Inspection on 25/05/06 for Thames Side

This inspection was carried out on 25th May 2006.

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

Thames Side 16/10/08

Thames Side 13/02/08

Thames Side 11/09/07

Thames Side 16/03/07

Thames Side 07/11/05

Thames Side 17/05/05

Thames Side 01/02/05

Thames Side 01/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Thames Side Thames Side Beldham Gardens West Molesey Surrey KT8 1TF Lead Inspector Damian Griffiths Unannounced Inspection 25th May 2006 10:00 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 Thames Side DS0000013813.V295915.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. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thames Side Address Thames Side Beldham Gardens West Molesey Surrey KT8 1TF 020 8939 3850 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) sharon.blackwell@anchor.org Anchor Trust To be registered Care Home 60 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (8) Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Of the residents accommodated in the home up to 26 may fall within the category DE(E) and up to 8 may fall within the category PD(E) The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE 7th November 2005 Date of last inspection Brief Description of the Service: Thames Side is a purpose built residential care home to accommodate older people. It was opened January 2003 and the home is sited in its own grounds with good size, well-maintained gardens that are accessible to the residents. Car parking facilities are available at the front of the building. The home is well presented, providing a good standard of accommodation for up to 60 service users over the age of 65 years. All bedrooms are for single occupancy and have en-suite facilities. The home has six separate units, each with its own sitting room, dining room and kitchen. Stairs or passenger lift accesses the upstairs accommodation. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the Commission for Social Care Inspection (CSCI) year April 2006 to 2007 using the new ‘Inspecting for Better Lives’ (IBL) process. It was an unannounced inspection and took place over a period of 8hrs. The IBL process involves a pre-inspection assessment of service information from a variety of sources initially helping to prioritise the order of inspections and identify areas that require more attention during the inspection process. A new ‘Inspection record’ is compiled from details of the previous inspection and other details supplied by the home that includes a pre-inspection questionnaire and notifications of significant events known as regulation 37. Comments and complaints received and previous inspection reports are all considered for inclusion to the Inspection record prior to the inspection visit. For more details of ‘IBL’ please visit the Commission for Social Care Website details can be found on the last page this Inspection report. Lead Inspector Damian Griffiths was assisted throughout the inspection by the Manager (yet to be registered) Mr Derek Purchese, yet to be registered and representing the establishment. A tour of the premises took place and the inspector was able to meet eight service users and five members of staff and three relatives who were able to contribute to the inspection report. A selection of documents and reports were sampled relating to service user information, care needs and quality of life issues. Staff files were also inspected for information about the recruitment process, skill mix, rotas and training. The inspector would like to extend thanks to the services users, management and staff of Thameside for their time and hospitality. What the service does well: The majority of Thameside residents stated that they were happy with the care received and that the home was a nice place to live. Some residents disagreed but appeared to be well cared for and staff respected their wishes and privacy. The homes garden is always accessible thanks to a safe pathway that leads the resident around the home. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 6 The home was clean, tidy and fresh and residents had full access to the building. What has improved since the last inspection? What they could do better: Risk assessment had not been reviewed for residents with challenging behaviour and dementia needs The service must ensure that suitably qualified and trained staff are available and have received training in: Challenging Behaviour and Dementia Awareness. Staff files also must be to be reviewed to ensure they hold all the details of each member of staff a required and listed in schedule 2 of The Care Homes Regulations (2001) This is the third time this requirement has been made. The service must ensure that staff receive formal supervision 6 times a year. The service must ensure that suitably qualified and trained staff in appropriate numbers and skill mix to meet the assessed needs of the residents are available at all times and that 50 of staff have obtained NVQ level 2 within the timescale given. The service must maintain, update and review all records relevant to the efficient running of the care home and ensure the health safety and welfare of the residents. It was recommended that: The service considers provide special jigsaw puzzles mats that allow residents to store the puzzles when they are still incomplete and to save space. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 7 That the service considers reviewing the position of the towel dispensers to ensure that they are assessable to wheelchair users. That the service considers photographs of all staff and details of the management structure to be produced and sited at the entrance. That the garden be weeded, lawns mowed and baskets and containers be prepared by staff and residents. 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. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users guide was in evidence and new and existing residents had received an assessment of need. EVIDENCE: The service users guide was in need of updating due to a new Deputy Manager starting at the home otherwise the guide provided useful resources for new residents to the home. Copies were to be found in residents rooms. Four residents files were sampled from residents who were new to the home all had received an assessment of care needs that had been formulated into care plans and contracts were in evidence and detailed as appropriate. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents care plans reflected the assessed needs but risks assessments could have been updated more regularly. Health care needs and medication records were well documented and most residents were satisfied with the standard of care. EVIDENCE: Eight care plans were sampled, some were selected due to CSCI receiving notification of an incident such as: bruising or challenging behaviour being exhibited. Care plans were in place and had been formulated from an initial assessment of need. Risks identified were in need of review for residents experiencing hallucinations and confusion. Two other residents were in need of a risk assessment review for depression and another residents care plan showed that she was often confused an likely to make accusations of theft. Resident’s health care needs were well documented and showed evidence of; Insulin and fluid levels being measured, residents weight loss being recorded. NHS input was easily identified showing appointments due. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 11 Service users medication administration records (MAR) were checked, storage and drug returns were all in order. Staff were directly observed showing sensitivity, care and assertiveness to residents exhibiting challenging behaviour. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 14 and 15. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Activities were available to the residents who did not think them always appropriate or desirable to do. Staff welcomed family and friends and residents were able to chose a variety of food from the menus available however more evidence of choice in other areas was required. EVIDENCE: The activity co-ordinator employed by the home had ensured that the residents a list of one activity was placed on notice boards throughout the home with a notice across the list informing residents of her absence due to annual leave. There were no activities observed during the day of the inspection. Activities for residents with dementia needs were not in evidence. Resident’s comments about the activities were mixed and ranged from good to bad however residents were appreciative of the activities co-ordinators efforts and enjoyed her company. Two residents with recorded behavioural difficulties would of benefited from focused activities that reflected the needs identified in the care plans such as visit to the local supermarket to choose a good bottle of Claret for one of the residents and another resident required help to purchase and construct a racing game activity for his grandchildren when they visited. There was no evidence to show that the local amenities close by the home such as, the local supermarket and post office, pubs, the river Thames and Hampton Court were being accessed by the residents other than being taken Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 13 by friends and relatives. The home must show that it making more use of the local area including the use of it’s own garden that has an excellent pathway surrounding the home. Residents commented on the quality of the food and enjoyed the meals that were provided. Staff will assist resident to choose their meal the day before however if a resident wishes to change her mind on the day the chef will prepare something else and special diets were also catered for. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Complaints were investigated promptly and measures were taken to safeguard vulnerable adults in the care of the home. Staff would benefit from a continuing raft of training following the Surrey Procedures for Safeguarding Vulnerable Adults and Whistle blowing procedures. EVIDENCE: The pre-inspection questionnaire submitted showed that there had been nine complaints and one vulnerable adult investigation in the last 12 months. A record of the complaints was in place and most had been completed. Regulation 37 notifications corresponded with the complaints listed at the home. A vulnerable adult investigation had been investigated and although not proven a staff member named in the investigation had been transferred. Staff were attending training to recognise abuse and to familiarise themselves with the surrey procedures, some staff commented that they were unsure of the whistle blowing procedures. The home was committed to providing its residents with a safe environment and residents reported to feel safe and well cared for although one relative of a new resident was not aware poof the complaints procedure. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 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 the following standard(s): 19,20,21,22,23,24,25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefited from the purpose build home as it provided good overall facilities. EVIDENCE: A tour of the premises was conducted confirmed that the home was ‘fit-forpurpose’. Residents commented on the different areas availed to enjoy on their own or with other people. Bedrooms reflected individual preference and rooms that had not been refurnished by the resident were provided with adequate furniture and fittings. Communal bathroom s and lavatories were available on each unit and were in good order clean and without harmful obstruction. The gardens were accessible and contained a clearly defined paving that benefited residents wanting a gentle stroll. The grounds would benefit from regular attention to ensure weeds and lawns were kept in check. Residents commented on enjoying gardening in the past and would like the opportunity to plant out hanging baskets and containers. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 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): 27,28,29 and 30. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staffing at the home could be better and the ratio of NVQ level2 qualified staff were below the national minimum standards. The homes recruitment policies and procedures were still in need of improvement as was the training needs of the staff. EVIDENCE: Five staff files were sampled for evidence of skills of those on duty on the day of the inspection and to see if the files contained all personal in formation required under schedule 2 of the Care Homes regulations (2001) and were able to meet the needs of the service users. There were 2 staff on duty covering 20 residents on two units. Seniors were available if needed but staff commented on the lack of flexibility that this situation presented. This view was further confirmed by the lack of staff available to assist residents with activities. One comment received from a relative stated that ‘the staff seniors were always pushed and that staffing was a constant headache’. 50 of staff were required to achieve NVQlevel2 confirming basic caring abilities this had not been achieved. The homes recruitment policies have not been strictly adhered to at the last inspection. The files sampled were overall of better quality however there was one staff member without the required number of references. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 17 Staff files sampled evidenced that training was adequate and covered most of the skills required to meet the basic needs of the residents, NVQ level 2 awards should not be difficult to attain by the staff at the home. Staff were observed working with patience and commitment with service users with dementia and challenging behaviour but files sampled did not show that they had received training in these important areas of need. Residents and their relatives generally felt that the care received was good and residents felt well cared for and respected. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 18 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): 31,33,35 and 38. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The management style was appreciated by staff but a Quality Assurance Exercise that would highlight the overall quality of care was incomplete. Staff were appreciated by residents but they were in need of additional training and in some cases the recruitment practices at the home needed to improve. EVIDENCE: The manager has been able to progress his application with but has yet to complete registration with CSCI. Staff felt they could approach him and that his door was always open and there was a comfortable and homely atmosphere throughout the home. Residents were treated with respect and were able to enter the office during the inspection. The home had begun to conduct a quality monitoring survey with the residents but the completed forms were without date’s or signatures and there were no input from Social Care and Health practitioners of the residents relatives and friends. As IBL progresses it is essential for care homes to conduct a quality Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 19 monitoring exercise every year in order to measure achievements and improvements. One resident financial accounts were sampled and was in order. There has been no concerns expressed or instances of financial abuse reported Residents were benefited from robust health and safety policies and procedure that were` observed to be in place: Fire safety, Coshh, Riddor in place and The home had produced stickers to highlight areas of health and safety throughout then home and were developing new policy to improve risk assessment procedures. Please see the requirements and recommendations section of this report. Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A 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 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 3 X 2 X 3 X X 3 Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 21 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 OP1 Regulation 4, 5, 6 Sched 1 12(1)(a), 15(1)(2) Requirement The service must update the service users guide periodically to include the details of new staff. The service must ensure that all residents receive a regular review of their risks assessment and actions required to avoid and minimise the risk to residents and staff. The service must ensure that residents are consulted about their social interests, activities and supported to gain access to facilities for recreation, exercise and make arrangements to enable them to engage in local, social and community activities and to visit and maintain contact with families and friends. The service must ensure that suitably qualified and trained staff in appropriate numbers and skill mix to meet the assessed needs of the residents are available at all times and that 50 of staff have obtained NVQ level 2 within the timescale given. DS0000013813.V295915.R01.S.doc Timescale for action 30/06/06 2. OP7 30/06/06 3. OP14 16(2)(m) (n) Sched’ 1 (9) 30/06/06 4. OP27 OP28 18(a) 30/08/06 Thames Side Version 5.2 Page 22 5. OP29 19 (1)(a) (c) 6. OP30 18(1)(a) (c) 7. OP31 9(2)(i)(ii) Schedule 2 8. OP33 24. (1)(2)(3) 9. OP36 18(2)(a)1 2(5)(a) (b) The service must not employ staff to work at the home he is satisfied on reasonable grounds of the authenticity of the references provided and referred to in para 5 of schedule 2 of the Care Homes Regulations (2001) This is the third time this requirement has been made. The timescale of 31/12/05 was not met therefore a new timescale has been agreed. The service must ensure that suitably qualified and trained staff are available at all times and that 50 of staff have obtained NVQ level 2 within the timescale given. The service must ensure that manager provides details of enrolment and a timescale for completion of the NVQ 4 management/care award. This was the second time this requirement has been made The timescale of 31/12/05 was not met therefore a new timescale has been agreed. The service must supply the CSCI with a Quality Assurance report in respect of the quality of care provided by the home. Residents, their representatives and Care practitioners must be consulted and a copy of the results to be made available to them. This was the second time this requirement has been made The timescale of 31/12/05 was not met therefore a new timescale has been agreed. The service must ensure that staff receive formal supervision 6 times a year. This was the second time this requirement has been made The timescale of 31/12/05 DS0000013813.V295915.R01.S.doc 30/06/06 30/06/06 30/06/06 30/06/06 30/06/06 Thames Side Version 5.2 Page 23 was not met therefore a new timescale has been agreed. 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 OP12 Good Practice Recommendations It was recommended that the service consider photographs of all staff and details of the management structure to be produced and sited at the entrance. It was recommended that the service consider provide special jigsaw puzzles mats that allow residents to store the puzzles when they are still incomplete and to save space. I was recommended that the home ensure that new residents are made familiar with the complaints procedures. It was recommended that the garden was weeded, lawns mowed and baskets and containers be prepared by staff and residents. It was recommended that the service consider reviewing the position of the towel dispensers ensure that they are assessable to wheelchair users. It was recommended that a fire safety check be conducted to ensure that the area designated to charge the electric hoists is safe and does not pose a threat to residents or staff. 3. 4. 5. 6. OP16 OP19 OP21 OP38 Thames Side DS0000013813.V295915.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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