CARE HOMES FOR OLDER PEOPLE
Swan House 47-49 New Road Chatteris Cambridgeshire PE16 6EX
Lead Inspector Elaine Boismier Unannounced 12 April 2005 @ 09:45 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. Swan House Version 1.10 Page 3 SERVICE INFORMATION
Name of service Swan House Address 47 - 49 New Road, Chatteris, Cambridgeshire, PE16 6EX 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) 01354 696644 01354 696645 Four Seasons Homes No 4 Limited Mrs Susan Ann Gough Care home with nursing 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability over 65 years of age of places (40), Terminally ill over 65 years of age (25) Swan House Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: 1 No more than 25 nursing places 2 No more than 25 places for terminally ill residents over 65 years of age Date of last inspection 25/10/04 Brief Description of the Service: Swan House, close to the centre of the town of Chatteris, is a care home that looks after people over 65 years of age, some who need nursing care. There are 40 single bedrooms and 39 of these have ensuite facilities. Also there are six bathrooms. On both floors of the home there are the bedrooms, a dining room and a choice of sitting rooms; the upper floor can be reached via stairs or a lift. There is a small garden at the back of the home. Swan House Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection of Swan House for 2005/6. This unannounced inspection took four hours and was carried out by two inspectors, between 9:45 and 13:45. On the day of this inspection there were 31 residents and 7 were spoken to. Other methods used for the inspection included reading documentation, speaking to staff (on their own and in groups), speaking to the Manager and walking around the home. The gardens were seen through the windows. At the time of the inspection the Registered Manager was in charge of the home. Currently there is a vacancy for a deputy manager. Some residents said that they would like to receive visits from the Manager, as they used to, when a deputy manager was in post. Comments made by residents included “It is very nice here” and “It is a good place.” What the service does well: What has improved since the last inspection?
The home manager has asked residents for their views about the food. Also both the recruitment of new staff and training of all the care staff has improved since the last inspection of Swan House. The carpet outside the upstairs dining area remains stained but showed some improvement after it had been shampooed whilst the inspection took place. This is a requirement made from the previous inspection that has been met. The Commission received, and investigated, a complaint made against the home during December 2004. Following the investigation, and during this
Swan House Version 1.10 Page 6 inspection, it was found that the home had improved the standard of care records. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Swan House Version 1.10 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 Swan House Version 1.10 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) 3 Preadmission assessments assure that care needs of new service users can be met by the home EVIDENCE: Four care files of residents were assessed. There was information provided by the referring social services and previous care homes about the residents’ needs and how these could be met by Swan House. Swan House Version 1.10 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 Care provided at the home is generally good although the home needs to improve communication with the residents, or their representatives. Some information about a few residents’ medical conditions was not kept confidentially EVIDENCE: Four residents care plans were seen. There were detailed assessments for the risks of the development of pressure sores, nutrition, falls and moving and handling. Care plans provided clear guidance for staff in how they were to meet the assessed needs of the residents. The care plans were reviewed each month, and sooner when there was a change in the residents’ conditions. However there was a lack of information in the care files to suggest that the resident, or their representative, had been consulted in drawing up their care plan and also when the care plan was revised. These findings have resulted in two requirements that are to be met by 30th June 2005. The residents’ files seen, and residents said that specialist health care services are available and that they access these services, with the help of the home. These services include advice from dieticians, hospitals, speech and language therapists and GPs.
Swan House Version 1.10 Page 10 During the walk around the home there was information, displayed on windows of the upstairs dining area, which included some residents’ medical diagnoses. A requirement has been made for the home to take action by 13th April 2005 to protect private and confidential information about residents. Swan House Version 1.10 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Residents are able to exercise their choice in how they wish to live. EVIDENCE: An assessment of the records about residents’ monies was carried out. It was evident that some, but not all residents, have chosen the home to handle their monies. Residents said that their families visited the home and some residents were seen with visitors in their bedrooms. The lunchtime period was observed during which it was noted residents had the choice where they took their meal, either in their own room or the dining areas, and what they chose to eat. Menus for a four-week period showed that there was a variety and choice of food available throughout the day, including fresh fruit. Residents said that if they did not like what was on the menu they could ask for something else they liked better. An incident of the interaction between a member of care staff and a resident was seen. This interaction was very good as there was a “social” element that included conversation and laughing, with music playing in the background. The resident was also asked what she would like to eat first from her plate.
Swan House Version 1.10 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The home has a satisfactory complaints system with evidence that residents and their representatives have their complaints or concerns acted upon. The home has satisfactory systems in place to ensure the protection of residents from abuse. EVIDENCE: The record of complaints responded to by the home was satisfactory and the home’s responses to complainants were made within a 28 day time scale. It was observed that care staff interacted with residents in an appropriate and respectful manner. A number of staff training files, including their induction training, contained details of staff attending training in what constitutes abuse against the vulnerable adult. Accounts of residents’ monies were seen and systems for the safe keeping of money were satisfactory. This included records of accounts kept on the home’s administrator’s computer database. Swan House Version 1.10 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 The standard of the environment of the home is good providing residents with a comfortable, clean and well-maintained place to live. EVIDENCE: The standard of décor and furniture provides a comfortable and homely place for residents to live in. At the time of the inspection a bedroom was being decorated. During the visit to the home the cleanliness of the carpet area, outside the upstairs dining room, had improved, after it had been shampooed. The garden was well kept with spring flowers and mown lawns. On the day of the inspection the home was clean, smelt fresh and was free of offensive odour. Staff training files and information of staff training, provided information of staff attendance in the control and prevention of infection to ensure the health and safety of people living and working at the home. Swan House Version 1.10 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 29,30 Staffing numbers and staff vetting and recruitment procedures were satisfactory for the protection of residents. EVIDENCE: The Manager said that there had been an increase in numbers of staff to fill the number of vacant positions. The staff rosters were seen for a three-week period and these showed when staff, including agency staff had worked. The Manager said that the levels of agency staff had decreased since the last inspection and that agency staff are only required when there is staff sickness. On the day of the inspection it was noted that care staff were attending to residents’ needs without rushing the residents. This included when care staff were assisting residents’ with their meals. Individual staff, and staff in groups, said that there was a sufficient number of staff to meet the needs of the residents. Three staff files were seen and all had satisfactory information about these people. Swan House Version 1.10 Page 15 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) 33,35,38 The home is managed to ensure that the health, safety and welfare of residents is maintained and that quality assurance systems are in place to ensure residents’ best interests are, on the whole, safeguarded. EVIDENCE: With the use of a questionnaire the Manager has asked residents their views on the standard of food. She said these comments were shared with the company and kitchen staff for improvements to be made. The Manager has also produced a “Welcome” letter for new residents. This letter is an introduction to the people and services provided at Swan House. A residents/relatives meeting was held in January 2005 and minutes of this meeting were seen. Residents said that they did not have the opportunity to contribute to the agenda of the meeting until at the time of the meeting. As
Swan House Version 1.10 Page 16 part of good practice it is recommended that residents are asked what they would like to discuss at their meeting, when the agenda is being drawn up. Accounts of residents’ monies were seen and systems for the safe keeping of money were satisfactory. This included records of accounts kept on the home’s administrator’s computer database. Records for staff attendance in training records in fire training, moving and handling and infection control were satisfactory. Also seen were the records for accidents, fire drills carried out, fire safety checks, emergency lighting checks and hot water checks: these were satisfactory in ensuring the safety and wellbeing of everyone living, working or visiting the home. Swan House Version 1.10 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 2 x 3 x x 3 Swan House Version 1.10 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15(1) Requirement The Registered Person must ensure that after consultation service user, or his/her representative, prepare a written care plan The Registered Person must ensure that after consultation with the service user, or his/her representative, revise the the care plan The Registered Person must ensure the privacy of service users by keeping medical information confidential Timescale for action 30th June 2005 2. OP7 15(2) 30th June 2005 3. OP10 12(4)(a) 13th April 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP33 Good Practice Recommendations The Registered Person should consider ways to consult with service users when drawing up the agendas for residents meetings Swan House Version 1.10 Page 19 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Swan House Version 1.10 Page 20 - 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!
