Inspection on 01/03/06 for Sweyne Court

This inspection was carried out on 1st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Sweyne Court 03/07/07

Sweyne Court 11/07/06

Sweyne Court 11/10/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Sweyne Court Hockley Road Rayleigh Essex SS6 8EB Lead Inspector Mrs Sharon Lacey Unannounced Inspection 09:50 1st March 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 Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 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. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sweyne Court Address Hockley Road Rayleigh Essex SS6 8EB 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) 01268 774530 Sweyne Healthcare Ltd Christine Anne Skeet Care Home 37 Category(ies) of Dementia - over 65 years of age (37), Old age, registration, with number not falling within any other category (37) of places Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service users` bedrooms with an area of less than 10 sq.m. will be used only following a written assessment. The assessment should include consideration of whether the facilities in the room are suitable for, and acceptable to the service user, taking into account their mobility needs. The service user plan should reflect the assessment of findings. 11th October 2005 Date of last inspection Brief Description of the Service: Sweyne Court is a two storey building set in a cul de sac. It is close to Rayleigh High Street and is convenient for buses and train transport. It is registered for 37 older people with dementia. The home is in the process of being refurbished and the bed numbers will eventually increase. The refurbishment has been completed downstairs and it now consists of a lounge diner and also a small separate lounge. All bedrooms downstairs are now ensuite. Upstairs refurbishment has not started, but there has been some changes made to the lounge and dining areas. There is a secure garden at the centre of the home, which is accessible to residents and seating is available during the summer months. The home has ground floor parking for visitors and staff. Sweyne Court has a Day Centre as part of its premises, but this is run entirely separately. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection, which took place over six and a half hours. A full Inspection covering most of the National Minimum Standards was completed on Sweyne Court in October 2005. The Inspection today was to look at the following areas and establish whether there had been any improvements where requirements had been made. • • • • • • Recruitment Residents Care Plans Training of Staff. Quality Assurance system. Supervision of Staff. The employment staff within the home. During the tour of the home, ten residents and one relative were spoken to about their life and experiences at Sweyne Court, these comments have been included as part of the report. Also five staff were spoken to. At the end of the Inspection, the areas where the home had improved or were further work was required was discussed with the Manager and advice and guidance given. What the service does well: What has improved since the last inspection? The Home has a Quality Assurance system in place and a report has been submitted to the CSCI. Some activities are now being organised for the residents, but this is to be developed further. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 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 Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 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 the following standard(s): 2 and 6. Contracts are not at present being routinely completed and placed on the resident’s files. EVIDENCE: The home have now implemented an Excelcare contract/terms and conditions of the home. Three files were inspected, but only one contained a fully completed Contract. Sweyne Court does not provide intermediate care. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 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 the following standard(s): 7, 10 and 11. If fully completed the new care plans format provides sufficient information regarding the care required. Death and dying wishes are not routinely recorded. EVIDENCE: Excelcare have a comprehensive care plan, which when fully completed covers all the required information. Three residents files were inspected and all contained evidence of the new care plan format. There is a space to record when residents and relatives have been involved in their plan of care, but these sections had not been completed. Excelcare also have a separate form, which confirms the family or resident have been involved in the care plan process, but these were blank. There was evidence of formal reviews having taken place, but monthly reviews of care plans need to be routinely recorded. The home has policies and procedure for death and dying and they try to ensure Residents are able to stay at the home in familiar surroundings for as long as possible. It was noted that not all files contained details of the Residents wishes in relation to death and dying. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 10 The privacy and dignity of residents is covered as part of the home’s induction process. Sweyne Court has a lot of dependent residents and many require the assistance of two staff members for personal care, toileting and hoisting. During the Inspection staff were observed providing these tasks with privacy and dignity. During the last Inspection it was noted that the dignity of those residents who needed assistance with feeding in the main lounge/diner was not always upheld. Some residents were left with their meals in front of them and help was not provided until most others had eaten both courses. The lunchtime meal was observed during this inspection and some areas had improved, but there were still some issues that needing addressing. It was noted that soft drinks were not provided during the meal, but a cup of tea was served before lunch. The tablecloths were creased or torn and no paper napkins were provided. One resident’s requested a hanky and was told to ‘finish your meal and then I’ll get you one’. In the upstairs lounge a staff member was assisting a resident to eat their meal and it was noted this was provided appropriately. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 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 the following standard(s): 12, 14 and 15. The home does not always offer residents a flexible routine or promote their independence and choice. Visiting arrangements are open and relaxed. Some activities are now being organised. EVIDENCE: Some activities had now been organised and written evidence was available. The home is in the process of employing a second activities co-ordinator so that activities can be provided each day. During the inspection the lounges had the television on, but there was no other organised activities or one to one sessions observed. Some outside entertainment had been organised at Christmas. Routines within the home are not as flexible as on previous Inspections. When arriving at ten o’clock residents were still being washed and dressed and none had had their breakfast or medication. On speaking to residents they expressed their concerns and comments included ‘it’s not good enough’, ‘I’m hungry and want a cup of tea’, ‘I have had nothing since my Horlicks last night’ and ‘I’ve been up since 7.30 am and not had anything’. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 12 This was also an area that was highlighted in the last Inspection. Two relatives spoken to at the last Inspection expressed their concerns regarding how late breakfast was and their relative had to go out before medication had been provided. Some residents and relatives also expressed their concerns regarding the time span between supper and breakfast, as many residents did not get anything to eat for more than a 12 hour period. This is an area that has not been improved and needs immediate action. Many of the resident’s are very dependent and their independence would depend on the staffing levels available within the home. The home has recently changed over to 12 hour shifts for staff, but those staff spoken to were positive regarding the new hours. The refurbishment and change of staff hours has had an impact on the running of the home. Staff are overseeing four lounges at present and due to the change in bedrooms there are also more residents downstairs that now need assistance. Due to the breakfast being so late, dinner was not served until 1.45 pm. Although the problems with the mealtime, most residents were complimentary regarding the food. It was noted during the lunchtime observation that the residents all received the same lunch and no other choice was offered. On speaking to staff they confirmed that if the lunchtime meal were a roast then all residents would receive the same. If they would have liked an alternative then they could have an omelette or fish, but this was not routinely offered. One resident was not able to eat the meat and she was given vegetables with gravy. No menu boards could be seen around the home advising the residents of the choice of meals. Fresh fruit was available. Hot drinks were served during the day, but it was noted that no juice was available in any of the lounges or given with the lunchtime meal. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home has policies and procedures for the protection of residents, but staff need further updated training. EVIDENCE: The Home does have policies and procedures in place to ensure the protection of service users, but these were not fully inspected. Guidance on verbal and physical aggression is in the staff handbook. Staff have received training on the recognition of abuse and what action should be taken, and updates have been arranged for later in the year. This was an area highlighted in the last report. It was established that appropriate checks are in place to ensure all new recruits are suitable to work with vulnerable people, and no staff have been referred to the Protection of Vulnerable Adults list since the last inspection. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, and 26. Improvements have been made to the building, which provides better accommodation and environment to the residents downstairs; upstairs is yet to be refurbished. EVIDENCE: The downstairs refurbishment has now been completed. Ensuite bedrooms are now available and the lounge/diner has also been decorated. There is a separate lounge available. Tiled floors are now throughout the hallways and diner, which assists with the odour control of the home. The upstairs refurbishment has not yet started, but there have been changes to the lounge and dining areas and smaller areas are available. Toilets and bathrooms were inspected and all were clean and tidy. It was noted that some did not have paper towels available and did not have a liquid soap dispenser. The doors on the sluices upstairs were noted to be left unlocked and one contained cleaning materials. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 15 The home has a secure garden, which is accessible to the residents and has seating available. The home also has ‘security pads’ at the front door to ensure residents do not go outside without staff being aware. During the Inspection it was pointed out to the Manager that a ‘secure’ door had been left open by workman – this was rectified immediately. Sweyne Court offers accommodation to residents with a variety of walking abilities. There are grab rails around the corridors of the home and wide doorframes for wheelchairs. The Manager confirmed that there was sufficient equipment for the present residents. There is a call bell system in every room, but this was not tested during the Inspection. The Manager was advised that the call bell in bedroom 20 was not near the bed. Sweyne Court has its own laundry facilities and this was well organised. Most residents stated they were happy with the service and all those residents seen during the Inspection were noted to be clean and well presented. One relative spoken to chooses to take their relatives clothes home to wash, as she felt clothing had been washed at too higher temperatures and had been ruined. The home was ‘odour free’ during this inspection. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Insufficient information is on new staff files. EVIDENCE: There is a core group of staff that has been employed at Sweyne Court for a long time and are aware of the residents needs. The home is now using one agency to support vacant shifts, which is giving some continuity. Excelcare have a recruitment process, which on discussion with the Manager meets with requirements and protects residents. Two staff files were inspected of staff recently employed from Poland. On looking at the files neither contained an application form and much of the information was written in Polish. It was not possible to establish whether satisfactory references had been sought or whether the gaps in employment on one CV had been investigated. Both contained a CRB. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 37. The Manager is very experienced and has a good understanding of the residents needs. Excelcare have comprehensive policies and procedures. There are clear lines of accountability. EVIDENCE: Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 18 The Manager has experience in managing a residential care home for older people. She also has extensive knowledge of caring for those residents with dementia. There are clear lines of accountability within the home. Although the home has a supervision policy this has not been fully implemented. Some evidence of supervision and meetings were available, but further development is needed to meet the National Minimum Standards. Policies and procedures used by Excelcare cover the health and safety and welfare of staff and residents. The Manager is aware of her responsibilities regarding safeguarding both staff and residents. Policies and procedures were in place to ensure safe working practices. Excelcare do not routinely assist with resident’s finances, most present residents have assistance from family. Some bedrooms have lockable storage for residents to keep personal possessions and valuables. Staff and resident files are kept secure and Excelcare are registered with the Data Protection Act. The Manager confirmed that residents could have access to their files. Excelcare do have a Quality Assurance system and questionnaires are sent to staff and service users annually to gain their views. A report has been submitted to the CSCI. Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 X X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 2 X Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 20 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5 Requirement The Registered person must ensure that all service users are issued with a contract or terms and conditions and these are available for inspection. Please ensure a fully completed contract is placed on each individual residents files. This is a repeat requirement. 2 OP15 12 (4)(a) The Registered provider shall make suitable arrangements to ensure that the care home is conducted in a manner, which respects the privacy and dignity of service users. This is in connection to meal times. Areas regarding staffs approach to meal times, availability of cold drinks, napkins and table clothes. 3 OP15 16(2)(i) The registered person shall having regard to the size of the care home and the number and needs of the service users provide, in adequate qualities, DS0000062901.V282654.R01.S.doc Timescale for action 30/06/06 31/03/06 31/03/06 Sweyne Court Version 5.1 Page 21 suitable, wholesome and nutritious food which is varied and properly prepared and available at such time as may reasonably be required by service users. This is in connection to meal times not having more that a 12 hour gap between supper and breakfast, offering at least 2 choices of meals, advising residents of menu choices etc. 4 OP18 18(1)(a) Staff must be provided with adequate training and updates; appropriate to the work they are undertaking. This is in connection to providing staff with updates on Abuse training. This is a repeat requirement. 5 OP29 19(4)(b) (i)(c) The registered person shall not employ a person to work at the care unless the employer has obtained in respect of the person the information and documents specified in paragraphs 1 to 9 of Schedule 2 and the employer is satisfied on reasonable grounds as to the authenticity of the references referred to in paragraph 5 of Schedule 2 in respect of that person, and has confirmed in writing to the registered person that he is so satisfied. This is in connection to ensuring all relevant documentation is held on staff files and is written in English so relevant checks can be made during the inspection. 07/03/06 30/06/06 Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 22 6 OP36 18(2) The Registered person must ensure that staff at the home receive regular formal supervision to support them in the work they carry out and written evidence is available on future Inspection visits. This is a repeat requirement. 30/06/06 7 OP38 13(4)(a) The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. This is in connection to the sluice doors being open and residents having access to chemicals and the doors throughout the home being secure. 07/03/06 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 Refer to Standard OP7 OP7 OP11 Good Practice Recommendations Ensure resident care plans are reviewed on a monthly basis and any changes recorded and implemented. Please ensure that residents are involved in their plan of care and where possible sign to state they agree with it. Please ensure that resident’s files contain details of their wishes in relation to death and dying, as this is still not being routinely done. Please ensure that call bells are in appropriate positions in the bedrooms and can be reached by residents if assistance is required. DS0000062901.V282654.R01.S.doc Version 5.1 Page 23 4 OP22 Sweyne Court 5 OP36 Recommend that staff are supervised at least 6 times a year. Recommend you introduce a supervision matrix to help identify those staff that need supervision. Please ensure that paper towels and liquid soap is available to staff to ensure infection control is adhered to. 6 OP38 Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Sweyne Court DS0000062901.V282654.R01.S.doc Version 5.1 Page 25 - 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!