Inspection on 23/07/08 for The Close

This inspection was carried out on 23rd July 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Close 19/06/09

The Close 24/07/07

The Close 25/07/06

The Close 29/09/05

The Close 26/04/05

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 09/11/2008.

CARE HOMES FOR OLDER PEOPLE The Close 53 Lynn Road Snettisham Kings Lynn Norfolk PE31 7PT Lead Inspector Alan Buttery Unannounced Inspection 23rd July 2008 11:00 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 The Close DS0000064311.V369522.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. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Close Address 53 Lynn Road Snettisham Kings Lynn Norfolk PE31 7PT 01485 540041 01485 540041 rsiva91@hotmail.com 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) Norfolk Care Ltd Manager post vacant Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2007 Brief Description of the Service: The Close is a care home providing personal care and accommodation for twenty-three older people. The home is privately owned by Norfolk Care Ltd. The home is located in the village of Snettisham. The coastal town of Hunstanton is approximately five miles away and King’s Lynn approximately ten miles. The Close is a large detached property and provides accommodation on the ground and first floors for up to twenty-three elderly people. Seventeen of the bedrooms are single and three are double. Nine of the bedrooms have en-suite facilities. Access to the first floor is gained by one of two staircases, one with a stair lift, or a passenger lift. There is a pleasant, well-maintained garden with lawns, trees and shrubs, which has a path all around the home, enabling residents to walk safely outside. The current fee range is £358.00 - £435.00. There are additional charges payable for hairdressing, private chiropody, newspapers and personal toiletries. People are advised verbally about the charge payable at the time of the initial. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality Rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an unannounced visit, and during the inspection we looked at the key minimum standards for older people. One of the owners, Mrs Siva, was available throughout to assist with information and documentation required, and during the visit the home’s deputy manager was also available. The deputy manager was acting up as manager at the time of our visit but has since decided not to take up the post and will remain as deputy. Our visit included a tour around the home during which time we spoke with some of the people living sand working in the home. What the service does well: What has improved since the last inspection? Since the last inspection, some parts of the home have been redecorated and upgraded and the requirements and recommendations that were made have been addressed. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 6 Some changes to the staffing have been introduced which offer more support in the afternoons, and procedures have been changed to ensure medication is audited. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3 and 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure people thinking of moving to the home can get information about the home and to ensure that before anyone moves in the ser vice assess their needs, and anyone thinking of moving can be sure the home is suitable and can meet their needs. EVIDENCE: We discussed the Statement of Purpose and Service User guide with the proprietor. In addition to these documents, they also produce a resident’s handbook, and this is potentially leading to some confusion, and we suggested therefore that the documents need to be reviewed, with just two new documents available to the people living in the home and to give to anyone interested ion moving to the home, which will ensure that everyone has up to date information. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 9 The service has a detailed admission procedure, and this applies to people funded privately as well as those whose support is funded by the local authority. Wherever possible, a copy of any professional assessment is obtained, and the service would then visit the person and complete their own pre admission assessment. On rare occasions, where this is not possible, information would be gathered from family members. The assessment is carried out be either the proprietor or manager. The service encourages the person interested in moving in to visit the home, and have a look at the facilities, although this is not always possible, for example when the individual is in hospital, and on occasions, it is members of the person’s family that would visit. Once the assessment is completed, and the home are happy that they are able to meet the identified needs, final details are agreed with the person moving to the home and initial care plans are produced. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. Although individual plans are in place more detail and recording is needed to ensure identified needs are met. Procedures are in place to ensure medication is administered safely. EVIDENCE: As already mentioned, initial care plans are prepared on the basis of the assessment information gathered. These are reviewed and extended over the first few weeks, and details of the individuals preferences taken. This process was discussed with the proprietor of the home, and three plans looked at in detail. Although the plans contained basic information there were a number of areas needing to be improved. Basic information gathered in respect of the person mentioned that they were married but contained no details of the spouses name or whether they were still alive. Little information was available to show how activities the individual liked were catered for, and health recording was poor. There was little evidence of review. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 11 The service has support from local health professionals including GP and district nurse services and the proprietor confirmed that people living in the home have access to dentist and optical services. Procedures are in place to ensure that medication is administered safely, and all staff who are likely to assist with the administration of medicines are given training. The Close DS0000064311.V369522.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Although a range of activities are available, more information is needed on what people in the home like to do so that the activities can be arranged around what people like to do. EVIDENCE: The service offer a range of activities and events to the people living in the home, and shortly before this visit appointed someone to co-ordinate the activities in the home. Some further work is needed to identify what people enjoy doing and ensure that this is backed up by an individual care plan. They should further make sure that activities are available to everyone in the home, not just the more active. Family and friends are welcome to visit the home at any time, and encouraged to join in events and activities. The service offers a good range of home cooked food, and has a separate dining room for the people living in the home. People living in the home are offered a choice of food and a variety of snacks are available. The Close DS0000064311.V369522.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to ensure concerns, complaints and allegations are appropriately dealt with, and people living in the home know that they will be listened to. EVIDENCE: The service has a complaints procedure, which is given to anyone living in the home and available to relatives. The procedure details how complaints are dealt with and gives the timescales that the service works to. The procedure needs updating with correct contact information for the CSCI. There have been no complaints received by the service since the last inspection, and the commission have not had any concerns raised with them. The service has adult protection procedures in place and arranges training for all new staff and regular updates for other members of staff. The Close DS0000064311.V369522.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service provides a spacious and well-equipped home providing a safe and comfortable environment for the people living there. EVIDENCE: The service is run from a large older style building, which has been modernised and updated to provide suitable facilities for the people living there. The home is set in large gardens and within easy reach of the facilities available locally. On the day of our visit, the home was clean and free from any unpleasant odours, although it was noted that some wheelchairs were being stored in one of the lounge areas. Some of the bedrooms that we saw showed that people moving into the home bring personal items with them, and all were appropriately furnished. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 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. All required information has to be obtained for staff to ensure that people living in the home know that they will be safe. EVIDENCE: We discussed with the proprietor the recruitment and training of new staff, and looked at recruitment records for two current staff members. Unfortunately the recruitment files for two new starters had been misplaced and couldn’t be found. The home is not currently following the required procedures, and must ensure that before anyone starts work in the home the information detailed in the regulations is obtained. The service operates with 3 care staff in the mornings and 2 in the afternoon/evenings, together with a cook and kitchen assistant and domestic staff. A handyman/gardener is also shared with the other home owned by the proprietors. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Although one of the owners is often on hand to manage the home, a full time registered manager is needed to ensure the home is run with the needs of people living in the home in mind. Procedures are in place to ensure that both residents and staff are safe. EVIDENCE: The service has not had a regular manager for some time, and on the day of the visit we saw the proprietor and the deputy manager who was acting manager. Since the inspection, she has decided not to continue in this role and again the service are looking to recruit a new manager. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 17 It is important that a new manager is in place as soon as possible, and an application submitted to the CSCI for registration. Although the proprietor is able to spend some time in the home, she also has another service to consider, and consequently must have someone in day-to-day control of the home. People living in the home are involved in day-to-day decisions that affect them, but at the present time no formal process is in place to ensure they are satisfied with the service they receive. A quality assurance procedure should be introduced to gather and monitor the views of the people in the home. Although a process of supervision is in place, this was described by the acting manager as sketchy, and does not provide supervision at a level that meets the requirements of the standards, again something that it would expected of a registered manager. Procedures are in place to ensure the health and safety of both residents and staff, and staff receive regular health and safety training. The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 18 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 X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 3 The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? No 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 Individual plans must show the involvement of the individual they relate to and how the individual can expect all their health and social care needs to be met, and show that the plans are kept under review. Evidence must be available to show how activities and events meet the expressed likes of people in the home All documentation detailed in schedule 2 of the regulations must be obtained before staff start working in the home to ensure residents are not at risk. A manager must be appointed to run the home, and an application for registration submitted to the CSCI to ensure the home is run for the benefit of the residents living there. A system to gain the views of people living in the home and ensuring the quality of the service is reviewed must be introduced to ensure that people living in the home are given chance to express their views. DS0000064311.V369522.R01.S.doc Timescale for action 31/10/08 2 OP12 15(1) 31/10/08 3 OP27 19(1) 30/09/08 4 OP31 8(1) 30/11/08 4. OP33 24(1) 30/11/08 The Close Version 5.2 Page 20 5 OP36 18(2) All staff must be appropriately supervised to ensure that any issues or concerns are dealt with. 31/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations The statement of Purpose and service user guide should be reviewed to ensure that people are not given conflicting or confusing information The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Close DS0000064311.V369522.R01.S.doc Version 5.2 Page 22 - 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!