Inspection on 14/06/05 for The Downs House

This inspection was carried out on 14th June 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.

Other inspections for this house

The Downs House 22/03/07

The Downs House 28/11/05

The Downs House 09/02/05

The Downs House 10/05/04

The Downs House 18/12/03

The Downs House 30/01/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Downs House Reservoir Lane Petersfield Hampshire GU32 2HX Lead Inspector Laurie Stride Unannounced 14/06/05 10.00am 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 Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Downs House Address Reservoir Lane, Petersfield, Hampshire, GU32 2HX 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) 01730 261474 Western Health Care Limited # To be appointed CRH 37 Category(ies) of OP registration, with number of places The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/02/05 Brief Description of the Service: The Downs House is a registered care home for up to thirty-seven older people. It is owned by Western Healthcare Limited. The Responsible Individual is Mr Rogers and the current manager is Mrs M Evans, although she is not yet registered. The home is situated in a quiet road just outside of Petersfield and provides a service based on ensuring the comfort and meeting the needs of service users. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that lasted four and a half hours, during which the inspector met some of the residents, staff and management team, undertook a tour of the premises and viewed some of the home’s records. A previous requirement had been met and no new requirements were made as a result of this inspection. What the service does well: What has improved since the last inspection? 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 Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 6 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 Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 7 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) None of these standards were assessed on this occasion. EVIDENCE: The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 8 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, 9 and 10 There are clear systems in place for support planning, healthcare and the safe administration of residents’ medication. Working practices within the home promote resident’s privacy and dignity. EVIDENCE: A sample of two resident’s care plans was seen and each included information on identified needs, action to be taken and ongoing evaluation to ensure needs were being met. Care plans were monitored on a monthly basis and reviewed as and when needed. Resident’s files also contained other relevant information such as completed admission and assessment forms, a photograph and pen picture of daily needs, personal and professional contacts, daily report and medication records. The manager reported that care plans were being developed further, for example correspondence was taking place between the home and resident’s relatives asking for updated information such as solicitors’ contact details, and background histories were being sought involving resident’s key workers as part of a more holistic approach to care. The home’s records showed that residents’ health and wellbeing were monitored and appointments with doctors and other specialists were made as The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 9 and when necessary. The home informed the Commission for Social Care Inspection of the occurrence of any falls and the manager kept a file of relevant information and contact with the District Nurse. Ways of eliminating or reducing potential falls were identified along with actions already taken and known ‘triggers’ or patterns of behaviour. The manager was also developing a medical information file for staff containing useful information about, for example, blood pressure, obsessive/compulsive disorders, what to do in summer heat waves. The home had a written medication policy and procedure and a copy of the Royal Pharmaceutical Society’s latest guidelines for the administration of medication in care homes. A number of resident’s were supported to manage their own medication within a risk-assessed framework that included regular staff checks and consultation with the individual’s doctors. Procedures and records were also on file regarding medications returned to the pharmacy, homely remedies and drug errors. A senior member of staff was observed administering medication to residents after lunch and explained the procedure. The member of staff giving out the medication checked and signed the records. A separate procedure was in place for the administration and recording of controlled drugs undertaken by authorised staff. The manager was putting together an ‘A to Z’ of medication used in the home as a further useful resource for staff. Staff were observed supporting residents in a friendly and respectful manner and this was confirmed in conversation with a resident. A dry-wipe board in the office was used to pass on important information between staff on shift and this referred to residents by room numbers only. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 10 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, 14 and 15 The home is good at providing recreational activities to suit residents’ needs and interests and enabling residents to exercise choice and control over their lives. The dietary needs and preferences of residents are well catered for with a varied selection of food available. EVIDENCE: Residents’ expressed satisfaction with the activities provided by the home and a calendar of events was on display outside the dining area. Activities on offer included arranged outings, shopping, flower arranging, hairdressing, diversional therapy, bingo, video, quizzes, knit and natter, communion and happy hour. Books and board games were available within the home. At the time of the inspection the Responsible Individual for the home was escorting a group of residents on a trip to Hayling Island for lunch. Staff confirmed that this sort of activity happened frequently and a record was kept of resident’s activities and preferred recreational interests. A garden party was arranged for July by the resident’s association and would help raise funds for future activities. Residents were supported to handle their own financial affairs according to their wishes and abilities. Information about the East Hampshire advocacy scheme was on display outside the office. It was confirmed through conversation with residents that they are able to bring an agreed amount of The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 11 personal possessions with them into the home and can access their personal records if they wish. Residents were observed moving freely about the home with staff assistance as required, and a service user commented that they were free to come and go as they wished. Lunch and supper menus were on display outside the dining area and meals on offer were varied and appealing. Staff in the kitchen reported that alternative meals could be provided if they were informed beforehand, and a resident confirmed this and said the food was satisfactory. The cook was aware of resident’s food preferences and any special diets. Staff were monitoring one resident’s food intake and keeping a record. The dining area included a conservatory and was spacious and comfortable. The atmosphere at lunchtime was relaxed and staff were observed giving assistance as needed. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 12 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) 16 The home has a suitable complaints procedure to ensure that residents’ concerns are listened to and acted upon. EVIDENCE: The home had a clear and accessible complaints procedure that included a timescale for responding to complaints and the contact details of the Commission for Social Care Inspection. A system was in place for recording complaints and one had been received since the last inspection. Through discussion with the manager it was apparent that the home had responded appropriately and within the timescale. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 13 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 The home provides a pleasant, clean and comfortable environment for residents. EVIDENCE: The home is located in a quiet lane and has pleasant well-kept and accessible garden areas. The premises were well maintained on a regular and planned basis and records were kept of work done. The home complied with the requirements of the Fire Authority and the Environmental Health Department. Suitable adaptations such as grab-rails, a passenger lift and assisted bath were installed. The layout of the home and variety of communal spaces provided residents with opportunities to socialise or to sit in quieter areas. Furnishings were of good quality and a resident confirmed that they liked the accommodation. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 14 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) 27,29 and 30 Residents are supported and protected by suitable numbers of trained staff and the home’s recruitment practices. EVIDENCE: The staffing rota clearly showed which and how many staff were on duty each day. There were five support workers plus the manager on duty during the morning, three support workers on the afternoon shift and another three on duty in the evening. Nights were covered by two awake staff and one sleeping-in. Staff working in the kitchen confirmed that they did not undertake personal care tasks. There was an on-call system in place covered by the management and senior staff members. At the time of the inspection four members of staff were working as care supervisors on a probationary period. This senior support role was being developed on a trial basis and gave these staff members responsibility for ensuring that key aspects of the work were carried out during the shift, for instance writing reports ensuring that each residents’ wellbeing was being monitored. Staff carried notebooks with them in order to record their observations and communicate all relevant information at the end of their shift. A file was kept to record handovers and a communications book, dry-wipe board and diary were used to ensure information was passed on effectively. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 15 A sample of three staff recruitment records was seen and these contained all the required information, such as recent photographs, Criminal Records Bureau (CRB) checks, written references and completed application forms with employment histories. The home had a planned programme for statutory staff training including moving and handling, fire safety, health and safety, first aid, infection control and food hygiene. Additional training was also provided that had relevance to individual residents or the group, for example insulin and blood sugar, wound care, and the use of inhalers. The manager stated that staff did not undertake tasks that should only be performed by professionals such as the district nurse who was consulted as and when necessary. A file was kept of staff who were competent in assisting residents with their blood sugar tests. Training on nutrition was planned and the manager reported that the home was looking to provide more training about dementia. Staff had also taken part in training about holistic care. Fifteen members of staff were reported by the management to be registered to undertake NVQ2 training and nine were registered to do NVQ3. The home was developing further its structured induction programme for new staff and this will be assessed at the next inspection. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 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 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) 33, 35, 36 and 38 The home’s systems for obtaining residents’ views, safeguarding residents’ financial interests, supervising staff and promoting safe working practices all serve to protect residents’ and ensure the home is run in their best interests. EVIDENCE: A resident questionnaire had been developed for quality assurance purposes and there were plans to implement this soon. The minutes for the last recorded resident’s meeting were dated October 2004. The manager stated she was going to re-instate these in July on a more frequent and informal basis. The resident’s association held annual fund-raising events. Residents were supported to control their own money according to their wishes and abilities. The home looked after small amounts of resident’s money/valuables and safeguards were in place. Only the manager and senior The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 17 staff had access to money/valuables deposited for safekeeping and a record was kept of all transactions signed by the resident and member of staff. Staff confirmed that they had regular supervision and there was a record of supervision dates and times set for staff. The supervision format included topics for discussion such as resident issues and care practices, workers roles and training needs, actions to be taken and by whom, and records of any additional discussions between supervisor and supervisee. Staff commented that the management team were approachable and friendly. The home had a health and safety policy statement and evidence was seen that safe working practices were being promoted. Fire safety training had recently been held on 14/04/05 and recent fire risk assessments had been undertaken. Test certificates were on file for fire alarms, emergency lighting and other equipment, electrical and gas appliances. Records were kept to show that fridge/freezer and meat delivery temperatures were being monitored. On the day of the inspection the premises were free from any visible hazards. The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x 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 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x 3 3 x 3 The Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 19 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 Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 20 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southanpton, Hants SO15 1GW 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 Downs House H54 s11770 The Downs House V231425 140605.doc Version 1.30 Page 21 - 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!