CARE HOMES FOR OLDER PEOPLE
The Homestead 6 Elwyn Road Exmouth Devon EX8 2EL Lead Inspector
Michelle Oliver Announced 13 September 2005 09:30hrs 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 Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Homestead Address 6 Elwyn Road Exmouth Devon EX8 2EL 01395 263778 01395 273371 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) Homestead Homes Ltd Mrs Hazel Joan Neville Care Home 24 Category(ies) of OP Old age (24) registration, with number Physical dis - over 65 (24) of places The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 3 February 2005 Brief Description of the Service: The Homestead is a detached Edwardian house set in large well kept gardens in a residential area of Exmouth close to shops and all local facilities. Accommodation is provided in 18 single bedrooms, 15 of which have en suite facilities, and 3 double bedrooms with en suite facilities. There are 2 lounges, and a dining room. One of the lounges provides day care facilities for residents and people who live elsewhere and visit the home for the day. There is also a small quiet sitting area plus a large entrance conservatory with a couple of chairs where some service users enjoy sitting. The home provides personal care for up to 24 older people who may also have a physical disability. There are waking staff on duty at night. The home places a high priority in providing a wide range of activities and outings to suit all interests. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on Tuesday 13th September 2005 from 9.30am to 1.45.pm. The providers, and manager were present throughout the inspection. The inspector spoke to 8 residents on this visit. All members of staff on duty also took part in the inspection. The atmosphere in the home was warm, welcoming and friendly. Residents were relaxed, content and spoke highly of the care they received in the home. The inspector looked around the home, a number of records were inspected, which included pre inspection questionnaire, comment cards, thank you letters from relatives and residents’ files. The manager and staff were very helpful on the day of the inspection and a lot of positive discussions, advice and suggestions took place throughout the inspection. What the service does well: What has improved since the last inspection?
No requirements or recommendations were made at the last inspection. The home continues to be well maintained. Since the last inspection some carpets have been replaced, new sitting room chairs have been provided, and new patio doors and blinds have been fitted in the dining room. Residents were involved in these changes and chose the colour and design for the chairs in the lounge. They also discussed the fact that the sun shone through the dining
The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 6 room window but they didn’t like the curtains being drawn so suggested having blinds instead. This was discussed at a Resident’ Meeting. The Manager has successfully completed the Registered Manager’s Award. The provider has updated, and made more comprehensive, the home Terms of Business after reading article in Caring Times. 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 Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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 Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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) 1 & 6. Service users benefit from good admission and assessment practice that ensures that the home is able to meet their needs. EVIDENCE: Care needs are well met through a full assessment process that is carried out before a resident decides to live at the home. Care plans are completed from this information. A comprehensive assessment was seen for a resident recently admitted to the home. The home does not admit residents for intermediate care. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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 & 10. Resident’s health and social care needs are well met and promoted by good planning arrangements. Resident’s privacy and dignity are met and promoted by the staff and management team at The Homestead. EVIDENCE: Records are properly kept for each resident. They include good guidance on help needed with mobility and risk of falls. Staff showed clear respect for residents’ privacy, for example they knocked on bedroom doors and waited to be asked in before entering. The home promotes residents’ welfare in cooperation with families and health care professionals. One relative said “ My mother was very happy in this home, the staff are very caring and nothing is too much trouble for them” The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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, 13 & 15. Social activities and meals are well managed, creative and provide daily variation and interest for people living in the home. Residents are encouraged to maintain contact with family and friends. EVIDENCE: Staff and management have worked hard to gain information about individual residents social and leisure needs. Residents enjoyed the many and varied outings which are arranged at The Homestead. Residents were looking forward to going on a “ Mystery Tour” in October. A notice board in the hall displays the month’s programme of events/ activities and photographs taken of residents enjoying themselves at outings, during special occasions and activities sessions. A resident spoke about the recent party given at the home to celebrate their Diamond wedding anniversary. Activities include exercises, bridge, I Spy, religious services, putting, outside entertainers and outings. Residents meet regularly at discussion groups and residents meetings and are involved in the running of their home. Visitors said that they are encouraged to visit whenever they wish and that they are always made welcome at home. The provider confirmed that visitors may visit at any time but only if the resident wishes to see them at that time. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 11 A variable, nutritious diet is provided at the home. This was confirmed by residents and from the meal on the day of the visit. Meals and activities are amongst the topics discussed at residents meetings. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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 & 18. Residents and relatives are confidant that they are listened to and their requests actioned. Satisfactory arrangements are in place for protecting residents and responding to concerns. EVIDENCE: Residents are aware of how to make a complaint at The Homestead. They were confident that any issues raised by them would be listened to, taken seriously and acted upon. A resident said that a concern would never get to be a complaint because the manager or providers would deal with it immediately. Also, any “grumbles” are discussed at the regular residents’ meetings. The home has received one complaint since the last inspection. The provider carried out the investigation and the complaint was not upheld. A record is kept of all responses and investigations into complaints received at the home. A relative commented that a “close liaison between staff and the owner ensures problems do not escalate to forcing a complaint. Suggestions are taken on board and frequently result in action”. Members of staff confirmed they are aware of the homes policy on the prevention of abuse and the Whistle Blowing policy and would not hesitate to report any incidents of poor care practice at the home. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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) None of these standards were assessed at the time of the visit. EVIDENCE: The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 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. Residents are supported by an effective, staff team with recruitment practices that protect residents. Resident’s benefit from having skilled experienced and friendly staff who have a good understanding of their needs. EVIDENCE: The manager aims to provide 4 carers on duty between 8am-2.00pm, 3 between 2.00pm and 8.00pm and 2 waking carers on duty between 8.00 pm and 8.00am. Residents said The Homestead is a well run, friendly comfortable home that they have made their own. During the visit staff spent time with residents and responded to their needs promptly. The providers and manager are committed to providing training for all staff at the home. Records confirmed staff had attended a variety of relevant training sessions. All staff were confident that they were able to meet the needs of the residents at the home. All staff are given induction and foundation training. The home’s recruitment procedure and practices ensures that the necessary checks are carried out for the protection of residents. Three recruitment files were inspected and all met the required standard. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 15 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 & 38 The manager provides clear leadership and guidance to staff to ensure that residents receive consistent care in a safe environment. EVIDENCE: The providers and manager give a clear lead and direction to staff. Residents and a visitor confirmed that the providers and manager are approachable and seek to ensure that all their needs are met. Some personal allowances are managed for residents by the home. A record is kept of all transactions and receipts of purchases are kept. The file was inspected and was detailed and accurate. The systems for resident, staff and relatives consultation are good with evidence that indicates residents’ views are both sought and acted upon. Residents’ meeting are held monthly, which covers subjects such as catering, personal care support, and residents’ activities. The provider inspects the
The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 16 home monthly and sends a report to the CSCI and the manager. The quality of these reports is excellent. Safe working practices are employed and risk assessments are undertaken. Records show that staff undertake regular training in the prevention of fire. Fire alarms and emergency lighting are regularly checked. Liquid soap and paper towels were available in communal bathrooms and in individual residents rooms. Staff confirmed that gloves and aprons were always available. Risk assessments relating to health and safety issues were completed. Quality assurance measures are in place to ensure the monitoring of standards and that the residents have a say in the running of the home. Residents meetings are held regularly at The Homestead and records are kept of topics discussed and actions taken as a result. The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 17 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 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 3 x 3 x x 3 x 3 x x 3 The Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 18 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 Homestead D54 D06_s22056_homestead_v241475_130905 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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