Inspection on 04/01/07 for The Devonshire Nursing Home

This inspection was carried out on 4th January 2007.

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.

Other inspections for this house

The Devonshire Nursing Home 15/01/09

The Devonshire Nursing Home 16/01/06

The Devonshire Nursing Home 22/07/05

The Devonshire Nursing Home 15/02/05

The Devonshire Nursing Home 04/08/04

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE The Devonshire Nursing Home 95 - 97 Carlisle Road Eastbourne East Sussex BN20 7TB Lead Inspector Kathy Flynn Key Unannounced Inspection 4th January 2007 11:45 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 Devonshire Nursing Home DS0000013977.V323670.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 Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Devonshire Nursing Home Address 95 - 97 Carlisle Road Eastbourne East Sussex BN20 7TB 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) 01323-736983 01273 736983 cmillsd@aol.com Mr Bernard Edward Clarke Mrs Barbara Ann Clarke, Mrs Caroline Mills Mrs Bernadette Wild Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Physical disability (42) of places The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is fortytwo (42). Service users must be older people aged sixty-five (65) years or over on admission. Service users with physical disabilities under sixty-five (65) may be admitted. Date of last inspection 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 stair 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 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 Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was carried out over five and half hours on the 4th January. A pre-inspection questionnaire and residents survey forms were sent to the home prior to the inspection. The pre-inspection questionnaire and 6 completed surveys were returned to the Commission. The inspection included a tour of the home, an examination of care plans, staff records, menus, medication records, activities, accident records and training records. The manager, registered nurses, care staff and the cook were happy to discuss the care and support provided during the inspection. There were 29 residents at the home during the inspection. 20 residents and 2 relatives were spoken with, those who expressed an opinion were very positive about the support they receive at the home. With some stating that ‘nothing is too much trouble’ and ‘they receive the best care and they could not find better anywhere’. The reader should be aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 uses the terms service user to describe those living in care home settings, for the purpose of this report those, living at care homes will be referred to as residents. What the service does well: What has improved since the last inspection? The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 6 There were no requirements or recommendations identified at the last inspection, and the management and staff continue to provide a service appropriate to the needs of residents. The care planning system has been reviewed and now includes a record of resident’s hobbies and interests to assist in the ongoing provision of activities at the home. The management processes at The Devonshire enable residents, relatives and staff to be involved in the development of services at the home. This is not a new process but feedback from residents and relatives identified that this is important to them and they feel they are able to contribute. 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 Devonshire Nursing Home DS0000013977.V323670.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 Devonshire Nursing Home DS0000013977.V323670.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): 3. Standard 6 is not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A pre-admission assessment is carried out for all prospective residents to ensure that the home can meet their needs. EVIDENCE: Pre-admission assessments are completed for all prospective residents, to ensure that the home can meet their needs, before they are offered a room. Residents and relatives spoken to said that they were very happy with their choice of home. One visited a number of other homes before choosing The Devonshire and was very pleased with her choice. The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The care planning system is clear and consistent providing staff with the information they need to satisfactorily meet the needs of residents. The staff protect residents by following the homes procedures with regard to the administration of medicines. The staff have a good understanding of residents support needs. This is clear from the positive relationships, which have been formed between the staff and the residents. EVIDENCE: The care planning system provides information about all aspects of the residents needs. 8 were examined, some for recent admissions and others who have been at the home for some time. They were up to date, had been The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 10 reviewed on a regular basis, in additional to when any changes were identified, with the involvement of relatives and residents. The care plans included relevant assessments including moving and handling, pressure area care and the support provided, falls assessments and nutritional assessments. Care staff record the care and support they provide for residents daily, this includes pressure area care, where residents spend their time, in the lounge or their own room, if they participate in any activities, or if there is any change in their needs. The registered nurses use this information when completing the daily records in the care plans, to ensure that the information available for each resident reflects their needs for each day. A key worker and primary nurse system is in place which ensures that each member of staff is responsible for supporting a group of residents, the residents are aware of this and know who there key worker is. Residents are registered with GP’s of their choice, as a number of residents are from the area they have kept the GP they had before admission. Residents are referred to the hospital or other health professional when required, including the Tissue Viability Nurse, Physiotherapists and Occupational Therapists. The registered nurses follow the homes policies and procedures for the administration of medicines. One set of MAR charts were viewed and were completed appropriately. A review of the medication prescribed for residents has recently been carried out by the Pharmacist, and some changes have been made to medication with the support of the GP’s. Communication between staff, residents and visitors was open and friendly, staff were noted to treat residents with respect. The staff spoken with said that this is the resident’s home and they should be supporting them to live and do what they like, residents said the staff provide the support they need and nothing is too much trouble. The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a varied programme of in house activities, and visits to places of interest in the local community. The routines of the home are flexible, this enables the residents to have control over their lives and encourages them to make choices about all aspects of their day to day living. The dietary needs of residents are well catered for with a balanced and varied selection of food available that meets the resident’s tastes and choices. EVIDENCE: The manager and staff advised that the activity person offers a variety of activities for residents. There were a number over the Christmas period including a pantomime, carol service, mulled wine and mince pies, residents who expressed an opinion said that these were very good and they enjoyed them. One resident said that the matron and staff put a lot of effort into lots of activities. The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 12 The activity person spends time with all of the residents, doing group activities or individually. The manager explained that an additional sheet has been included in the residents care plans to enable the activity person to record their hobbies and interests. This will also enable them to record the considerable amount of support that is provided, and ensure that they develop an activity programme that reflects the resident’s preferences. Several residents said they preferred to stay in their rooms and were not keen on joining others in the lounges, when asked if they would like to do any activities they said they watch TV, one lady knits and another reads the newspaper ‘cover to cover’. Visitors spoken with were very positive about the care and support provided, they both visit every day, one assists her partner with meals and drinks. They were invited to the Christmas activities, including meals and joined in some of them. They said that they are welcomed at any time and there are other visitors that come at different times depending on their work shifts. Residents are encouraged to spend their time as they wish, some spend it in their own rooms, others in the lounge. The staff said they are able to choose what they want to do, the residents spoken with supported this and said staff offer the support they need. The meals are attractive, nutritious with choices available throughout the day. The cook stated that they can have what they want and there was evidence to show that this is what happens at the home. Relatives and residents were very positive about the food with one stating that it is excellent, particularly as she is vegetarian and they always offer her a choice. Staff are now required to complete a food diary as part of the residents nutritional assessments this includes what they eat, how much and if any supplements are given if they do not want the meals offered. The Devonshire Nursing Home DS0000013977.V323670.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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with some evidence that residents feel their views are listened to and acted upon. Staff have good knowledge of Adult Protection Issues which protects residents from abuse. EVIDENCE: There have been no complaints about any aspect of the services provided, to the home or to the Commission. The manager confirmed that there is a complaints policy in place. Residents who expressed an opinion said that they have nothing to complain about, and they said that if they wanted to talk to someone about something then they could do so. Training in Adult Protection is provided for staff. Those spoken with were able to demonstrate a good understanding of the protection of vulnerable adults, whistle blowing and what action they should take if they have any concerns. The Devonshire Nursing Home DS0000013977.V323670.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): 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 standard of the environment within this home is good providing residents with a homely and comfortable place to live. All parts of the home are accessible and infection control systems are in place to protect residents, visitors and staff. EVIDENCE: The home is made up of two buildings connected by a corridor on the ground floor. It retains much of its original features, including fireplaces, which residents felt make it more homely. The home is clean, there were no odours, and feedback from surveys as well as residents and visitors during the inspection show how important this is. The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 15 Resident’s rooms are personalised with their own possessions, ornaments and pictures, as well as small pieces of furniture of their choice. Some of the bed tables are rusty and would be difficult to clean, this was discussed with the manager who advised that some have been replaced and there are plans to replace all of them in the near future. Some of the bedroom furniture is worn and this will also be replaced when the rooms are vacant and due for redecoration. The kitchen has been updated with additional fridges and freezers and the washing up area has been separated from the food preparation area. The cook confirmed that the design of the kitchen ensures that there is sufficient space to prepare the meals comfortably. Access to the kitchen is restricted and if staff enter the main kitchen area they are required to follow infection control policies by covering their uniforms with the coats provided. The manager confirmed that appropriate infection control policies are in place and training is provided for staff. Staff were noted to be using gloves and aprons appropriately and those spoken with have completed the relevant training. The Devonshire Nursing Home DS0000013977.V323670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff morale is high resulting in an enthusiastic workforce that work positively with residents to improve their whole quality of life. There are sufficient trained and competent staff on duty at all times to meet the assessed needs of residents. Recruitment procedures are not robust and may place residents at risk. The arrangements for the induction of staff are satisfactory, enabling staff to provide appropriate levels of support and care for residents. EVIDENCE: The manager confirmed that there are sufficient staff on duty to meet the needs of residents. Staff who were spoken with said they had time to do the work they were allocated and did not feel that they needed to hurry. They also said they had time to talk to residents or visitors and this was an important part of their work. Residents spoken with said staff provide the help and support they needed, there were no concerns raised that they had to wait a long time for anything, The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 17 several stated that nothing was too much trouble and the staff are very good and ‘help us as much as we need’. Recruitment procedures are followed and all but one of the files examined contained the relevant information. A POVA/CRB check for a new member of the care staff team had not been requested as one had been provided by the carer when she started at the home. The manager was advised that POVA/CRB checks should be completed by the home for all staff and she stated that she would do this immediately. She also advised that this member of staff has been supervised at all times by senior staff since she started work as she has no previous experience and is currently working through the induction course provided. New staff are required to complete induction training, which consists of three to four weeks learning about the home and their role, with the rest over twelve weeks so that it covers all aspects of the Skills for Care course. The nurse responsible for training at the home explained that some staff move on from the induction to NVQ 2 and two staff are currently doing this. She has recently started the A1 Assessors course and as part of this will be assessing the care staff while they complete the NVQ. The home does not meet the 50 of staff with NVQ level 2 or equivalent but does encourage and enable staff to work towards it if they wish. The Devonshire Nursing Home DS0000013977.V323670.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management approach at the home is open and inclusive. Staff, residents and relatives are encouraged to be involved in any decisions about the support and care provided. The manager is supported well by staff in providing clear leadership throughout the home with staff demonstrating an awareness of their roles. Systems are in place to ensure the health, safety and welfare or residents and staff. The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 19 EVIDENCE: The relationship between staff, residents and visitors was relaxed and friendly. Residents and relatives spoken with said that they are able to discuss anything with the staff and feel that they are able to contribute to the care and support provided if they wish. Staff are quite clear about their responsibilities and do not find it difficult to raise any issues with colleagues or the senior staff, including the manager as she is ‘open to discussions about anything’. Staff and residents said it is like a ‘family’ and were equally positive about the management and the support provided. Residents meetings are held quarterly and the manager and staff stated that they ask residents about the support and care provided daily, and discuss this with relatives and friends on a regular basis. Yearly questionnaires will be sent out later this month to residents and their relatives or representatives. Feedback from residents and relatives during the inspection and from the surveys was very positive. The manager confirmed that the home does not accept responsibility for the resident’s finances, some are responsible for their own, while most are supported by relatives or solicitors. Training required by legislation including moving and handling, fire training, first aid and infection control is provided for staff. Staff spoken with said they attend all the required training and the manager keeps a record of the training they have attended, she is able to identify staff who may need updates. The Devonshire Nursing Home DS0000013977.V323670.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 21 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. 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. Refer to Standard Good Practice Recommendations The Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Devonshire Nursing Home DS0000013977.V323670.R01.S.doc Version 5.2 Page 23 - 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. 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