Inspection on 01/06/05 for Solent Cliffs Nursing & Residential Care Home

This inspection was carried out on 1st June 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

Solent Cliffs Nursing &... 02/07/07

Solent Cliffs Nursing &... 20/06/06

Solent Cliffs Nursing &... 14/12/05

Solent Cliffs Nursing &... 21/01/05

Solent Cliffs Nursing &... 06/09/04

Solent Cliffs Nursing &... 16/04/04

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Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Solent Cliffs Nursing & Residential Care Home 2 Cliff Road Hill Head Fareham Hampshire PO14 3JS Lead Inspector Pat Trim Unannounced 1 June 2005, 8:30 st 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. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Solent Cliffs Nursing & Residential Care Home Address 2 Cliff Road, Hill Head, Fareham, Hampshire PO14 3JS 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) 01329 662047 Solent Cliffs Nursing Home Limited Mr Gordon Robert Mott Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (5), Physical disability (6), Physical disability of places over 65 years of age (30), Terminally ill (6), Terminally ill over 65 years of age (30) Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No service user is to be admitted under 55 years of age. 2. No more than 5 beds may be used at any one time for service users who are only in need of personal care. 3. Only 6 service users between 55 - 64 years of age may be admitted at any one time. Date of last inspection 1/6/2005 Brief Description of the Service: Solent Cliffs is a care home that offers nursing care to residents over the age of 55 years, residents who are terminally ill or residents who have a physical disability. It may also accommodate up to five residents who are only in need of personal care. The home is owned by Solent Cliffs Limited and the registered manager is Mr. Gordon Mott. The building comprises the main house and an annex, which are joined by a ground floor corridor. Bedrooms are located on two floors in each building and comprise twenty-five single and five shared rooms. There is a shaft lift in the main house and a stair lift in the annex so that residents may access the first floor. Communal space in the main house consists of a large lounge and conservatory. The annex has a large lounge and conservatory/dining room. There are gardens to the front and side of the property with seating provided for residents use. There is a car park to the side of the property. The home is located in a quiet residential area, close to the sea, local amenities, shops and public transport. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection for the year 2005/2006 and was unannounced. The inspection took 6.5 hours and during it there was an opportunity to speak with six residents, three visitors and three staff. The daily routines of the home were observed and a partial tour of the premises completed. Three residents were case tracked to assess care provision. Requirements made following the last inspection in relation to the environment had not yet been met. The management of the home and the Commission for Social Care Inspection were having discussions about how to achieve the best outcome for residents and more time was given for compliance in order to achieve this. During this inspection people living in the home were asked how they would like to be referred to in this inspection report. The consensus of opinion was they would like to be referred to as “residents”. This term is used throughout this report. What the service does well: What has improved since the last inspection? Staffing levels on the evening shift have been reviewed and sufficient staff are now provided to meet the needs of residents. The activities programme continues to develop. Residents said how much they enjoyed it. More time is being spent providing one to one activities for those unable to participate in the group ones. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.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 Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.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 and 3 Standard 6 does not apply. The information given to residents prior to admission enables them to make an informed choice about whether they wish to move in. A comprehensive pre admission assessment ensures only residents whose needs may be met are offered a placement. EVIDENCE: A resident recently admitted to the home confirmed he had been able to visit the home prior to admission. He had a copy of the service users’ guide and confirmed he was given information about the home. A pre admission assessment had been completed prior to admission and the resident confirmed he had been asked for information about his abilities and needs. Information from the assessment had been given to kitchen staff to enable them to meet his needs in respect of his morning routine. For example, staff knew what time he wanted a cup of tea and his breakfast. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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 standard(s) 7, 8, 9 10 and 11 Care plans do not provide sufficient information about residents’ social and emotional needs for staff to be able to meet them satisfactorily. The health care needs of residents are well met with evidence of staff working with other health care professionals to meet residents’ needs. A consistent approach to assisting residents with oral medication was not being followed and this could compromise residents’ welfare. The staffs’ commitment to core values enables residents to feel they are treated with dignity and respect. The home’s policy and practice in respect of residents’ death and dying promotes a sensitive approach in dealing with the resident and their family at this time. EVIDENCE: Each resident has a care plan that is regularly reviewed. These gave clear information about physical needs but did not contain any information about Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 10 social or emotional support needs. Care plans must be developed that address these needs in order to provide a holistic approach to residents’ needs. There was clear evidence that residents were able to access a wide range of health care. Staff monitored identified health care problems such as weight loss and fluid intake for particular individuals and referrals were made to health care professionals such as dieticians and physiotherapists for additional support. Moving and handling risk assessments were completed where there was an identified risk. The dispensation of morning medication was observed. One member of staff was observed tipping medication into her hand and then putting it into a resident’s mouth. This practice did not comply with Royal Pharmaceutical Guidelines. It was agreed a protocol should be drawn up which recorded the resident’s permission for medication to be placed directly in his mouth. It should also include clear instructions on how and when staff should do this and the G.P. should be consulted to clarify if this was the best way to deal with this problem. Residents felt staff treated them with dignity and respect and this was observed during the inspection. One relative had written to the Commission for Social Care Inspection to express her gratitude for the dignity given to her mother as she was dying. During the inspection a resident died. Staff were observed treating her and her relative with sensitivity and respect. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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 standard(s) 12,13, 14 and 15 The routines of the home are flexible to enable residents to make choices about how they spend their time. A wide variety of activities are offered to provide mental stimulation for residents. The relatives group provides a good opportunity for issues to be raised and feedback about the service to be given to the provider. The meals in this home are good, offering residents both choice and variety and catering for special dietary needs. EVIDENCE: Residents said they felt routines in the home were flexible to meet their needs. For example, all are able to get up when they want and have breakfast when and where they like it. They move freely about the home, spending time in the lounges or their own rooms. Residents choose what they wear, how and where they spend their day. The activities programme provides stimulation for those who want it. Activities include bingo, crafts, games and manicures. The home does not have its own transport, so opportunities for going out are limited. The activities organiser confirmed she accompanies residents to the beach or local shops but would like to develop this aspect of provision. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 12 Residents are supported to continue with their personal preferences of activities. For example, large print books are supplied to one person who enjoys reading each day. Residents are able to order daily newspapers. Relatives visited the home throughout the day. They are able to have a meal with their relative if they wish and there are no visiting times. Notices to this effect are displayed throughout the home. All residents spoken with said meal provision was excellent. The home employs two cooks who prepare breakfasts, main meals and tea. Residents are informed during the morning of the main meal choice and are able to choose an alternative if they wish. On the day of the inspection the main meal comprised roast chicken, potatoes, carrots, broccoli and peas followed by home made rice pudding. One person had chosen to have sausages instead. The home had a large supply of fresh fruit and vegetables. The cook confirmed puddings are home made. The menu reflected a balanced diet. Several residents have to have a soft diet. The meals are pureed with each item separate. The home has an active relatives’ committee. Minutes from their meetings are posted on a notice board. Relative spoken with confirmed issues raised at the meetings are dealt with by the management and feedback given. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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 standard(s) 16 The home has a robust complaints procedure that enables residents to make a complaint and feel confident it will be investigated. EVIDENCE: Residents confirmed they had copies of the complaints procedure. A copy was also on display. This gave information about how to complain, who to complain to and timescales for the management to deal with complaints. Most residents said they had not had to make a complaint but were confident they would be able to. Relatives said the residents’ group was often used as a forum for bringing concerns to the management team. For example, a recent concern was staff having breaks together. Feedback had been given by the management confirming that this practice was not allowed and would be monitored. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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 standard(s) 19 20 and 26 The home is well maintained, providing a safe and comfortable environment for those living there. The practice of using communal space for staff training can restrict the residents’ choice of where they may spend their time. The cleaning schedule in the home provides a clean and fresh environment for residents. EVIDENCE: The home provides a pleasant environment with a variety of communal space for residents to use. The home is well maintained, with a maintenance programme in place. There are long term plans to develop the space between the main home and the annex. The lounge/diner in the annex is used by residents and visitors. It is also used by staff having training and supervision, for meetings and for staff having breaks. During the inspection this area was observed being used by the Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 15 registered manager and a member of staff for training, a new member of staff and his mentor, completing induction training, someone discussing NVQ2 with another member of staff and staff having breaks. A requirement was made following the last inspection that alternative arrangements must be made. The provider has already identified that this is not appropriate for either residents or staff and is trying to find a solution. A further six months has been given by the Commission for Social Care Inspection to find a short and long-term solution. The lack of storage space for equipment means that much of it is stored in corridors and communal bathrooms. This could be a potential hazard and also detracts from the overall pleasing appearance of the environment. The home employs three domestic staff to clean each day. Residents commented on the cleanliness of the home and said their rooms were regularly cleaned. There are policies and procedures for staff to follow in respect of infection control and suitable equipment is provided to protect residents and staff against the risk of infection. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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 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, 29 and 30 Staff are supplied in sufficient numbers at appropriate times to meet the needs of current residents. The recruitment practice of the home ensures that suitable staff are employed and residents are protected. Staff are offered specialist training to enable them to meet the needs of residents. EVIDENCE: There was evidence that a thorough recruitment process was followed for the appointment of new staff. References were taken up and staff did not commence employment until a Criminal Records Bureau Disclosure check had been undertaken and confirmation received that the person was not on the Protection of Vulnerable Adults register. Staff confirmed they completed an induction programme which included shadowing experienced staff and completing mandatory training such as moving and handling and food hygiene. Initially new staff worked as a supernumerary member of staff. Information about training courses was displayed on the staff notice board. This included palliative care and continence training. Staff were being encouraged to complete their NVQ2 training and staff who completed their nursing qualifications overseas were supported to complete an adaptation course whilst working at the home. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 17 Staff confirmed they were able to attend training that enabled them to meet the needs of residents. For example, the member of staff responsible for activities had been supported to apply for a course relating to activities for older persons. Staffing levels are provided that comply with staffing notices issued under previous agreements with the Health Authority. Residents and relatives felt that at times staff were under pressure and did not always have time to spend socialising with residents. Staff also felt that at times they were not able to spend quality time with residents. The demands on staff time have reduced recently as the home is not full. This needs to be monitored as new residents are admitted to make sure staffing levels are adequate to meet the needs of all residents. The requirement to provide sufficient staff during early evening had been complied with. Residents said staff were available to provide supper drinks or assistance to get undressed. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 18 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) 38 Staff training, and the regular review and servicing of equipment ensures that the health safety and welfare of residents are promoted and protected. EVIDENCE: Staff are required to complete basic training such as moving and handling and food hygiene. Gloves and aprons were being used for all tasks including the handling of waste. Guidance on infection control was available for staff to refer to. There was evidence that equipment was regularly serviced. For example the home had contracts for monitoring of hot water, removal of clinical waste and checking the wiring system. Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 2 x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 20 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 7 Regulation 15 Requirement Care plans must include a section that addresses the social and emotional needs of residents. Clear guidance must be given when medication has to be put directly into a residents mouth. This must include the residents permission, G.P. confirmation that it is necessary and that there is no alternative and a procedure for all staff to follow. Suitable storage space must be provided for staff to change their clothes and to store their personal belongings whilst on duty. (Previous timescale of 1/4/05 not met). Provide sufficient communal space for residents. The practice of using the communal lounge/diner for meetings and training must stop and an alternative environment be provided. Suitable storage space must be provided for equipment stored in a corridor in the annex that does not present a possible risk to residents (previous timescale of H54 S11496 Solent Cliffs V229558 010605.doc Timescale for action 1/08/05 2. 9 13 1/08/05 3. 20 23 1/12/05 4. 20 23 1/12/05 5. 22 23 1/12/05 Solent Cliffs Nursing & Residential Care Home Version 1.30 Page 21 1/4/05 not complied with) 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 Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 Page 22 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Solent Cliffs Nursing & Residential Care Home H54 S11496 Solent Cliffs V229558 010605.doc Version 1.30 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. 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