Inspection on 22/06/05 for The Old Library

This inspection was carried out on 22nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Old Library 22/01/09

The Old Library 09/01/08

The Old Library 31/01/07

The Old Library 01/02/06

The Old Library 10/03/05

The Old Library 16/08/04

The Old Library 26/03/04

Similar services:

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Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Old Library Isaacs Hill Cleethorpes North East Lincs DN35 8JR Lead Inspector Kate Emmerson Unannounced 22nd June 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 Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Old Library Address Isaacs Hill Cleethorpes North East Lincs 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) 01472 601364 Mr charles William Jackson Position Vacant Care Home 30 Category(ies) of OP (30) registration, with number of places The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 March 2005 Brief Description of the Service: The Old library is a 30-bedded care home registered for older people. The accommodation is set in a Victorian style building, retaining much of its original features. It is set in the seaside town of Cleethorpes, with views of the main thoroughfare to the sea front. The home’s ownership has remained stable for a number of years and many staff have been retained by the home, which has given a great deal of stability to the service users. The current acting manager has yet to be approved by the CSCI. There are eighteen single rooms and six shared rooms; one of the shared rooms has en-suite facilities. The home has two lounges and an adjoining dining area; all rooms are decorated and furnished to a good standard. There are bathroom and WC facilities located on each floor. The home has equipped itself with a variety of aids to accommodate the dependency of the service users’ in the home. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over one day in June 2005. To find out how the home was run and if the people who lived there were pleased with the care they got the inspector spoke to the manager and 3 of the staff working in the home at the time of the inspection. The inspector also spoke to 7 people who lived in the home and 1 visitor. Some of the records kept in the home were checked. This was to see how the people who lived in the home were being cared for, that staff were safe to work in the home and that they had been trained to their job safely and to make sure that the home and the things used in it were safe and were checked regularly. The home was checked to see if it was kept clean and tidy. What the service does well: The manager visited residents before they arrived at the home to see if their needs could be met and then a detailed care plan was developed so the staff knew what care the person needed. The residents said that there were plenty of things to do at the home and there were regular outings. The staff were very keen to be involved in the activities at the home and were raising money through sponsored events for a summer house and a green house for the residents. The residents said that their visitors were made to feel welcome and the visitor spoken with said they were invited to events in the home and that the staff made the events fun. The residents said that the food was good and that there was always a choice, the staff were good at helping people if they needed it. The home provided very comfortable and clean and tidy accommodation. The manager made sure that the health and safety of the residents and staff were protected through staff training and procedures in the home. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 6 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 Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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 Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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) 2 and 3 The home provided each service user with a written contract/statement of terms and conditions. The service users needs were assessed before admission and service users were informed that their needs could be met at the home. EVIDENCE: A detailed contract had been developed and provided to all the service users. The home only kept a copy of the page that had been signed as evidence that the document had been provided with the exception of 3 service users who were unable to sign/understand and had no family involvement. The manager was advised to also maintain a copy of the areas that record the room no and the fees agreed. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 9 The manager had further developed the assessment documentation in the home following advice at the last inspection. The information recorded identified service users needs and care plans had been developed from the information gathered. The inspector examined 3 care programmes and there was evidence that the assessment documentation had been completed. The majority of the information had been completed pre- admission with further assessment activity carried out following admission. There was some evidence that copies of local authority care summaries and care plans had been obtained. The manager now confirmed in writing to the service user that having regard to the assessment the care home was suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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 and 8 There were detailed care programmes in place to support the care that was given in the home. The care plans must be further developed to include plans to minimise risk. The service users did not always have the opportunity to agree to their care plans and risk assessments. EVIDENCE: The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 11 The inspector examined three care programmes. The care programmes comprehensively covered the majority of needs identified from assessment, There was evidence in the programmes that individual risk management was good; risk assessments for moving/ handling, tissue viability, falls, nutrition, bed rails and general issues were in place and reviewed regularly. However where an area of high risk had been identified, an associated care programme to identify how the risk would be minimised through care provision had not been developed. This was particularly evident where the risk assessment showed a high risk of pressure sore development. Daily records were well maintained and detailed. All programmes were regularly evaluated although the care plans had not always been updated to reflect changes. The manager had identified that there were some issues relating to how service users dietary needs were being assessed and met. The dietician at the local hospital had been contacted and a nutritional screening tool was now in place and the dietician monitored these monthly. Diet sheets had been provided to meet special needs. Although some of the service users stated that they knew they had a care plan, there was little recorded evidence that the service users had seen or agreed to their care plans and risk assessments. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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) 12, 13 ,15 The home provided the service users with opportunities to satisfy their social and religious needs. The home was welcoming to the visitors. The service users were provided with good quality meals that were appropriate for their needs. EVIDENCE: The service users stated that the home provided plenty of opportunity for activities and outings. The manager stated that some of the local care homes had formed an activities group and service users meet up for various events. Ladies days and gent’s days are arranged to offer different topes of activities. She stated that the home had just organised an activities team. The activities available were displayed for the service users. The staff were very proactive in arranging and joining in activities and were willing to dress up, as in the recent VE day celebrations and complete The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 13 sponsored events to raise money. The staff were raising money for a green house and summer house for the garden. The service users were able to go to a club at the Salvation Army and another service user attended Old Clee church. The visitor stated that they were made to feel welcome and were invited to join in events in the home and stated that the staff injected fun into the events. All the service users spoken with stated that the food in the home was good, choices were always available and alternatives would be provided where necessary. They also stated that they had home baking. Staff were seen assisting service users in a sensitive manner and food was presented to meet individuals needs. Discussions with the cook and the staff at the previous inspection identified that the home would benefit from the provision of a Bain Marie to improve arrangements for the serving of meals however due to the limited size of the kitchen and storage areas, it had been decided that this equipment could not be easily and safely stored. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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 service users had access to a well-developed policy and procedure for complaints and felt comfortable to use this if necessary. EVIDENCE: The complaints procedure had been further developed since the last inspection and timescales for investigation had been included. The procedure was on display in the home. The service users stated that they would feel confident to complain if necessary. Staff were knowledgeable about the complaints procedure. The commission had received a complaint just prior to the inspection and the manager had been requested to investigate this. Preliminary findings were that this complaint was not founded. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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, 24 and 25 The home provided a very comfortable and homely environment. It was clean and tidy and well maintained. The home and gardens were accessible to all the service users accommodated. The hot water systems in the home were still a cause for concern, with regard to sufficient temperature for the kitchen outlets and appropriate Legionella control. EVIDENCE: The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 16 The home was located in a very central area, close all the local amenities and sea front. The home had three floors that were accessed via stairs or passenger lift. The general condition of the furnishings and decoration was of a good standard; redecoration and refurbishment was ongoing. The manager had completed audits of all the bedrooms, which detail all the furniture and belongings; the documents needed to detail if any furniture has been withdrawn through risk or choice. All areas seen as part of this inspection were clean and tidy, including the grounds. All service users rooms were individually and naturally ventilated, the central heating could be adjusted in the room; all radiators had low temperature surface covers fitted. Restrictors had been fitted to appropriate windows. There was evidence that the manager had discussed the provision of privacy locks with the service users and risk assessments had been completed. The locks had yet to be fitted but the manager stated that the time scale set at the last inspection would be met. A random selection of outlets were tested including bathrooms and problems with hot water temperatures at outlets accessible to service users had been resolved since the last inspection. However discussions with the manager indicated that the water system in the home was a pressurised system and hot water was not stored, lessening the risk of Legionella. To ensure that the hot water temperatures were at safe levels for service users the water temperature was maintained at 43 deg C throughout the home. This is not an adequate temperature for use in the kitchen. The manager was requested to provide evidence from the plumber with regard to the hot water system and Legionella controls required in the home and take advice from Environmental Health regarding the hot water temperature in the kitchen. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.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) 27 and 29 There were some indications that the staffing levels may not be adequate to meet the needs of the service users at times. The manager had little evidence to show how the decisions were made in relation to staffing levels. The recruitment procedures in the home were not being adhered to and this does not afford adequate protection for the service users. EVIDENCE: The home is registered for 30 service users and at the time of the inspection there were 24 service users accommodated. The manager stated that 3 service users were high dependency 2 were medium and 19 were low dependency. The staffing was arranged so there were 3 carers on duty during the day and Monday to Friday there was the manager and deputy manger on duty until 5pm. At night there were 2 carers on duty. There were differences of opinion from the staff group as to whether there was sufficient staff on duty. Some felt that the dependency of the service users had increased recently and at weekends particularly they were very stretched. There was only one negative comment from service users and a visitor regarding staffing when one indicated that they were slow to answer bells at times. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 18 The manager stated that she used the residential forum to assess the required staffing levels but there was little evidence of this. Adequate numbers of staff were employed in catering, domestic, maintenance and administration capacities. The home had policies in place for recruitment and selection, equal opportunities, staff grievance, disciplinary, and working with volunteers. At the last inspection the inspector noted that not all the staff had CRB checks. The manager had audited the files and provided evidence that these had now been sent for. Discussion with recently employed staff and examination of records showed that the manager did not obtain all the required checks prior to employment. In 3 cases there was no ID, in 2 cases there was no CRB checks completed and in one case there was no references. The manager stated the reasons for this were that they had worked at the home before or were known to her. The manager was advised that his does afford adequate protection for the service users. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 19 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, 36 and 38 The manager was experienced and had had a positive effect on the home. She has still to complete the registration process to be the Registered Manger. The manager positively promotes the health and safety of the service users and staff. EVIDENCE: The acting manager Sue Heppleston was appointed and commenced employment at the home on the 2/08/04. The Commission had received her application to register as manager for the home and this was currently being processed. There had been a delay in this process, as the manager had not completed the CRB forms. This was completed at the inspection. The manager had been proactive in her role and had made many positive changes in the home. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 20 She had worked hard to meet the requirements from previous inspections. Most of the staff stated that the atmosphere in the home was more positive and that the manager and senior staff were approachable. There had been significant investment in the staff training and the home had been awarded the Investors in People Award. There was evidence that the home offered staff support and supervision through regular one to ones and meetings. The manager had regular meetings with the proprietor. The manager had developed format for the Registered person to complete the Regulation 26 reports but these had not been implemented at the time of the inspection. There was no evidence that the proprietor had developed a current business plan for the home as requested at the last inspection. The manager was clearly aware of the legislation to protect the health, safety and welfare of service users and staff in the home. One of the senior care staff had lead responsibilities in this area and had accessed a health and safety course through the local college. There was evidence that staff have undergone moving and handling, infection control, fire safety, basic food hygiene, health / safety, COSHH and first aid training. Records to support fire safety and equipment checks were in place and up to date. At the last inspection the inspector noted that the Appollo bath had last been serviced by the registered provider in July 2004; advice was given to the manager to ensure that the bath seat was checked for load bearing capacity and not just” working order”. The manager was still looking for an appropriate person to complete this testing. Accident reports were followed through and individual risk assessments reviewed accordingly; the manager audited all accident records monthly and maintained records of all further action taken. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 21 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 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 2 x STAFFING Standard No Score 27 2 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x x x x 2 The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 22 yes 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 OP7 and 8 Regulation 15 Requirement The registered person must ensre that where areas of risk have been identified care plans are developed. (Previous timescale of 31May 2005 not met) The registered person must ensure that the serivce users or their representative agrees and signs the care plan and risk assessments. The registered person must provide evidence from the plumber with regard to the hot water system and Legionella controls required in the home and take advice from Environmental Health regarding the hot water temperature in the kitchen. The registered person must fit privacy locks to all service users private accommodation. The registered person must keep clear recoerds to show how the decisions about the staffing provided have been made and ensure that his adequate staff are on duty to meet needs of Timescale for action By 31 August 2005 2. OP7 15 By 31 August 2005 By 31 July 2005 3. OP25 13(4) 16(2)(j) 4. OP24 23 5. OP27 18(1) Previous timescale stands -by 31 July 2005 with immediate effect The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 23 the serivce users 6. OP29 19 The registered person must ensure that all the inforamtion as listed in Schedule 2 is obtained prior to employment of staff in the home. The registered person must complete a report to support formal visits to the home and provide copy to the Commission. (Previous timescale of 31 May not met) The registered person must provide a current business plan for home. (Previous timescale of 31 May 2005 not met) with immediate effect 31 August 2005 7. OP37 26 8. OP34 25 31 August 2005 9. 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. 2. 3. 4. Refer to Standard OP3 OP24 OP35 OP38 Good Practice Recommendations The registered person should keep a copy of the contract which states the fees and room no. The registered person should ensure room audits detail if the furniture is removed removed through choice or risk. The registered person should expand the policy and procedure to include the safe keeping of valuables. The registered person should explore the need for the Apollo bath seat to be tested for weight bearing capacity during the servicing. The Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit 3, Hesslewood Country Office Park Ferriby Road Hessle East Yorkshire HU13 0QF 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 Old Library J54 Old Library S2908 V233368 22.6.05 Stage 4.doc Version 1.30 Page 25 - 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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