Inspection on 29/09/05 for The Close

This inspection was carried out on 29th September 2005.

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

The Close 19/06/09

The Close 23/07/08

The Close 24/07/07

The Close 25/07/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Close 53 Lynn Road Snettisham Kings Lynn Norfolk PE31 7PT Lead Inspector Mr Christopher Handley Unannounced Inspection 29th September 2005 09:30 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.V252908.R01.S.doc Version 5.0 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.V252908.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Close Address 53 Lynn Road Snettisham Kings Lynn Norfolk PE31 7PT 01485 571962 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 Mrs Wanda Adriana Cairns Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2005 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 two 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 had a path all around the home, enabling residents to walk safely outside. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors, which took place over six and half hours. Many records were viewed and a tour of the premises was undertaken. Mrs Wanda Cairns, Manager, was present during the inspection and Mrs Siva, Proprietor, was present for part of the inspection. This is the first inspection since the new owners have taken over. Four residents and two members of staff were spoken to privately and six residents were spoken to as a group whilst sitting in the conservatory. What the service does well: What has improved since the last inspection? What they could do better: • • • • • The home would benefit from more formalisation of their systems, which are already in place i.e. pre-dating reviews of care plans and further developing the quality assurance system. Implementing a more formal method of staff supervision. Developing meetings for residents and their relatives. Renewal of bathrooms in accordance with the changing needs of the residents would be beneficial. Introduce a choice of meals on the menu. DS0000064311.V252908.R01.S.doc Version 5.0 Page 6 The Close 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 Close DS0000064311.V252908.R01.S.doc Version 5.0 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.V252908.R01.S.doc Version 5.0 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): 1,3 & 6 Although there is a statement of purpose in use, this has not been updated by the current owners. Prospective residents’ needs are assessed and relatives are encouraged to visit the home to enable them to assess the quality of the home. The home does not provide intermediate care. EVIDENCE: The statement of purpose and service users guide in use are the ones provided by the previous owners. The current owners must produce their version of these documents in order for prospective residents to be clear about the services the home provides to meet their needs. A copy must also be forwarded to the CSCI. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 9 The Manager visits prospective residents and written information is sought from the social workers prior to admission. It is recommended that the documentation used for this assessment be headed ‘Pre-admission Assessment’ and state that this is ‘Confidential Information’. The assessment for the most recent admission was seen and that resident and their relative were spoken to. This gave a clear indication of need and the relative said that they and other members of the family visited the home prior to the admission and that they were very happy with the standard of care provided. The Close DS0000064311.V252908.R01.S.doc Version 5.0 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&9 Residents are looked after well in respect of their health and personal care needs. Further attention needs to be given to the revision and review of care plans. The medication at this home is well managed promoting good health. EVIDENCE: Existing care plans have not been revised from those used by the previous owner, but the Manager advised that new care plans will be implemented with newly admitted residents. The pre admission assessments were seen to form the basis of the care plans. Several care plans were viewed and these contained comprehensive information including life histories and risk assessments. Although reviews were undertaken, it is recommended that the next planned date for review is recorded on the care plans. It is further recommended that the resident or their representative sign their care plan. The Manager is again commended for the further improvement of these care plans. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 11 The medication trolley was locked and chained to a wall. The home uses a monitored dosage system and all staff except for two new ones have completed the Boots Care of Medicines training. Newly delivered medicines are kept in the locked office. At the time of inspection, no controlled drugs were in use and no residents wished to administer their own medicines. The returns book was seen. The Close DS0000064311.V252908.R01.S.doc Version 5.0 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): 14 & 15 Residents are able to exercise choice and control over their lives whilst living in this home. Since the last inspection the standard of food offered appears to have deteriorated. EVIDENCE: The residents’ spoken to indicated that there was plenty of choice within the home. They could go to bed and get up when they would like, they are able to sit where they like in the home, choose their clothes to wear for the day and one resident likes to eat her breakfast late. The residents’ spoken to commented that the food was “good”, “reasonable”, “alright” and one resident commented that “the food is not as good since the new owners”. One resident said that there was no variety at teatime and there was “no choice at lunch-time; there was, but there isn’t now”. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 13 The menus seen offered a varied diet, although as stated, there was no choice offered. During the inspection, it was noted that although the food cupboards were well stocked, a large number of products were only available in the ‘value’ range. Meat and eggs were bought independently. Homemade apple crumble and cakes were seen during the inspection. The diabetic diet offered is recorded. The Close DS0000064311.V252908.R01.S.doc Version 5.0 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 Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The home has a complaints book, which includes the name and address of the Commission. One complaint was seen and this was dealt with appropriately. However, it is recommended that the telephone number of the Commission be included and more confidentiality be incorporated into the company procedure. The Close DS0000064311.V252908.R01.S.doc Version 5.0 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): 21 & 26 The home provides sufficient and suitable toilet facilities. EVIDENCE: The home provides nine bedrooms with an en-suite facility. In addition, there are five toilets and three bathrooms, two of which are assisted. There were plans to renovate bathrooms in accordance with residents needs, however, these have not yet been started. The laundry was appropriately situated at the side of the building and the floors were impermeable for ease of cleaning. A policy for the control of infection was in place. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 16 During the tour of the premises, it was noted that some windows were able to open enough to pose a risk to residents, it is therefore required that a risk assessment be written for falls from first floor windows and restrictors be fitted wherever necessary. The home was clean, hygienic and free from unpleasant odours. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): 28 The home has an ongoing programme of NVQ training. EVIDENCE: One member of staff has completed the NVQ level III and one is starting it. Three members of staff have completed the NVQ level II and one is still training. Another is waiting to start. Three members of staff have completed the Foundation training. The Close DS0000064311.V252908.R01.S.doc Version 5.0 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 & 36 The Manager manages the home efficiently, providing clear leadership throughout the home. EVIDENCE: The Manager is a qualified nurse, although she will need to complete the registered managers award, which she is keen to do. The Manager has attended a staff supervision study day and regular informal supervision sessions take place between the Manager and the staff, but these are not recorded. Supervision sessions are also required between the proprietor and the manager. The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 19 Regular staff meetings take place and the next is on the 10th October. A residents and relatives survey has been undertaken, but there was not a great deal of response. Comments from this survey have been acted upon and it is recorded that the residents do not want to hold meetings at this time. Some audits are in place, for example, medications and are undertaken monthly. The accident book was seen and the entries were clearly written and dated. The records of tests to the fire safety equipment were in good order and health and safety issues were well managed. The Close DS0000064311.V252908.R01.S.doc Version 5.0 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x x x 3 x x x x 3 STAFFING Standard No Score 27 x 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x x 2 x x The Close DS0000064311.V252908.R01.S.doc Version 5.0 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 Requirement The registered person must ensure that an updated copy of the statement of purpose and residents guide is forwarded to the Commission for Social Care Inspection. The registered provider must ensure that the residents are offered a choice for their midday meal. The registered person must undertake a risk assessment of falls from first floor windows and install window restrictors wherever necessary. The registered manager must undertake formal management training. The registered person should ensure the Manager receives regular, recorded supervision. The registered manager must implement a system of formal supervision for care staff. Timescale for action 31/01/06 2 OP15 16(2)(i) 31/12/05 3 OP38 13 (4) 31/12/05 4 5 OP31 OP36 9 18 31/03/06 31/01/06 The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 22 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 OP3 OP7 OP16 Good Practice Recommendations It is recommended that the documentation used for assessing the resident prior to admission be headed ‘Preadmission Assessment’ and ‘Confidential Information’. It is recommended that residents or their representatives sign their care plan. It is recommended that the telephone number of the Commission for Social Care Inspection be available and confidentiality be incorporated into the company procedure. It is recommended that bathrooms and some toilets are refurbished according to residents’ needs. It is recommended that the resident’s name is on the door and in an appropriate format. 4 5 OP21 OP24 The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 The Close DS0000064311.V252908.R01.S.doc Version 5.0 Page 24 - 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!