Inspection on 07/12/05 for Shalom

This inspection was carried out on 7th December 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Shalom 29/05/07

Shalom 03/10/06

Shalom 16/05/06

Shalom 25/07/05

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 Unannounced Inspection 7th December 2005 9:30 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 Shalom DS0000021210.V261514.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. Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Shalom Address 8 Carew Road Eastbourne East Sussex BN21 2BE 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) 01323 410926 01323 504324 Mr David McMeekin Mrs Sandra McMeekin Mr David McMeekin Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is eighteen (18) Service users must be older people aged sixty-five (65) years or over on admission, not falling within any other category. 25th July 2005 Date of last inspection 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 DS0000021210.V261514.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 7 December 2005, starting at 9.30 am and lasting for four and a half hours. The aim was to inspect those key standards not assessed at the announced inspection of 25 July 2005 and to assess the compliance with requirements previously made. The inspection process involved talking to the proprietor of the home and three staff. There was a tour of the premises, where nine of the fifteen service users were spoken with. The process also included reading care plans, policies and procedures, records and checking on the storage, administration and recording of medication. It is of concern that there are a number of requirements from previous inspections which have not been met. What the service does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments should be updated to provide clear details of the current needs of the service users and to identify where those needs have changed. In addition, the care plans should include clear support guidelines to enable the staff team to provide consistent and focused care. Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 6 The service should ensure staff access relevant NVQ courses, as well as undertake training in adult protection, first aid and fire safety. The service should ensure that fire safety precautions have been taken, including that equipment is regularly checked and serviced and fire doors are not wedged open. The proprietor should ensure that Criminal Record Bureau checks and references are taken for all new staff, before they commence employment at the home, to ensure the safety of service users. The service should review the night-time staffing arrangements to ensure the personal and care needs of all service users are effectively met at all times. The service should consider installing a passenger lift to enable easy access to the upper floors for all service users. Radiator guards should be fitted to all radiators to ensure the health and safety of service users. 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 DS0000021210.V261514.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 Shalom DS0000021210.V261514.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): 6. Not applicable, as the home does not provide intermediate care. The other standards were not assessed at this inspection. EVIDENCE: Shalom DS0000021210.V261514.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, 10. Service users do not routinely have their needs effectively met as care plans and risk assessments contain insufficient detail and do not accurately reflect the needs of, or the care that should be given to the service users. Service users generally have their health needs met by accessing a range of health services. An effective system ensures that service users are protected by the safe storage, administration and recording of medication. Service users are treated with dignity and respect and have their rights and privacy protected. EVIDENCE: There were insufficient details in the care plans viewed, although there was evidence of daily recordings, but no clear tracking of care, or identification of changes in need, or how those needs should be safely and effectively met. Some care plans had been signed to indicate they had been reviewed, but there were no changes in need recorded, or details of the review of care. Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 10 The care plans did not contain detailed support guidelines to enable staff to provide consistent care, especially where needs had changed. The details in the care plans did not always reflect the practice of the staff. Staff were able to identify how the needs of some service users had changed, but this was not supported by documentary evidence in the care plans or risk assessments. There was documentary evidence of pre-admission assessments for the service users, but they lacked sufficient detail. Risk assessments viewed lacked sufficient detail and had not been updated to reflect changes in need. There was documentary evidence that service users are supported to access a range of health services. All service users are registered with a local General Practitioner and the District Nurse visits regularly. There was documentary evidence that service users also access chiropody and dentistry. Medication is stored securely and had been dispensed and recorded in line with the home’s policy and procedure. Staff who dispense medication had received training. All service users spoken with said they were treated with dignity and respect by the staff. They all said that the staff provide sensitive care and are approachable and helpful. Service users clothes are all labelled and stored to ensure service users always wear their own clothes. Shalom DS0000021210.V261514.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, 13. Service users are able to access a range of activities to meet their needs and interests and their family and friends are welcomed in to the home. EVIDENCE: There was evidence of regular activities provided in the home, including singing, dancing and outings. Service users reported that there had been a carol concert in the home. Service users spoken with said they were able to choose to attend activities. Some service users said they access activities and facilities in the community, including shops and cafes in walking distance in Eastbourne town centre. Service users said they were able to have visitors in the home and that they are made welcome. Service users are able to see visitors in their own rooms or in any of the communal areas in the home. Shalom DS0000021210.V261514.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): 16, 18. There is an effective complaints policy, which enables service users to raise issues or concerns about the service. The service cannot ensure the safety of service users as staff have not received up to date training in adult protection. EVIDENCE: The home has a complaints policy, although no formal complaints had been received. The service users spoken with said they were able to raise any concerns with the proprietor or the staff, who they said, deal with any issues sensitively. Whilst the home has an adult protection policy, staff had not received recent training in adult protection. It was discussed at the inspection that it is important for staff to have up to date training to ensure they are able to identify and appropriately respond to any concerns about the safety and protection of the service users. Shalom DS0000021210.V261514.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, 26. Service users live in a generally clean and well-maintained environment. The absence of a lift means all areas of the home are not accessible to all service users. EVIDENCE: The home was generally clean and tidy, although one area had a strong unpleasant smell. There was evidence of on-going maintenance work in the home to keep it in reasonably good condition. However, the absence of a lift to the upper floors presents difficulties to those service users who struggle to use the stairs. Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 14 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. There are generally sufficient staff on duty during the day, although the lack of waking night staff means that service users do not have their needs met at all times. The lack of robust procedures and employment checks means the service cannot guarantee the safety and protection of service users. Whilst staff are caring and dedicated, the lack of relevant training does not ensure they have up to date skills and knowledge to meet the needs of the service users. EVIDENCE: There are generally sufficient staff on duty. At the time of the unannounced inspection, there were two care staff on duty, along with the proprietor and the cook. There are staff available on call during the night, although it is required that the home reviews its staffing arrangements at night to ensure all service users are appropriately supported to ensure their general and personal care needs are met at all times. There was evidence that staff have worked hard to meet the needs of the service users. It was reported that where staff had spent considerable time and efforts to meet the complex needs of one service user, who has Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 15 subsequently moved out, they had insufficient time to meet the needs of the other service users. One new staff member had been employed, and whilst there was evidence of an application form having been completed, the home had not taken up references, nor a Criminal Records Bureau check, having relied on checks taken for the applicant on a training course. An immediate requirement was left for all checks to be completed on new staff prior to them commencing employment. Staff did not have up to date training for first aid, fire safety or adult protection. In addition, the home does not have fifty percent of its staff with relevant NVQ training courses. Shalom DS0000021210.V261514.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): 33, 36, 38. The home does not have sufficient structures or procedures in place to ensure it is run in the best interests of the service users to meet their needs. The service cannot ensure service users are provided with consistent and appropriate care practices at all times, as there is no formal supervision programme for staff. EVIDENCE: Service users reported that the proprietor and staff provide sensitive and caring support. One service user said “they will do anything for you”, another said “The staff are very kind”. There was evidence that the proprietor spends time with all the service users, on a regular basis to ensure the home is run in their best interests. Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 17 Whilst staff reported that there is regular informal support from the proprietor, there is no formal supervision programme for the staff. This was a requirement from the previous inspection, which has not been met. It is of concern that staff are not supervised, are not currently on relevant NVQ courses and have not completed update training for adult protection, first aid or fire safety. Whilst staff continue to work hard to provide care to the service users, the service is not taking sufficient measures to ensure the safety and well-being of service users as there are not procedures in place to support staff to provide targeted and consistent support or to maintain sufficient knowledge to effectively carry out their duties. There were a number of health and safety issued not addressed by the home. Some fire doors were wedged open and an immediate requirement was left for the wedges to be removed,. It was discussed at the inspection that if fire doors are to be kept open, they should be fitted with approved automatic closing devices. At the time of the inspection, fire safety equipment had not been recently checked. Shalom DS0000021210.V261514.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X X 2 X 2 Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 19 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 14 (2) Timescale for action Care plans should be reviewed to 06/02/06 provide more detail and clear support guidelines. This is a requirement outstanding from 31/8/04 Review and update risk assessments. This is a requirement outstanding from 21/2/05 All staff receive update adult protection training. This is a requirement outstanding from 25/7/05 That service users who are old, infirm or disabled have freedom and access to all areas of the home. That a stair lift or passenger lift is considered or other appropriate action taken. This is a requirement outstanding from 21/2/05 Review the provision of night time staffing. 50 of staff should have attained a relevant NVQ. DS0000021210.V261514.R01.S.doc Requirement 2 OP7 15 06/02/06 3 OP18 18 (1) (a) (c) 06/02/06 4 OP19 23 (2) (0) (n) 06/05/06 5 6 OP27 OP28 18 (1) (a) 18 (1) 07/12/05 06/05/06 Shalom Version 5.1 Page 20 7 8 OP29 OP30 19(1) Sch 2 23 (4) (d) All employment checks are completed for staff prior to them commencing employment. All staff receive training in fire safety. This is a requirement outstanding from 25/7/05 All staff receive training in first aid. This is a requirement outstanding from 25/7/05 Fire doors must not be wedged open. This is a requirement outstanding from 25/7/05 Appropriate safety checks should be carried out on all fire safety equipment. All radiators should be fitted with guards. This is a requirement outstanding from 31/8/04 07/12/05 06/02/06 9 OP30 13 (4) 06/02/06 10 OP38 23 (4) 07/12/05 11 12 OP38 OP38 23 (4) (a) 23 (4) 06/01/06 06/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Shalom DS0000021210.V261514.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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