Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 07/01/08 for Southwater Residential Home

Also see our care home review for Southwater Residential Home for more information

This inspection was carried out on 7th January 2008.

CSCI found this care home to be providing an Adequate service.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Southwater is an attractive building, domestic in character, being a row of houses joined by the conservatory that runs along the front of the house. The dining room is particularly bright and attractive. There are two other lounges, and one resident had their own private lounge. One person volunteered "If I have to live anywhere other than my own home, it had better be here", another commented in a similar vein with particular reference to their bedroom location. Good food is served at Southwater, and residents were seen to enjoy their meals. There are a multitude of choices at breakfast and high tea. The standard of cleanliness was good. There was an absence of unpleasant odours.

What has improved since the last inspection?

An effective administrator has been appointed. Amongst her first achievements has been the production of a Statement of Purpose for the service, describing for the public what is provided at Southwater, and how the service is organised. A ramp had been built from the level of the conservatory to the level of the lounges, so it is now possible to get from the front entrance to the foot of the stairlift without negotiating a step.The laundry has been reorganised and redecorated to make it a clean and hygienic place to care for residents` clothes and bedding. A staff member called a `befriender` has been appointed, to visit residents who prefer to stay in their rooms for conversation and social activities, to prevent them from becoming isolated.

CARE HOMES FOR OLDER PEOPLE Southwater Residential Home Southwater Residential Home 3-4 Conway Crescent Paignton Devon TQ4 5LG Lead Inspector Stella Lindsay Key Inspection (unannounced) 9:30 7th January 2008 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 Southwater Residential Home DS0000018427.V355196.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. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southwater Residential Home Address Southwater Residential Home 3-4 Conway Crescent Paignton Devon TQ4 5LG 01803 524140 NONE 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) Mr Thomas Lamont Mrs Mary Lamont Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2007 Brief Description of the Service: Southwater Residential Home is registered to provide accommodation and care for a maximum of eighteen people in the registration category of ‘Old Age, not falling within any other category’. It is made up of three houses joined together with a conservatory running along the entire front of the building, and a small but pleasant garden behind. There is a stairlift to the first floor. Two bedrooms are up a flight of stairs with no lift. There is ample car parking space at the front of the house. Southwater is in a residential area of Paignton and is close to the town centre and the bus and railway stations. Information is available from the home on request in the form of a written Statement of Purpose and a Service Users’ Guide. Copies of inspection reports are kept at the Home and are also available on the CSCI website. The current fees range from £330 to £440 a week, although additional charges may be made for hairdressing, newspapers, clothing and all other items of a luxury or personal nature. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means the people who use this service experience adequate quality outcomes. This inspection took place over two days in January 2008. The inspector was accompanied by the Pharmacy Inspector, who carried out an inspection of the way that medication is administered in the home. An Expert by Experience joined the inspection and spent time with eight residents in their rooms and at dinner, in order that their views could be reflected in this report. The inspector made a tour of the premises, met with seven residents and six staff on duty, examined care records and staff files, and met with the Home Owner. Comment cards were received from relatives of people living at the home, and their views are represented on the text. What the service does well: What has improved since the last inspection? An effective administrator has been appointed. Amongst her first achievements has been the production of a Statement of Purpose for the service, describing for the public what is provided at Southwater, and how the service is organised. A ramp had been built from the level of the conservatory to the level of the lounges, so it is now possible to get from the front entrance to the foot of the stairlift without negotiating a step. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 6 The laundry has been reorganised and redecorated to make it a clean and hygienic place to care for residents’ clothes and bedding. A staff member called a ‘befriender’ has been appointed, to visit residents who prefer to stay in their rooms for conversation and social activities, to prevent them from becoming isolated. 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. The summary of this inspection report can be made available in other formats on request. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 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 Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is adequate. Clear information is being provided for prospective residents and their representatives. The home owner meets prospective residents as part of the assessment process, but has not always given full consideration to all aspects of the admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A Statement of Purpose had been produced, to provide clear and accurate information for prospective residents and their representatives about the home and service provided. Some details needed checking, such as room measurements. The new administrator is commended for completing this task promptly and clearly. She said that she is now working on the Service Users’ Guide. The files of two recently admitted residents were examined. Information about their care needs had been obtained before they were offered accommodation. The home has a format for collecting the information necessary in order to make the decision about whether the home is suitable to meet the person’s Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 9 care needs – a pre-admission assessment - though it had not always been used. There was information from the Discharge Liaison Nurse, and the Home owner had visited the person before they were discharged. They were familiar with the home as they had been a regular visitor in the past. The other new admission had been visited in their home by their Social Worker and the home owner, and their care needs assessed, though the admission assessment form was not completed till after their admission. There was no record of the judgement that had been arrived at, and no record of the person being informed of this decision. More clarity is needed in following the home’s own procedures, to make sure that good decisions are made consistently. Residents had been given up to date versions of the home’s terms and conditions, so that they would know what was included in the service. Intermediate care is not offered at Southwater. Southwater Residential Home DS0000018427.V355196.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): 6,7,9,10 Quality in this outcome area is adequate. The home owner was fully aware of the needs of the people living at the home and was trying to put their interests first, but care plans were not kept up to date or written in a way that would enable staff to know what residents need daily for their health and welfare, if she were not there to pass on this information. The home owner was not sufficiently active in obtaining professional help for residents. The system for administering medication was basically sound, but some aspects of practice needed to be corrected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans had been written on behalf of each client. Information had been gathered with regard to their medical history, health and personal care needs. A summary should be written in consultation with the resident, to show any member of staff including new recruits, what the resident actually needs done for them. This should be written from the point of view of the resident, to include what is important for them, and be signed by them (or a representative) if possible. Personal or family history should be included, Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 11 according to the preference of the resident, to help staff – especially new or young staff – to understand the resident as a whole person. There should be evidence that care staff check the care plans each month, and up-date them if necessary. One was seen to be entirely out of date and not relating to the current situation, and therefore of no help to new staff. At present the Home owner is on-call most nights and on duty every morning, and she gives an up-date to staff coming on duty without referring to any records. If she were not there for any reason, there would not be sufficient information for good consistency of care. People with specific conditions such as diabetes should have instructions for staff in the plan of care, to ensure their health and well being is promoted. Two residents had been booked in to the home for a short stay and were still there. They needed professional help and advice in order to make progress with their plans. Southwater was not expected to provide this assistance, but the management need to obtain this help on behalf of the clients. Another resident had a condition that had deteriorated placing them outside the scope of this home to care for them. The home owner requested a visit from the GP during the course of this inspection, to deal with some health issues before a reassessment of care provision. Residents who spoke to the Expert by Experience were satisfied with their bathing arrangements. All felt that there was no restriction on bathing/showering. Some had en suite facilities that they could use, and some used the new shower or the bath, although a powered seat has not yet been provided. Some residents are able only to have strip washes, as they cannot get to the shower, or get into a bath. We found that medicines were stored in a locked cupboard, although at the time of the inspection the keys were not kept securely. The provider told us that she normally carries them on her person and agreed that she would remember to do so in future. We also found that medicines requiring refrigeration were not stored correctly and that no provision had been made for the secure storage of these. We also found that the home had a cupboard for the storage of controlled medicines but it was not fixed in the correct manner. We found some loose tablets in the cupboard and were told that these were medicines that had been removed from the original packaging but had been refused by the person and had been kept in case they would take them later. These medicines were no longer in their packaging and had no reference with them as to what they were or whom they belonged to. Discussion took place around the correct recording and disposal for these medicines both now and in the future. We found that the person administering medicines had a very good knowledge of the people receiving the medicines but that this information was not available in the individual service user plans. For one person the dose of Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 12 medicine had been changed by the prescriber and had become a variable dose but there was no reference made to the change in the service user plan or any indication of who would make the decision about the dose to be taken. We were told that the person makes the dosage decision himself or herself and it is related to their personal circumstances. We found that for one person they were looking after their own medicines, but this was not supported by a risk assessment having taken place. We also discussed ways in which the independence of this person could be further promoted. For this person a record had been made of the receipt of their medicine into the home but there was no record of the medicine having been supplied to the person. We also found that the records being made in the controlled register were being signed before the medicine was actually administered so meaning that the record was not accurate. We were told that further people were to receive training on the safe administration of medicine and that others would also be trained to witness the signature in the controlled register. We also found that staff who were not competent to administer medication were given tablets to take to residents on their supper trays. This is not acceptable practice, as one person needs to be responsible for administering and recording the medication. At all times staff were observed to knock on the door prior to entering bedrooms. However, the dignity of two individuals who had been asked to share a room was not being promoted. One of these people had health problems which meant that no sharing arrangement should have been contemplated, and the room provided was not big enough to contain a cupboard for each person, so their belongs were not separated. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 13 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): 12,13,14,15 Quality in this outcome area is adequate. Work has begun to combat isolation felt by some residents at Southwater. The meals are good and the residents benefit from being offered a wide range of options. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents who are quite well and mobile are comfortable with this service. One resident is able to walk to the seafront and back, while another drives a car. Residents said they choose when to retire and rise. Breakfast is taken to people in their rooms, and they can have what they want. There were no complaints from residents about the laundry system. The Expert by Experience noted that the various lounges were totally deserted throughout their visit, from 11am to 2.30pm. One of the staff often engages residents in board games during the afternoons, this is popular but limited to three or four people. A County and Western singer is engaged to entertain residents occasionally and a singer/dancer visits from time to time. One resident said they enjoyed sitting in the garden in good weather. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 14 The Home owner has appointed a member of staff called a ‘befriender’ to spend time with residents who do not come out of their rooms, and engage them in conversation and social activities. This is seen to be working well, and good work is being done to tackle some residents’ isolation. However, several people spoke of boredom and said they stayed in their room and read or watched television, as there was nothing better to do. One resident has been adopted by the house cat and enjoys the feline company. Visitors are actively encouraged, welcomed and offered refreshments. Two residents go to their own Church every Sunday. There was said to be a monthly menu rotation for the set lunch and whilst there was no choice for this meal the chef claimed to be aware of people’s preferences. The home owner said that a vegetarian option is always available. For Breakfast and High Tea there is a multitude of choice. These latter meals are taken in the bedrooms whilst Lunch is served in the ground floor dining room. On the day of this visit only 4 residents were eating lunch in the dining room. The lunch was beef casserole (minced beef) with creamed potatoes, carrots, swede and broccoli followed by rice pudding with cream and two prunes. The meal was well presented, tasty and was suitably hot. Comments from the residents indicated that they considered the food to be of a satisfactory standard. We met the Supper Cook at 3pm while she was visiting residents in their rooms to take their choices for tea. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 15 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): 16,18 Quality in this outcome area is adequate. The procedures are in place but the home owners have not always ensured that peoples’ views are heard, and the records are not complete. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure on display, and copies had been printed and given to each resident prior to the last inspection. Copies were seen in their rooms. A complaint made on behalf of a previous resident alleged that a person felt they had been subject to intimidation. The Complaints procedure is to be amended to ask that any complaint or concern be passed directly to Mrs Mary Lamont. A record of complaints made within the home had been started. This was to provide supporting evidence in case of any repercussions. A public record should also be kept in compliance with the home’s complaints policy, showing time scales, outcomes, and what has been done in response to the complaint, to prevent any recurrence. Residents spoken with on this visit said they had not had occasion to make any complaints. An allegation of abuse regarding an alleged incident in the home several years ago had been referred to the Safeguarding Adults team. It was not substantiated due to lack of corroborating evidence. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 16 Staff said they had received in-house training in awareness of abuse. Professional training in the Protection of Adults from Abuse must also be provided for all who work in the home, whatever their role. Unsuitable locks had been removed from bedroom doors, and access around the home had been improved so that no resident need stay in their room due to environmental restrictions. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 17 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): 19,21,26 Quality in this outcome area is adequate. An attractive domestic environment is provided, which is fine for people who do not have mobility problems. Improvements have been made to help residents get around the building, though not all residents have bathing facilities that they can access. Most bedrooms were attractive, but two people were found to be sharing a single room. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location of this home is good, as it is close to the town centre and seafront. Its layout is homely and attractive, and comprises three houses joined at the front along the conservatory. There are three staircases. The one to the far right of the home has a stair lift fitted. A large bathroom and a shower room have been installed on the first floor, accessed via this stairlift. Some residents have en suite facilities, and one resident uses a communal bathroom up the stairs at the other end of the house. At the time of this inspection there were three residents who were unable to get to a bath or Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 18 shower. The home owners have been arranging for the installation of an assisted bath seat for their new bath since summer 2007 but at the time of this inspection there was not yet one in place. A ramp had been built from the level of the conservatory to the level of the lounges. Now people can get from the front door at the left of the building, which has a ramped access, to the bedrooms and lounges on the ground floor as well as the dining room and the base of the stairlift without having to negotiate a step. There are three further bedrooms down a few steps to a lower ground floor, and two bedrooms on the first floor accessible only via a flight of stairs. The dining and lounge areas are well maintained and decorated to a high standard with suitably comfortable good quality furniture. Two residents were found to be sharing a room that was too small to meet the National Minimum Standards, and did not have room for a cupboard for each of them. It was unsuitable because of their personal requirements, and although one of them had agreed to move in as a temporary measure two months earlier, they had not made an active choice to share together. In fact, problems were occurring, and an immediate requirement was issued, to make other arrangements. Radiators had been covered, to prevent risk of residents being harmed if they were to fall against one. A free-standing heater was seen in a bedroom. It had sharp phlanges, and posed potential harm to the occupant. Two further heaters were seen in the conservatory, one of which had similar sharp edges and posed a potential hazard to anyone who might fall against it. An immediate requirement was made to remove these or cover them. Small ramps had been fitted over the door leading to the garden, to aid access, though anyone with mobility problems would still need help to get out. There is a passageway that leads from the conservatory through the house to the garden. It is currently used as a storage area, but the home owners said they planned to clear it and make it accessible to residents who would then have level access to the garden. The standard of cleanliness was good. There was an absence of unpleasant odours. The laundry had been cleaned out and was in good order, and arrangements were in place for the collection of soiled waste disposal. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 19 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): 27,28,29,30 Quality in this outcome area is adequate. Provision of staff had improved, to improve care and social engagement of residents by day. Cover by night is still very limited, and staffing is low in the evenings. A carer had been allowed to start work over the Christmas period without the proper checks to assure protection of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A staff rota is kept, which shows there are three carers working alongside the home owner on weekday mornings from 9 – 11am, two until 2pm. During the afternoons, one carer has been on duty alongside catering staff while the home owner takes her break. This carer provides social activities in the lounge for those who are able to join in. A ‘befriender’ has been appointed since the last inspection, who works 10.30am – 3.30pm four days per week, to visit residents in their rooms, who cannot or will not join a social life in the home. The staff rotas show that the home owners are covering night care between them every night except Friday. They agreed in their Improvement Plan returned to the CSCI dated 22/10/07 that more night staff would be recruited so that all service users would be checked regularly, and ‘not just the ones who are unable to use their call-bells’. The Statement of Purpose states that ‘personal care is available 24 hours per day’. At the time of this inspection only Friday nights were staffed regularly. The Home owner said that she sits up during the night, responds to bells and checks anyone who might have a Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 20 problem. She lives at the home and is on duty seven days per week. No resident reported having any problem by night, and staff said it is usually quiet. Prospective residents who need help during the night should look elsewhere, and this should be recommended in the Statement of Purpose until such time as cover is arranged. A carer was on duty at the start of this inspection whose name was not on the rota. The home owner said she had worked for her nine years ago, and had called her in to help out, to cover for sickness over the Christmas period. She had not made any of the checks that are required for protection of the residents from potential harm. The administrator sent off for the necessary checks at the earliest opportunity, and had kept proof of identity on file. The home’s own policies and procedures, there for the protection of residents from harm and to promote their good health and well being, must be adhered to at all times. Induction training has been provided for new staff, though evidence was not requested on this visit. During 2007 staff had received training in Moving and handling, First Aid, and First Aid, fire safety and Food and Special diets. The Training video for raising awareness of issues surrounding Protection of Vulnerable Adults had been viewed. Training in Person Centred Planning should be obtained, to improve the effectiveness of care planning within the home, and enhance consultation with the residents. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 21 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): 31,33,35,38 Quality in this outcome area is adequate. Administrative processes have improved. The home owner has a hands-on style of management and is not always aware of the requirements of current good practice, which has led to less fortunate outcomes for some residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr and Mrs Lamont have owned and run Southwater for 20 years, and are both Registered Providers for the service. The care industry has altered in recent years, caring for more dependant people with more complex problems of all sorts. The home owners have not up-dated their qualifications. Mr Lamont had been registered as the Manager of the home, but has said that is not his role and agreed that his name should be removed from the certificate. He is responsible for catering and home maintenance. Mrs Lamont has a Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 22 qualification in care management gained in 1993. She is involved in care of the residents seven days per week, and most nights. Management decisions that have suffered or been neglected include;failure to obtain specialist assessment or help for clients, needed because of mental health needs, developing dementia, conflict within the family, or OT assessment in order to make a safe transition home, failure to appoint night staff over many months, failure to ensure that residents are accommodated in appropriate rooms, failure to provide a powered bath seat. The inspector was told that a trainer was booked to visit the home owner and Deputy Manager to discuss the prospects of both working towards the Registered Managers’ Award. Arrangements must be made urgently to assure that good management decisions are taken, in accordance with the regulations and National Minimum Standards. An effective new administrator had been appointed, who is developing good management practices in the office. Quality Assurance information was not seen on this visit, and none was available at the previous inspection. The Registered Provider live at Southwater and are on site every day, but there is no evidence of consultation. The home owners do not handle money on behalf of any resident. They add the cost of hairdressing and chiropody to the bill in arrears. Staff appraisal sessions had been held in the past, but no records were seen since December 2006. The administrator had plans to introduce a new system. Accident records were kept. None had been recorded since May 2007. The fire precaution system had been checked professionally on 11/09/07. Professional fire safety training had been provided on 19/06/07, with initial inhouse training provided for new staff on 08/10/07 and 12/11/07. Windows were found to be restricted where necessary for the safety of residents. Bedroom doors had hold-open devices fitted, which is good, but residents were propping them ajar, as they wanted their door neither fully open or closed. This leaves them at risk in an emergency, and a way must be found of providing for their comfort while protecting them from potential harm. Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 23 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 3 2 2 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 2 X 1 X 3 2 X 2 Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Timescale for action 10/04/08 2 OP8 12(1) a & b, 13(1)b Care plans must be up to date, written clearly so that staff can easily see what care the residents need, and there must be evidence that the resident has agreed. Residents’ mental health needs 10/04/08 must be monitored regularly and preventative and restorative care provided. Previous timescale for compliance 30/09/07 3 OP9 13(2) Arrangements must be made to 10/04/08 ensure that the individual service user plans reflect the individual risk assessments relating to medicines and that this also reflects assessment for selfmedication. Arrangements must be made for the safe storage of medicines requiring refrigeration and also for the fixing of the controlled drugs cupboard in accordance with the current regulations. Arrangements must be made to Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 25 have sufficient staff trained to safely administer medicines and witness signatures so that inappropriate processes are not used. 4 OP16 22 The home owners must ensure that any concern raised is heard in a professional manner, and a record is kept of any action taken in response. 10/04/08 5 6 OP18 OP22 13(6) 23(2) n All people who work in the home 30/04/08 must receive training in the protection of vulnerable adults. The registered persons must 30/04/08 provide a suitable bath seat to enable all residents to use a bath safely. Previous timescales for compliance 13/04/07 & 04/06/07 & 30/09/07- not met. 7 OP27 18(a) The registered persons must, having regard to the size of the care home and the needs of the service users, ensure that there are sufficient care staff on duty at all times. In particular this relates to the continuing lack of provision of waking night staff, as some of the service users would not be able to use their call bells. Previous timescale for compliance for the provision of waking night staff 30/07/06 & 13/02/07 & 04/05/07 & 31/08/07- not met. The registered persons make sure that the premises are maintained safely by; Removing or covering free standing heaters. 30/04/08 8 OP38 13(4) & 23(4) 10/04/08 Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 26 Removing any wedges or other unsafe objects used to hold doors open. 9 OP31 9(2)b(1) The home must have a Manager who is qualified to NVQ Level 4 in Care and Registered Manager Award. 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP3 Good Practice Recommendations The Statement of Purpose should be checked for accuracy throughout. Following assessment of a prospective resident, the decision whether or not care can suitably be provided at Southwater should be recorded, and they should be informed in writing. Care plans should include a summary of care to be provided, agreed with the resident. Staff training in Person Centred Planning should be provided. Staff supervision should be provided, with care staff receiving at least six sessions each year. 3. 4. 5. OP7 OP30 OP36 Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 © 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 Southwater Residential Home DS0000018427.V355196.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!