CARE HOMES FOR OLDER PEOPLE
Solway House Residential Care Home 5 Station Road Benton Newcastle Upon Tyne NE12 8AN Lead Inspector
Anne Brown Key Unannounced Inspection 13:00 2nd and 6th November 2006 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 Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 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. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Solway House Residential Care Home Address 5 Station Road Benton Newcastle Upon Tyne NE12 8AN 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) 0191 2660138 F/P 0191 2660138 No Email Mr Davinder Vij Care Home 27 Category(ies) of Dementia (5), Old age, not falling within any registration, with number other category (22) of places Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Bedrooms 1,2,3,4,5,6,7,8,9 in the south wing of the premises must only be occupied by service users who do not require staff assistance for moving and handling. Date of last inspection Brief Description of the Service: Solway House offers residential care to male and female residents over the age of 65 who are suffering from problems relating to general old age and/or dementia. The home was opened in 1983 and was originally a Victorian house which has now been extended with wings on either side, that are in keeping with the original building. The accommodation is provided on two floors and a passenger lift has been installed. There are two main lounges, a dining room and a sun lounge overlooking the gardens. There are twenty-one single and three twin bedrooms. Nine bedrooms in the south wing are not suitable for residents with mobility problems due to the size of the rooms. The home is situated in Benton close to the metro network and local shops are nearby. The home is surrounded by gardens and there is seating in the patio areas. The fees range from £361 - £365 per week. Information about the home and inspection reports are readily available. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over 6 hours and two visits were made to the home. The inspection was carried out to check on the progress made towards meeting the requirements and recommendations from previous inspections and to assess the service against the National Minimum Standards. Two additional visits have been made since the last inspection. Letters sent to the registered person following these visits can be obtained from the CSCI office on request. A tour of the premises was carried out and staff files, care plans, fire logbook, accident and complaints records were inspected. Four staff members, one visitor and the majority of residents were spoken to. What the service does well:
The residents who made comments stated that they were comfortable living in the home. They said the staff team were very good and attended to their needs in a kind and friendly manner. The residents stated they had no complaints. One visitor said their relative was well cared for and they had no concerns about the home. They said the staff were very good and they always made them welcome when they visited. They also confirmed that their relative could request alternative meals if they wished. The staff team work hard to provide various activities for the residents. They were enthusiastic about their roles and are keen to improve their skills. There was a pleasant and relaxed atmosphere in the home and good relationships exist between the staff and the residents. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
The care plans should be expanded and provide clear guidelines for staff. A number of repairs were identified during the inspection. There should be regular checks made to see what repairs are needed and a renewal and maintenance programme should be produced. Health and safety risk assessments should be carried out on the premises.
Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 7 Plans to improve the layout of the rooms in the south wing have not been forwarded to the CSCI as requested. A sluice should be provided in the interest of infection control. Mandatory health and safety training should be brought up to date and staff should be provided with training on challenging behaviour, restraint and nutrition. Alternative activities and stimulation should be provided for residents who suffer from memory loss. The staff team should be issued with contracts of employment and job descriptions so they are clear about their role in the home. Photographs should be placed on the staff files for identification purposes. The medication trolley should be secured to the wall for security reasons. 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. The summary of this inspection report can be made available in other formats on request. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 8 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 Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are fully assessed prior to moving into the home to ensure their needs are able to be met. EVIDENCE: Residents are assessed by care managers and/or senior staff prior to moving into the home. Copies of assessments were available on the case files, which give the care staff the information they require to meet the residents’ needs. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The individual personal and health care needs are monitored in residents’ care plans but this information is sometimes limited. Therefore staff may not always have comprehensive information about the needs of the residents. The system for administering medications is suitable. The staff ensure that residents’ privacy and dignity is respected. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 11 EVIDENCE: A sample of care plans was examined. The staff continue to work hard to improve the care plans. They are well organised and evaluated on a monthly basis. However one care plan did not give clear instructions to the staff regarding the mental health needs of the resident. Each person’s care and support is regularly reviewed and action is taken on any change in needs. Health needs are monitored by the staff who work closely with a range of other professionals to ensure that any specialist needs are met. A random sample of medication records and the system for storage and handling medication was looked at. This system was appropriate apart from the medication trolley not being secured to the wall in the medication cupboard. Residents are assessed and encouraged to keep their own medication if they are able. The residents confirmed that staff respect their privacy and dignity. Staff were observed to be working with the residents in a caring and sensitive way. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities and events are provided in the home for the residents to enjoy. Friends and family are encouraged to visit and participate in any events taking place. Residents are able to make personal choices and the staff encourage them to retain their independence. The residents are offered a choice of food and mealtimes are flexible to meet their needs and preferences. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 13 EVIDENCE: Activities include bingo, crafts, armchair exercises, knitting, board games and sing a longs. Social events are arranged on a weekly basis. These include pea and pie suppers, broth and stotty nights and seasonal parties. The residents confirmed they had recently enjoyed a Halloween Party and firework party. Residents are encouraged to plan these occasions and decorate the dining room accordingly. The majority of residents said they usually enjoyed the activities taking place. Short trips have recently taken place to the local shopping centre and staff escort one resident to the local pub. Three residents were escorted to an Autumn Fayre at a local sheltered housing complex. The needs of some residents who suffer from dementia were discussed. Although they enjoy music, no alternative stimulation is offered when organised activities are not taking place. A tuck shop is open in the home every Sunday and is proving to be very popular. Activities taking place in the home are displayed in the dining room and are recorded in the activities book. A visitor in the home confirmed they were always made welcome and encouraged to join in any events that take place. The residents said they could choose what they would like to eat and how to spend their time. The menus have been reviewed to include a choice of meal and they list the alternatives that are available. The daily menus have been laminated and are placed on each dining table. The chef asks each resident what they would like from the menu on a daily basis. He was enthusiastic and proud of his work. Menus are discussed during the residents’ meetings and the chef meets new residents to ask their likes and dislikes. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system in place. Residents are protected from abuse. EVIDENCE: A complaints procedure is in place and forms part of the service user guide. No complaints have been received since the last inspection. The residents confirmed that they speak to the staff if they needed to make a complaint. Numerous thank you cards and complimentary letters have been received from residents and relatives. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 15 The acting manager said that some staff had completed a training course with North Tyneside Council on the protection of vulnerable adults. All other staff have been booked to attend. The staff on duty stated they would not hesitate to report any bad practice. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A programme is in place to redecorate all areas of the home. There are sufficient and suitable toilets and bathing facilities to meet the needs of the residents. The majority of bedrooms suit the needs of the residents. Commodes are currently cleaned in a bathroom which is not good practice for infection control. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 17 EVIDENCE: The dining room has been redecorated and new ceiling and wall lights have been fitted. New blinds have been fitted to the windows. The corridor in the north wing has been redecorated and the residents confirmed they were involved in choosing the wallpaper. New carpet has been ordered for the dining room and the north wing corridor. The front lounge is being decorated. The shower room and toilet in the north wing have been refurbished. One resident said the new blind and shower curtain gives her more privacy and independence. A new fax machine, laminator and photocopier have been provided in the office. Bedroom furniture in a number of bedrooms was broken and shabby. Some towel rails were broken in residents’ bedrooms. The armchair in bedroom 9 was shabby. The mechanical ventilation system in the toilet located in the north wing was not working and was clogged with dust. A sluicing facility is not provided and commodes are cleaned in the bath. This does not meet infection control recommendations. The bedrooms in the south wing are extremely small and narrow. This means it is not possible for carers to assist residents who may require help getting in and out of bed. The Commission has not received an application and plans to alter these rooms. A condition of registration has been made to ensure that only residents who are mobile occupy the rooms. The acting manager confirmed that plans have now been drawn up and the owner would be submitting these in the near future. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to meet the needs of the residents in the home. The recruitment policy and practice supports and protects the residents. Staff are provided with training to help them carry out their roles more effectively. Further training is required in some specialised areas. EVIDENCE: At the time of the inspection the acting manager, three care assistants and the chef were on duty. Two domestic assistants and the laundry assistant had been on duty that morning. The acting manager stated that she would be reviewing staffing levels very soon to make sure time is used effectively. When the second visit was made to the home the manager had changed the rotas for the domestic staff so there is a member of staff working during both mornings and afternoons.
Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 19 A policy and procedure supporting the recruitment and selection of staff is in place. A random sample of staff files was examined and these confirmed that Criminal Records Bureau checks are received prior to staff being employed by the home. Photographs of each staff member have not been placed on their personal files. Job descriptions and contracts of employment have not been provided for the staff. Mandatory health and safety training for some staff members was not up to date. Training has not been provided on restraint, dietary and nutritional needs. Nine members of staff have completed NVQ Level 2 or above. The residents confirmed that they enjoyed good relationships with the staff and they were well cared for. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents. Systems are in place to safeguard the residents’ finances. Staff receive appropriate supervision and support to ensure the residents receive good care. Health and safety of the residents is promoted by well-trained staff and individual risk assessments are in place. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 21 EVIDENCE: The registered manager terminated her employment in the home on 30th October 2006 and the deputy was appointed as acting manager the same day. A senior care assistant has been appointed as deputy manager. The acting manager has a number of years experience in working with older people and is currently undergoing training to obtain a Registered Manager’s Award. She will be applying to become registered with the Commission in the near future. Residents are involved in the running of the home. Regular meetings are held and a residents’ committee have been appointed. Choice of food, activities and décor are discussed. The meetings are advertised to let people know what is to be discussed and to show the action taken on discussions from the previous meeting. Policies and procedures are in place for dealing with the residents’ finances. The staff in the home do not act as appointee or agent for any residents. Money is deposited by residents for safekeeping. A random sample of records and money held was examined. This confirmed that two staff signatures are not always obtained when residents are unable to sign the record themselves. The previous manager had set up formal supervision sessions for the staff team. The acting manager is continuing to bring these up to date so staff have the opportunity to discuss their roles and training needs. The acting manager has obtained a health and safety risk assessment form. As yet this has not been completed to safeguard the residents. Appropriate tests had been carried out on the fire detecting and fire fighting equipment. Some bedrooms doors did not close fully onto their rebates, which could be a fire safety risk. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 22 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X 2 X X 2 STAFFING Standard No Score 27 X 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 2 X 2 Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 23 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. 2. 3. 4. Standard OP9 OP19 OP23 OP23 Regulation 13(2) 16(2)(j) 23(2)(a) 16(2)(c) Requirement The medication trolley must be secured to the wall for security reasons. The mechanical ventilation system in the north wing toilet must be cleaned and repaired. Plans must be submitted to increase the size of the bedrooms in the south wing. Shabby bedroom furniture must be replaced and towel rails provided in all bedrooms. (Previous timescale of 31/10/06 not met). Sluicing facilities must be provided. Mandatory health and safety training for all staff must be updated. Staff must receive training in restraint, nutrition and dietary needs. (Previous timescale of 31/10/06 not met). Two staff signatures must be obtained in the financial records where residents cannot sign for themselves. All doors in the home must close
DS0000000295.V304991.R01.S.doc Timescale for action 24/11/06 24/11/06 30/11/06 31/12/06 5. 6. 7. OP26 OP30 OP30 23(2)(k) 13(4) and (5) 18(1)(c) 30/11/06 31/12/06 31/01/07 8. OP35 16(2)(l) 24/11/06 9. OP38 23(4)(c) 24/11/06
Page 24 Solway House Residential Care Home Version 5.2 10. OP38 13(4) fully onto their rebates in the interests of fire safety. Health and safety risk assessments must be carried out on the premises. 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP7 OP12 OP29 OP29 OP36 Good Practice Recommendations Care plans should be expanded to give clear guidelines to the staff. Ways should be found to provide more stimulation to some residents with dementia. Staff should be issued with contracts of employment and job descriptions to ensure they are clear about their roles and responsibilities. Photographs should be placed on the staff files for identification purposes. Programme to provide all staff with formal supervision should be continued. Solway House Residential Care Home DS0000000295.V304991.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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