Inspection on 27/07/05 for The Noel

This inspection was carried out on 27th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

The Noel 04/06/09

The Noel 28/04/09

The Noel 30/01/09

The Noel 17/03/08

The Noel 24/01/07

The Noel 01/02/06

The Noel 07/10/04

The Noel 07/04/04

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 Noel St. Boniface Road Ventnor Isle of Wight PO38 1PN Lead Inspector Annie Kentfield Unannounced 27th July 2005 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 Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Noel Address St. Boniface Road, Ventnor, Isle of Wight, PO38 1PN 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 852292 Miss S V Phillips Miss S V Phillips Care Home 12 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (12), of places Physical disability over 65 years of age (4) The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2004 Brief Description of the Service: The Noel is a large period house on the outskirts of Ventnor enjoying fine sea views to the front and views of St Boniface Down at the back. The home is owned and managed by one person and although registered for 12 older people, has 8 residents, as the owner prefers to provide single accommodation and the double rooms are used only if residents choose to share. The owners philosophy of care is to provide tailor made care that is relaxed and flexible to suit the individual needs of frail older residents. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place in the afternoon. The manager explained that two of the staff were unexpectedly away and the rota had been re-arranged to cover this. This meant that the manager was preparing and cooking lunch and tea so it was agreed that the inspection would focus on discussion with the residents and some of the staff. Some records were looked at but these will be inspected in more detail at the next inspection. The inspection also included a tour of the premises. At the time of the inspection there were 7 residents in the home with the manager and two members of staff. Inspection comment cards were left for residents and visitors to complete and return if they wanted to. What the service does well: What has improved since the last inspection? What they could do better: The building is in need of some re-decoration and refurbishment: the first floor bathroom needs to be renewed and the hallways require decoration. The building exterior requires windows to be repaired and painted. A requirement has been made for the registered manager to provide a maintenance programme that indicates the timescale planned for all of the above work to be completed. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 6 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 Noel H55-H04 S12516 The Noel V218458 020805 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 Noel H55-H04 S12516 The Noel V218458 020805 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) 4 & 5 New residents are not admitted to the home without an assessment of their care needs. Prospective residents are able to move into the home on a trial basis before making a decision to stay. EVIDENCE: The owner/manager is very clear about the level of care that the home can offer given the particular layout of the house, staffing etc. and does not admit anyone to the home unless it is clear that all individual care needs can be met. The manager is able to access specialist community services to meet individual care needs and has good working relationships with the GP practices and community health services, and care managers from Social Services. The manager is happy to be as flexible as possible and residents are asked to provide notice of one week if they wish to make alternative arrangements for their care and accommodation. The home does not offer intermediate care but will offer respite care if there is a room available. The Noel H55-H04 S12516 The Noel V218458 020805 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) 8,10,11 Residents’ health care needs are fully met. Residents’ rights to privacy, dignity and respect are maintained at all times. EVIDENCE: It was evident from discussion with the residents that all health care needs are fully met by the staff in the home and the appropriate community health specialists, GPs and District Nurses. Residents’ health care needs are monitored daily and where appropriate, referral is made to other services, usually via the resident’s GP. The home has its own mobility aids and equipment for the use of residents, and staff monitor the need for the prevention or treatment of pressure sores and ensure that residents have the necessary pressure cushions, mattresses etc. The manager demonstrated a good knowledge and awareness of the health care needs of older people and is confident about accessing the appropriate services and equipment needed to maintain the residents’ health and welfare. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 10 All of the residents said they were very satisfied with the high level of care and attention that they receive from the staff in the home and it was evident that privacy and dignity are maintained at all times. Care is provided in the way that residents choose. The manager and staff have a great deal of experience and skill in providing palliative care and also work closely with specialist palliative care agencies when appropriate. The philosophy of the home is to ensure that residents’ wishes regarding terminal care and arrangements after death are discussed with the resident and/or family and recorded. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 The routines of daily living in the home are flexible and informal. Residents maintain contact with friends and family as they wish. Residents are offered a choice of menu to meet their needs and preferences. EVIDENCE: The manager is committed to ensuring that daily life in the home is organised around the choices and preferences of the residents. Times for getting up and going to bed are agreed by the individual residents. Meals can be taken in the sitting room, or in individual bedrooms, as residents choose. It was clear from talking to residents that they are happy with the way that daily living activities are arranged in the home and expressed their satisfaction with the “lovely, home-cooked food” that is offered. Staff in the home are careful to ensure that any special dietary needs are catered for and are prepared to go to great lengths to ensure that meals are attractively and nicely presented. Visitors are always welcome in the home and some of the residents have friends and family who live locally. The home does not have a formal programme of leisure and social activities, however, residents said that they prefer to spend their day as they choose and The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 12 had no wish to take part in organised activities. Staff are always willing to assist residents with games, activities, or outings, wherever possible. Some of the residents enjoy trips out with family and friends. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 - 26 Residents live in a safe and comfortable environment. The home is clean and tidy and all of the bedrooms are single. Although the environment of the home does not meet all of the National Minimum Standards, residents are very satisfied with the accommodation provided. EVIDENCE: Houses in this part of Ventnor are built on several floors with steps up from street level. Although the location of the home and the fine views it offers are enjoyed by the residents, the home is not easily accessible for those residents who need some assistance with mobility. The home does not have a shaft lift and the ground floor is accessible by steps or an outside stair lift from the street, with stairs or a stair lift from the ground to the first floor. Residents do not have access to the basement that houses the kitchen, laundry, office and the owner’s and staff accommodation. The garden area at the back is not easily accessible, independently, for residents. It was evident that the layout of the building and the absence of a passenger lift do restrict the residents’ mobility and independence. However, all of the The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 15 residents were aware of this and said that they would still prefer to be in the home, in spite of the difficulties of using the stairs or the stair lift. The home has a comfortable sitting room but no dining room, however, most of the residents prefer to spend time in their own rooms and use the sitting room on occasions, if they wish to. Some residents like to take their meals in the sitting room and there is a dining table or individual tables, as they choose. The sitting room is light and sunny with fine sea views and is comfortably furnished in a homely way. The bedrooms vary in size, but all of them provide enough space and comfortable furniture for the rooms to be used as a bed-sitting room if residents choose to. Residents are encouraged to furnish their rooms with their own possessions if they want to. There is a call alarm system in the home and residents confirmed that staff always respond promptly if the call system is used. Bedrooms have a wash-hand basin and there are two bathrooms for residents, one on the ground floor and one on the first floor. They both have handwashing facilities that meet infection control procedures with liquid soap and paper towels provided. Both bathrooms have assisted bathing facilities and grab rails. Laundry is carried to the basement in self-closing bags and the recommendation to seek advice from the Environmental Health Department, at the last inspection, has been carried out. The manager confirms that the laundry facilities meet the requirements for safe working practice and infection control. The home was clean and tidy and there were no unpleasant odours in any part of the home. The ground floor bathroom was renewed fairly recently and at the last inspection the manager said that the same would be done to the first floor bathroom. This bathroom is now badly in need of decoration and refurbishment and new flooring, and a requirement has been made for a maintenance programme to be provided, to demonstrate when the bathroom and other decoration and refurbishment work will be carried out. One of the first floor bedrooms has cracked glass in the sash window and the window needs painting. The exterior of the building also needs some maintenance and the exterior windows painted. Some of the bedrooms have been decorated and have new carpeting since the last inspection and the sitting room was decorated and refurbished quite recently. Other parts of the home (hallways and stairwell) are in need of redecoration. However, the manager explained that although bedrooms can be decorated and re-carpeted when they became vacant and before a new resident moves into the home, it was very difficult to arrange for bathrooms The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 16 and communal areas to be decorated without greatly inconveniencing the residents and this was the main reason why the work has not yet been carried out. This work needs to be planned with this in mind. Residents said that the home is warm and comfortable and “homely” and that they have everything they need. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 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) 27,28,30 Staff in the home are skilled, competent and qualified and there are sufficient staff to meet the care needs of the residents. EVIDENCE: At the time of the inspection there were two care staff and the manager on duty and this was sufficient to meet the needs of the 7 residents. There is a stable staff team of 6 with one person available to work as and when required. Staff enjoy working in the home and staff turnover is very low. One person is responsible for cooking and has an NVQ in food hygiene and all of the staff have either achieved, or are about to achieve the NVQ level 2 or 3 in care. Feedback from the residents was very positive about the “wonderful care” that staff in the home provide. As a small home, staff supervision is informal but ongoing, but the home is clearly well run and organised and staff work closely with the manager and feel well supported and are prepared to be flexible to meet the needs of the residents at all times. There is one waking member of staff on duty at night, with the manager also available whenever needed. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 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) 31,32,38 The home is well managed and run in the best interests of the residents. EVIDENCE: The owner/registered manager has many years of experience in providing care for frail older people and is very knowledgeable and familiar with the conditions and diseases associated with old age. The manager does not have formal qualifications in care or management and has no plans to achieve them. However, although the registered manager does not meet the National Minimum Standards qualification recommendation, the evidence from the residents and staff, and comments from health and social care professionals, and relatives and visitors, is that the home is well managed and well run, and the care needs of the residents are fully met. The management approach of the home is open and positive and the manager is always available and very approachable at all times. The manager has excellent communication skills and is pro-active and flexible in ensuring that The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 Page 19 the needs of the residents are met and their choices and preferences always valued. The home was inspected in March of this year by the Environmental Health Officer and there were no recommendations or requirements. The manager confirmed that all fire equipment in the home is serviced annually and that fire safety systems are checked and tested weekly. The manager also confirmed that the home has a fire safety risk assessment. The Fire Safety Officer was consulted last year and advised the manager on installing self-closing devices on some of the doors and this work has been carried out. The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 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 x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 2 3 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 3 x x x x x 3 The Noel H55-H04 S12516 The Noel V218458 020805 stage 4.doc Version 1.40 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 19,20,21 Regulation 23 Requirement A programme of maintenance and refurbishment must be provided to the Commission that demonstrates when the first floor bathroom will be be renewed, the exterior windows re-painted and the first floor window repaired and re-painted. The most urgent work is the first floor bathroom and repairs to the first floor bedroom window. Timescale for action 30 September 2005 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. 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