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Inspection on 22/07/05 for The Devonshire Nursing Home

Also see our care home review for The Devonshire Nursing Home for more information

This inspection was carried out on 22nd July 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents are encouraged to regard The Devonshire as their home and are supported in making choices about all aspects of their day to day living if appropriate. During the inspection residents chose how to spend their time, some took part in the general knowledge quiz, while others were in the other lounge or their own rooms. Residents who expressed an opinion said that they felt the staff provide the care and support they need, they were positive about all aspects of the services provided and stated that they had no concerns. Relatives and friends were equally positive and this was supported by the staff who expressed an opinion during the inspection.

What has improved since the last inspection?

There was one requirement from the last inspection and this has been addressed with an appropriate recruitment procedure now in place to protect residents.

What the care home could do better:

There were no requirements concerning the standards assessed during this inspection.

CARE HOMES FOR OLDER PEOPLE The Devonshire 95 - 97 Carlisle Road Eastbourne East Sussex BN20 7TB Lead Inspector Kathy Flynn Announced 22 July 2005 10.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Devonshire Address 95 - 97 Carlisle Road Eastbourne East Sussex BN20 7TB 01323 736983 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr and Mrs Bernard Edward Clarke Mrs Caroline Mills Mrs B Wild Care Home with Nursing 42 Category(ies) of Old age, not falling within any other category registration, with number (OP) 42 of places Physical disability (PD) 42 The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be older people aged sixty-five (65) years or over on admission. 2. Residents with physical disabilities under sixty-five years may be admitted. Date of last inspection 15 February 2005 Brief Description of the Service: The Devonshire is registered to provide nursing care for up to 42 residents, older people over 65 years and individuals with physical disabilities. The home is situated in a residential area, close to Meads village in Eastbourne with local shops and amenities, including public transport nearby. The home is made up of two buildings linked on the ground floor by a corridor. The building has been adapted and converted with limitations on the allocation of some rooms due to the physical restrictions of the building. There is a shaft lift in one part of the home and a stairt lift in the other, with prospective residents offered rooms in the part of the home that is appropriate to their assessed needs. There are lounges in each part of of the home, with dining areas and sufficient space for social and religious activities. There are attractive gardens to the rear that are accessible to wheelchair users and are used by residents when the weather permits. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the home was informed of the date and time of the inspection several weeks before it was carried out. The requirement from the previous inspection, the information provided in the pre-inspection questionnaire that was completed by the manager, and the comment cards completed by the residents and their relatives, were used to plan this inspection. The aims were to assess if the home had met the requirement, identify the aspects of the service that have improved and if the service could be improved for the benefit of residents. The inspection was carried out over six and a half hours from 10.00am and included a tour of the building, an examination of pre-admission assessments, care plans, personnel files and policies. There were 34 residents in need of nursing care at The Devonshire during the inspection. Fifteen residents and a number of friends and relatives were happy to talk about the care and support provided by the home. The manager, the administrator, the cook and her assistant, as well as staff, on an informal basis, were also pleased to discuss the services provided at the home. What the service does well: What has improved since the last inspection? There was one requirement from the last inspection and this has been addressed with an appropriate recruitment procedure now in place to protect residents. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3, 4 and 5. Standard 6 is not applicable. An appropriate pre-admission assessment is used prior to the offer of a room to ensure that the home can meet prospective residents needs. EVIDENCE: Pre-admission assessments are completed for all prospective residents to ensure that the home can meet their needs. The manager discussed the homes ability to meet the needs of residents, and residents who expressed an opinion said that the home provides the support and care they need. Prospective residents and their relatives are encouraged to visit the home and residents may move in on a trial basis before they decide to take a room on a permanent basis. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10. The care planning system is clear and consistent and provides staff with the information they need to satisfactorily meet the needs of residents. Staff have a good understanding of the residents needs. This is clear from the positive relationships which have formed between the staff and residents. EVIDENCE: Care plans are developed from the information provided in the pre-admission assessment, they identify the needs of residents’ and include risk assessments and a daily record of the care and support provided. They are reviewed when a residents needs change and on a regular monthly basis, with the involvement of residents and their representatives if appropriate. The residents are registered with GP’s and have access to allied health professionals when required, including physiotherapists and Tissue Viability Nurses. It was noted that residents are treated with respect and that communication between staff, visitors and residents is friendly and relaxed. The residents who talked about their care said they felt that the staff are very supportive The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 10 providing the care they need. This was supported by visitors who were happy to discuss the services provided at The Devonshire. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Links with the local community are good and support and enrich residents’ social opportunities. The routines at the home are flexible this enables residents to have control over their lives and encourages them to make choices about all aspects of their daily living. The dietary needs of residents are well catered for, with a balanced and varied selection of food available that meets residents’ tastes, choices and special dietary needs. EVIDENCE: There is a programme of organised activities at the home for three days a week and the manager plans to increase this when staffing permits. On the morning of the inspection some residents were taking part in a general knowledge quiz. It was noted that staff spent time with residents chatting, while they worked and when they were free. There are links with the local community with fortnightly church visits to the home, a Summer Fayre recently attracted a considerable number of friends The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 12 and relatives and was, as residents, staff and relatives explained, very enjoyable. There is open visiting at the home and residents are encouraged to keep in touch with friends and relatives. During the inspection relatives and friends spoke positively about the care provided at the home, stating that the home provides all the support that residents need. Residents are encouraged to exercise personal autonomy and choice if appropriate. They choose how to spend their time, sitting in the lounge if they wish or their own rooms and have an active role in deciding the care and support that is provided and are able to make changes to their daily routine. One resident has a cat that lives in her room and is therefore able to enjoy and benefit from his companionship at The Devonshire. The manager advised that an appropriate risk assessment has been completed. Choices are provided for all meals with drinks and snacks available throughout the day. Lunch was enjoyed in one of the lounges with residents, who were complementary about the food provided, one resident changed her mind about her choice for lunch and was able to request a different meal. The residents were relaxed and comfortable discussing a number of topics during the meal and it was clear that they all enjoyed the food. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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 standard(s) EVIDENCE: These standards were not assessed. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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 standard(s) 19, 20, 21, 22, 23, 24, 25 and 26. The standard of the environment within the home is good providing residents with an attractive and homely place to live. EVIDENCE: The home is a converted property of two buildings joined by a corridor on the ground floor. The allocation of rooms in each part of the home is based on the assessed needs of the residents, in particular their mobility. A chair lift enables access in one part of the home with a shaft lift in the other. Hoists, assisted baths and toilets are available to ensure that residents are supported safely in all aspects of personal care. The Devonshire provides homely, comfortable communal and individual space for residents. There are two lounges in the home, with a dining area in each, that are also used for social and religious activities. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 15 There are large attractive gardens to the rear that are accessible to wheelchair users. Residents and their visitors were taking advantage of the warm weather and were sitting outside after lunch during the inspection. There are 35 single rooms in the home and two double rooms, although these are used as single rooms unless a couple request to share. There are 15 rooms with en suite facilities. The home provides furniture, including an adjustable bed, storage for clothing, a table and two chairs. Residents can bring some of their own furniture to the home and many have personalised their rooms with ornaments, pictures and small pieces of furniture. The home was clean and there are systems in place to prevent the spread of infection. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 Thorough recruitment procedures help to ensure the safety and protection of residents. EVIDENCE: Appropriate recruitment procedures are followed at the home and include two references and POVA/CRB checks. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 36 The systems for resident consultation are good with evidence that residents’ views are both sought and acted upon. EVIDENCE: The management approach at the home is open and encourages staff, residents and their representatives to be involved in decisions about the services provided. Residents are encouraged to regard The Devonshire as their home and the manager explained that there is feedback from the residents on a daily basis with a more formal residents meeting taking place twice yearly. A considerable number of comment cards were received from residents, as well as a few from relatives, they were all positive about the care and support provided at The Devonshire. Informal supervision is part of the daily management routine at the home. This is now supported by formal supervision for all staff on a regular basis. The The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 18 manager discussed its introduction and there is evidence that it is used appropriately to support staff. The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 3 x x x 3 x x The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 Good Practice Recommendations The Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Devonshire H59-H10 S13977 The Devonshire V227345 220705 stage 4.doc Version 1.30 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!