Inspection on 23/08/05 for Summerfields House Rest Home

This inspection was carried out on 23rd August 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

Summerfields House Rest Home 31/01/07

Summerfields House Rest Home 08/03/06

Summerfields House Rest Home 16/02/05

Summerfields House Rest Home 21/09/04

Summerfields House Rest Home 03/03/04

Summerfields House Rest Home 30/10/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Summerfields House Rest Home 12 Burton Road Branston Burton On Trent Staffordshire DE14 3DN Lead Inspector Rachel Davis Unannounced 23 August 2005 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. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Summerfields House Rest Home Address 12 Burton Road Branston Burton On Trent Staffordshire DE14 3DN 01283 540766 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) Mrs Annette Gilliland Mrs Annette Gilliland CRH 21 Category(ies) of DE(E) -7 registration, with number OP - 21 of places PD(E) - 3 Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 16 February 2005 Brief Description of the Service: Summerfields care home is a privately owned large Victorian detached house that has been extended to provide accommodation for 21 older people with needs associated with old age, seven of which may have dementia care needs and three of who may have physical disability. The home is not registered for service users with nursing needs. Health service professionals such as district nurse, community psychiatric nurse, and physiotherapist are accessed when required and local GP’s and a pharmacist service the home. The home is situated on a main road in a residential area of Burton on Trent, within a short distance of the town centre with all its amenities, a bus route passes the door and parking is available. Accommodation is provided on two floors the first floor being accessible by shaft lift as well as a staircase that is fitted with a stair chair lift. On the ground floor there are ten single bedrooms and one double bedroom, and on the first floor there are seven single and one double bedroom. Three of the single bedrooms on the ground floor have en-suite facilities. There are two assisted bathrooms, one on each floor, plus a domestic style bathroom and seven separate toilets located throughout the premises. Communal facilities consist of two lounge areas and a dining room. Externally there are secure garden areas to the rear that include a pleasant patio area that has been fitted with garden furniture. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5 hours. A partial tour of the home was undertaken, followed by a walk round the exterior of the property. Two service users, one staff member and the care standards manager were spoken to in depth. Case tracking of two residents was undertaken. Some staff records were examined and observation of the staff on duty took place. The inspector witnessed the senior staff administer medication appropriately. What the service does well: Being quite small in registration and size the home is able to provide a cosy and friendly environment. People who use the service said that they were happy with the care they received. ‘they are very good, the staff are very efficient ’ ‘staff are very responsive during the night’ Privacy and dignity are upheld within the home; direct observation, service users comments, and staff practice confirmed this to be an accurate account. Staff were also heard offering choice and enabled the service users to make decisions and as many choices as they were able in their daily lives. The requirement and recommendations made at the last inspection have been met. Pre assessment and care planning information for each service user is detailed and covers all areas of individual need including health care monitoring. Care plans are reviewed monthly. Medication procedures are as required and the home liaises with the General Practitioner and pharmacist to seek advice as and when necessary. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 6 It was confirmed that the registered manager supervises and assists staff on a day-to-day basis and is supportive in her role. Records were seen to corroborate this. Residents meetings are held and recorded; this empowers the residents and ensures they play a vital part in the running of the home. What has improved since the last inspection? 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. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 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 Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 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) 1,3 and 4; standard 6 is not relevant to this establishment. The documentation prepared by the home prior to admission outlays the service to be provided to the prospective resident, additional information must be included to fully meet requirements. This will ensure that prospective and existing residents have a greater understanding of what facilities the home has and the care it is able to provide. EVIDENCE: The Statement of Purpose and Service User Guide are made available to all residents and/or their representatives, the establishments Statement of Purpose needs to offer further information so an informed choice about the services provided and whether the home can meet their needs can be made. The Service User Guide contains all the necessary information as required under the regulations. All of the above, plus the most recent inspection report and the homes complaints policy and procedure are available as you enter the home. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 9 Summerfields had two vacancies at the time of inspection; the paperwork seen by the Commission confirmed that residents were assessed appropriately; the admission procedure adequately guides staff on the actions to be taken to ensure that new residents are properly assessed and planned for. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, 9 and 10. Individual care plans are developed, which ensure that the needs of the residents are identified and met. There was a safe system for the receipt, storage, administration and disposal of medicines, which safeguarded residents. Residents were treated with respect, privacy and dignity, during the caring process, which has enabled each resident to maintain these values. EVIDENCE: Two residents’ care records were examined and the information contained within was clear and succinct. Each service user had agreed plans that were reviewed regularly. The community care plans, provided by the social worker, as part of the individual needs assessment process, were not seen on this occasion. Discussion revealed the social work team did not always provide these, it was confirmed by the Commission that this information must be given to the home prior to admission. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 11 Some risk assessments were in need of either implementation or further development, for example, behaviours that challenge, bath hoists, manual handling and bodyweights. National Health Service facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, and these events were seen recorded. Eight GP practices service the home, and it was confirmed there were good working relationships with them. Records of their visits and outcomes were well documented. The medicines within the home, medication administration records, controlled drugs book and drugs returned book, were all checked and no errors were noted. It was observed that a safe system was in place. The Care Standards Manager, Fiona Harrison, confirmed that only trained staff administered medicines. No resident was ‘self medicating’ at this inspection but locked facilities were available. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Visitors are made welcome and various avenues for encouraging resident choice were evident. Worthwhile activities and stimulation for residents were in place; this provides daily variation and interest for people living in the home. EVIDENCE: A small number of residents choose to stay in their own rooms, some bedrooms evidenced that private telephones, radios, televisions, video records and sound systems were in place. Both double rooms offered screening as required. Residents provided confirmation that church services were held on occasion. Activities were discussed at length with the Care Standards manager, but not seen on this occasion, it was confirmed that ‘in house’ and external entertainment was provided. It was revealed that residents were taken shopping, on day trips and to the local pub; six residents also attend a weekly luncheon club held close by. The home has access to transport; therefore community-based trips are facilitated. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 13 The Commission did not have the opportunity to speak with visitors or other professionals on this visit as none were received. During lunch, staff were observed to be courteous and polite, offering choices and support for those residents who needed it. Lunch was unhurried and relaxing for the residents. The dining room area was pleasant and clean, those who may chose to eat their meals in their rooms would be supported to do so. Discussion around evidencing residents’ awareness of the meal of the day was discussed, as those spoken to by the Commission did not recall what was on offer. The kitchen was not inspected on this occasion. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Overall comments received from residents confirmed that they lived in a safe environment, however, the procedures relating to recruitment practice in the home do not adequately demonstrate that residents are fully protected from abuse. EVIDENCE: Discussion with the care standards manager revealed that training for staff is in place and issues relating to abuse were covered within National Vocational Qualifications (NVQ2 and 3). It is recommended that this is further strengthened by training for staff in the local procedures and what constitutes abuse, this will enable staff to have a greater awareness and understanding and improve their knowledge base. The recruitment procedures are not as robust as needed, one CRB disclosure had not been obtained for a member of care staff, there were a number of references missing. This compromises the safety of those residing at the home. Discussion revealed that training for staff on abuse procedures had not been sought, this should be seriously considered. It must be noted that staff who have undertaken a National Vocational Qualification (NVQ) will have covered abuse and protection of residents during that time. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 and 26. The premises were fit for purpose, with adequate personal and communal facilities provided. Summerfields is adequately maintained, satisfactorily clean and tidy; the home provides a comfortable environment for service users. EVIDENCE: A partial tour of the environment was undertaken during this inspection of the communal areas, laundry some bedrooms and bathrooms. Most areas are in a good state of repair, the proprietor may wish to consider re-sealing the flooring in some toilets and a lock is required on the bathroom door by the extension. All radiators are now guarded as required. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 16 The bedrooms are equipped to assure comfort and privacy, the manager has previously audited care plans against Standard 24 of the National Minimum Standards to ensure everyone has been offered a bedroom door key or lockable storage. The manager confirmed that the recommendations made by the fire officer have been complied with baffle locks having been installed; this ensures the safety of those within the home. Toilets and bathrooms are well situated and residents were offered at least two baths a week. Hoists were serviced six monthly as required; this ensures residents are not placed at harm or at risk. Liquid soap was available in all communal areas, the Home felt paper towels were inappropriate and confirmed cotton towels were changed regularly. The home needs to provide foot operated bins for all clinical waste, the home should not be using latex gloves; these should be discarded and latex free should be used unless all staff and residents have a latex allergy risk assessment on file. The registered manager needs to consider the suitability of the storage area of Control of Substances Hazardous to Health (COSHH). The lock to this area is very simplistic and on 3 separate occasions was evidenced by the inspector as being unlocked. A risk assessment is most certainly required. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30. The home has a consistent and in the main long established staff team. The home had not made sure that all the information needed prior to employment was in place; not doing so does not confirm that the right staff are employed to look after vulnerable people. EVIDENCE: On the morning of this inspection, there was one care staff, one cook, one domestic and the care standards manager; the Commission was informed that the cook assists with helping residents in the morning prior to breakfast; there were eighteen residents in the home. Two care staff cover the afternoon/evening period and two waking night staff support the residents during the night. The ratios of care staff to service users must be determined according to the assessed needs of residents, and a system operated for calculating staff numbers required, in accordance with guidance recommended by the Department of Health. The home is required to review the quality of care provided at the care home to evidence sufficient staff are on duty. Two staff files were seen on this occasion and there were a number of deficiencies, neither contained the required references or proof of identity, and one did not have a Criminal Records Bureau check (CRB). Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 18 The manager is required to maintain the staff files according to Schedule 2 of The Care Homes Regulations. Training records for the care standards manager were seen. The records evidenced that she had benefited from ‘in house’ and external training, which had covered the needs of the registered client group. Mandatory manual handling training was out of date but has been booked for September 2005. The Commission was advised that the second cook has attained the required Basic Food Hygiene certificate. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this unannounced inspection. EVIDENCE: Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 20 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 2 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 2 STAFFING Standard No Score 27 2 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x x Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 21 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 1 Regulation 4(1)(c ) Requirement The registered person produces and makes avalible to service users an up-to-date statement of purpose setting out the information required listed under Schedule 1. Further risk assessements must be undertaken both generically and individually. The registered person needs to ensure systems are in place to control the spread of infection in accordance with relevant legisalation and published professional guidance, in this instance appropriate bins are required for incontinence waste. The registered person needs to risk assess the control of substances hazardous to health and the use of latex gloves. The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving quality of care provided at the care home. The registered person shall not employ a person to work at the care home unless they have obtained all the documents and Timescale for action 1.10.05 2. 3. 7 26 13(4)(3) 13(1)(3) ongoing 1.9.05 4. 26 13(4)(3) 30.8.05 5. 27 24(1)(a) 9.9.05 6. 29 19(1)(b) (i) ongoing Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 22 information specified in Schedule 2. 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. Refer to Standard 8 15 18 21 Good Practice Recommendations Service users weight should be regularly recorded within their care plan The registerd manager should consider alternative ways to ensure residents are fully aware of the meals on offer. Discussion revealed that training for staff on abuse procedures had not been sought, this should be seriously considered. The registered manager should consider re sealing some toilet and bathroom floors to prevent the ingress of liquid. Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Summerfields House Rest Home E51-E09 S5009 Summerfields V246244 230805 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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