Inspection on 26/05/05 for The Limes

This inspection was carried out on 26th May 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 Limes 08/02/07

The Limes 11/10/05

The Limes 07/10/04

The Limes 15/04/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE The Limes 43 Foreland Road Bembridge Isle of Wight PO35 5XN Lead Inspector Neil Kingman Unannounced 26 May 2005 9:30 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 Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Limes Address 43 Foreland Road, Bembridge, Isle of Wight PO35 5XN 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) 01983 872116 Mrs Susan Jennifer Betteridge and Mrs Alison Neve-Dewen Mrs Lynne June Preston Care Home 32 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (9) The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7/10/04 Brief Description of the Service: The Limes is a care home providing personal care and accommodation for up to 32 older people. It is located in a residential road in Bembridge village; a few minutes walk from a range of local shops and the nearby beach. There is some off road parking for visitors or on road parking is to the front of the premises. The accommodation offers a range of mostly single rooms on 3 floors, all with en-suite facilities. Access for residents is via a passenger lift to all but 4 rooms on the mezzanine floor, which are not suitable to be occupied by people with mobility difficulties. There is access to an enclosed garden at the rear with a seating area for residents. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place unannounced over 6 ½ hours. Residents were variously located in the lounges, conservatory or in their own rooms. The atmosphere was friendly and very relaxed. A tour of the premises took place and a selection of records was inspected. Two staff and two visitors were spoken with. Three residents were spoken with in the privacy of their rooms and several others as a group in the dining room. Comments about the service were extremely positive and no concerns were raised. On 25 January 2005 an additional inspection of The Limes was undertaken to look at standards relating to specific issues following an accident in the home. All standards inspected at that time were found to be met. What the service does well: What has improved since the last inspection? Since the last inspection progress has been made with a programme of covering the radiators in residents’ rooms, with the majority now covered. A new bright and airy laundry has been built at the rear of the building with new industrial appliances installed. The home has achieved the Investors in People Award. The Limes H55-H04 S54200 The Limes V218052 260505.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 Limes H55-H04 S54200 The Limes V218052 260505.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 Limes H55-H04 S54200 The Limes V218052 260505.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 and 4 The manager ensures that the care needs of the people who live at The Limes will be met by undertaking a proper assessment prior to them moving into the home. The home ensures that residents’ needs will be met with appropriate equipment, access to specialist services and the skills and experience of the staff. EVIDENCE: The newest resident admitted to The Limes three weeks before the inspection had come from the mainland. While a personal visit for a pre-admission assessment was not practical the manager undertook the assessment by way of telephone consultations with all interested parties. Records showed that the assessment covered all relevant areas of need. During the inspection there was an opportunity to speak with this resident’s son who said that he chose The Limes after having viewed several others. He and his mother were very positive in light of the fact that they had had only three weeks to experience the service. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 9 A resident who had been admitted to hospital recently was assessed by the manager prior to her discharge and return to the home. Records showed the assessment was used to ensure that appropriate equipment was in place to meet her change in needs. The Limes has an experienced and stable staff group with no turnover of care staff since the last inspection. 75 of care staff are qualified at NVQ level 2 with others undertaking the training. The home has a range of equipment to enable staff to transfer residents safely including a standaid, hoist, two Parker baths and a wheel in shower. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 The home has a system of care planning with an individual plan for each resident. They demonstrate that residents’ health care needs are identified and met. Medication is securely held and appropriate records are maintained. EVIDENCE: The principal of case tracking was used in a sample of care plans. The intention was to look at the outcomes for residents in general by assessing all areas of care for those sampled. The sample included a resident with complex needs, a resident who had recently returned to the home from hospital, and the newest admission to the home. Plans were seen to be comprehensive. They contained admission details, a long-term needs assessment, psychological assessment and plan of care. Risk assessments were in place and reviews were up to date. Plans showed that a range of health care professionals was consulted where appropriate, including psychiatry, GPs, and the infection control nurse. Additionally, they contained information on the progress made with mobility and pressure areas for one, and how the home was coping with the deteriorating health of another. Only The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 11 one resident spoken with showed some knowledge of the care planning system and fully understood the need for such a record to be kept. Four residents and a relative expressed, in written comments, satisfaction with the care provided. While controlled drugs are held under secure conditions it is recommended that the present cabinet be replaced with a metal one. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 and 15 Residents are supported to manage their own financial affairs for as long as they are able. Where this is not possible family or advocacy are brought in to assist. The promotion of choice extends to all aspects of daily living including personalisation of rooms, and meals. EVIDENCE: The manager explained that some residents manage their own financial affairs but most have family to assist. One resident is under the Court of Protection. She said that while currently advocacy is not required she has accessed the service for a resident in the past and is familiar with the procedure. Information about independent support is available to residents and their representatives in the service users’ guide, a copy of which can be found in the resident’s room. Some of the rooms visited during the inspection showed a good level of personalisation. One very articulate resident was very clear about choices in the home, saying that there are no regimes and she can do whatever she wants. As at previous inspections there was a high level of satisfaction with the food provided. One resident described the food as ‘exceptional, home cooked’ and another said it was ‘very good indeed’. While the home operates a five week menu the manager said that basically residents can have whatever they like. Menus showed food to be varied and nutritious. Lunch appeared to be a very sociable The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 13 affair with staff present to assist throughout. The sweet trolley containing a varied selection of sweets proved to be particularly popular. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home treats residents’ complaints seriously and responds appropriately. EVIDENCE: The home has a complaints policy and procedure which is included in the service users’ guide. There was a complaints register in which the last recorded complaint was April 2004. The manager said that minor issues are dealt with immediately but no formal complaints about the service had been made in the past year. Residents spoken with said they were confident in the manager’s ability to resolve concerns if they had any. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 All areas of the home are kept clean and tidy and free from unpleasant odours. The location and layout of the home is generally suitable for its stated purpose in providing a safe and comfortable environment for those who live and work there. Some improvements have been made since the last inspection. EVIDENCE: Residents at The Limes are accommodated in spacious single rooms, all with en-suite facilities. A passenger lift provides access to rooms on the first floor except four on the mezzanine level. These rooms are only occupied by people who are able to use the stairs without assistance. There is ramped and level access to the rear garden in which there is seating for residents during the summer. There is an ongoing programme of maintenance and decoration. Since the last inspection radiators in many of the rooms have been covered on a risk assessment basis. There was evidence that the process was ongoing. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 16 Furniture has been replaced in residents’ rooms and a new laundry has been built at the rear of the property, with new industrial machines installed. Residents spoken with expressed general satisfaction with their accommodation. Two made special mention of the pleasant outlook they had and one was particularly pleased with her room having the sleeping area separate from where she sat. While there were no unpleasant smells detected the manager pointed to one room where a change of floor covering is planned to better manage a problem with incontinence. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 and 30 Staff at The Limes have the necessary skills and experience to meet the needs of the people who live there. Staff turnover is low and a robust recruitment procedure ensures residents are protected. EVIDENCE: There have been no new care staff recruited since the last inspection when recruitment records were checked and found to be in good order. 75 of care staff are qualified at NVQ level 2 and others are undertaking the training. Some staff have achieved the qualification at level 3. Each member of staff has a training profile. A selection was viewed. Training needs are identified at staff supervision and as well as statutory training dementia awareness, coping with Parkinson’s disease and adult protection are included. Two members of staff were spoken with. They confirmed that training is ongoing and the manager arranges for courses as and when they become available. Residents were very clear that staff were kind, cheerful and supportive. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 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 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) 31, 35 and 38 The registered manager has the experience and qualifications to run the home and meet its stated purpose, aims and objectives. The home provides a sound system to ensure residents’ finances are safeguarded. While policies, procedures and staff training generally are in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff, records of weekly fire alarm tests must be regularly maintained. EVIDENCE: The manager Mrs Preston had several years’ experience as the deputy manager at The Limes before becoming the registered manager during 2003. She has since achieved the NVQ Level 4 in care and has completed the training for the Registered Managers Award. She was able to demonstrate that she has undertaken periodic training in various care related subjects. One of the The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 19 proprietors Mrs Betteridge spends time in the home most days. Residents felt that they could approach both with confidence. It was understood from the manager that the majority of residents have family to represent them. Others are able to manage their own affairs or have a solicitor to help. The integrity of the system for administering residents’ monies was examined by way of dip-sampling. Receipts were kept of transactions and records and monies balanced. Records showed that a recent fire risk assessment had been carried out for the whole building. There are policies and procedures in place to ensure safe working practices in the home. A sample of records was viewed including accidents, COSHH assessments, TOPSS induction training and the electrical certificate, all of which were in good order. The recording of fire alarm and lighting tests was over one month behind. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 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 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 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x 3 x x 2 The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 21 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 38 Regulation 17(2) Sch 4 Requirement Records of weekly fire alarm tests must be regularly maintained. Timescale for action 26/5/05 Immediate requiremen t notice served. 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 9 Good Practice Recommendations Controlled drugs to be stored in a metal cabinet. The Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 Page 22 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, PO30 2AA 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 Limes H55-H04 S54200 The Limes V218052 260505.doc Version 1.30 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. 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. 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