able to meet the needs of the service users, whose needs had not significantly changed. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 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 standard(s) 7, 8, 9, 10. Care plans did not contain sufficiently detailed information to ensure the needs of service users are always met. The home ensures service users have their health needs met by accessing appropriate health services. A robust system ensures service users have their medication administered and recorded effectively. Staff provide sensitive and dignified care to service users. EVIDENCE: Whilst there was documentary evidence of care plans having background information about service users and of being regularly reviewed, some of the information was not sufficiently detailed. The plans did not contain enough information about the direct care needs of the service users, including their personal care requirements, and details of transferring service users from their bed to chairs, where moving and handling support was required. The care plans did not contain sufficiently detailed risk assessments, which had also not been reviewed and updated recently. Staff were able to describe in detail the care regimes for each service user, but this was not sufficiently supported in written form in the care plans. There was documentary evidence of the home regularly weighing each service user. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 11 The home enables service users to access a range of health services to meet their needs. All service users are registered with a local GP, and are able to access other specialist support as required. All medication is stored securely and was administered and signed in line with the policy and procedure of the home. All staff who dispense medication have received training and were able to describe in detail the process of administering and recording medication. Staff were observed providing dignified and sensitive care, including knocking on bedroom doors before entering. All the service users spoken with spoke highly of the staff, saying they were professional, caring and friendly. One service user said that the staff were “kind and thoughtful”. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15. Service users make choices about all aspects of their lives and are able to have access to a range of activities to meet their needs and interests. Family and friends are welcomed in to the home. Service users have a varied and wholesome diet with plentiful and good quality food. EVIDENCE: The home provides a range of activities in the home and in the community. Activities include games and quizzes, music sessions and having a ‘pat dog’ coming to the home. Service users said that the owner also arranges trips out for coffee and sight-seeing. A number of the service users are able to get out independently and walk to the town centre to use local shops and facilities. Three visitors spoken to all confirmed that they were always welcome in the home and were encouraged to visit. Family and friends are encouraged to visit the home with the prospective service user as part of the pre-admissions process. There is a menu providing a varied and nutritious diet. All the service users spoken with reported that the food is very good quality and is plentiful. Service users said they were able to choose what they ate and an alternative is available should they not want what is on the menu. The cook has a clear Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 13 knowledge and understanding of the dietary requirements of each of the service users and is able to cater for those needs. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17. There is an effective complaints policy, which enables service users to raise issues or concerns about the service. EVIDENCE: There was documentary evidence of six complaints having been received and resolved swiftly. One service user said she had raised a minor concern, which was treated by the home as complaint and was resolved swiftly and to her satisfaction. All service users are registered to vote and supported to do so, if they so choose. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25, 26. The home is clean and tidy and generally in reasonable condition. Service users have comfortable and homely bedrooms, which meet their needs and individual preferences. Fire doors wedged open did not ensure the safety of the service users. The absence of a lift means all areas of the home are not accessible to all people. EVIDENCE: The home is clean and tidy, with evidence of a regular cleaning programme. There are sufficient laundry facilities to meet the needs of the service users. During the inspection, a number of fire doors were wedged open. The service should ensure that all fire doors are closed, or fitted with appropriate automatic closing devices to ensure the safety of service users and staff in the event of a fire. Some radiators had not been covered and therefore presented a risk of burning to services users. There was evidence of an on-going maintenance plan to decorate the home. Some areas of the home required work, including a hole in the floor of a service user’s bathroom, which needed mending. The home offers a range of Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 16 communal areas, with lounge/dining space on the first and ground floors. There is a well-maintained and comfortable garden, which service users can access. There is a small porch area at the front of the home, where service users can sit. All service user bedrooms have en-suite facilities, supplemented by communal bathing space as required. As there is no lift in the building, service users with bedrooms on the upper floors have to be able to manage the stairs. All the service users spoken with confirmed they were currently able to get up and down the stairs. Service users are able to personalise their bedrooms to suit their tastes and preferences. They are able to bring in their own furniture, pictures and ornaments. The bedrooms are homely and comfortable. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 30. An experienced and skilled staff team provide sensitive and dignified care to the service users. Gaps in training for some staff mean that the home cannot ensure it meets the needs of all the service users. EVIDENCE: The home has an established and experienced staff team who are able to describe the needs of the service users. Staff raised concerns about their abilities to meet the changing needs of some of the people living in the home. They were aware of the changing needs of some service users and felt the home would struggle to continue to meet those changing needs. All the service users described the staff as helpful and caring, with one saying “Staff are kind and if you need anything, they rush to help”. Staff were observed providing skilled and sensitive care to all the service users, and particularly one service user, whose needs had significantly changed, to require skilled personal care. There are sufficient staff on duty on all shifts, although the home needs to continue to review the staff numbers to ensure it can meet the changing needs of the service users. There was evidence of four staff having relevant NVQ qualifications. As there had been no new staff employed recently, it was not possible to inspect any new employment procedures or records. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 18 There were gaps in the training of the staff team, as some had not recently updated their moving and handling; first aid; food hygiene and fire training. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35, 36, 37, 38. An experienced owner/manager provides clear direction, leadership and ensures the home is run in the interests of the service users and is financial viable. Propped open fire doors and gaps in staff training mean the service cannot ensure the safety of the service users. EVIDENCE: The owner/manager has been running the home for many years and was able to describe in detail the needs of the service users. All service users said that the owner is approachable and caring. Staff reported that the owner is approachable and supportive and good to work for. The owner spends considerable amounts of time at the home and is therefore able to provide clear direction and ethos to the care provided. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 20 All the service users spoken with said that they felt the home was run in their best interests and that the owner and staff work hard to ensure the service users are happy and having their needs met. There was documentary evidence of audited accounts. The home does not hold any money for service users. Service users either manage their own money or their families or an appointed power of attorney administers it on their behalf. Staff communicate with each other when the shift changes, using a hand-over system. Staff reported that there was good communication between staff and the manager. However, there was no programme of formal supervision for staff to address issues that cannot be addressed at staff change-over times. The records and policies of the home were up to date and accurate. The home has a range of health and safety checks including the fire systems, water temperature and daily temperature checks on the fridge and freezers. Whilst the cook had completed food hygiene training, other staff had not. Nor had they completed training in moving and handling and health and safety. Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 x STAFFING Standard No Score 27 3 28 3 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 3 3 3 2 3 2 Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 22 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 4 Regulation 14 (2) Requirement The home arranges for a reassessment of the needs of three service users identified during the inspection. Provide more detailed care support guidelines in the care plans. (Requirement from the previous two inspections) Review and update risk assessments in the care plans.(Requirement from the previous two inspections). Repair the floor in the en-suite bathroom identified during the inspection. Staff to receive training in moving and handling. Staff to receive training in food hygiene Staff to receive training in fire training. Satff to receive training in first aid. All staff to receive regular formal supervision. Fire doors must not be wedged open. All radiators to be covered.(Requirement from the previous two inspections). Timescale for action 25/9/05 2. 7 15 25/9/05 3. 7 13 (4) b, c 13 (4) a 18 c (i) 16 (2) j 23 (4) d 13 (4) 18 (2) 23 (4) 23 (4) 25/9/05 4. 5. 6. 7. 8. 9. 10. 11. 19 30 30 30 30 36 38 38, 19 25/9/05 25/9/05 25/9/05 25/9/05 25/9/05 25/9/05 25/7/05 25/9/05 Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 23 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. Refer to Standard Good Practice Recommendations Shalom H59-H10 S21210 Shalom V227354 250705 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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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