Inspection on 11/02/08 for The Old Malthouse

This inspection was carried out on 11th February 2008.

CSCI found this care home to be providing an Adequate service.

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 Old Malthouse 10/02/09

The Old Malthouse 29/03/07

The Old Malthouse 17/10/05

The Old Malthouse 11/05/05

The Old Malthouse 21/02/05

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE The Old Malthouse 33 High Street Selsey Chichester West Sussex PO20 0RB Lead Inspector Sheila Gawley Key Unannounced Inspection 11th February 2008 10:00 X10015.doc Version 1.40 Page 1 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 The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 2 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 Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Malthouse Address 33 High Street Selsey Chichester West Sussex PO20 0RB 01243 605410 01243 602380 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Timothy Whites Ltd Laura Ann Bow Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34), Physical disability (6), Physical disability of places over 65 years of age (6) The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 6 service users in the category Physical Disability (PD) aged 50 years and over may be accommodated. 29th March 2007 Date of last inspection Brief Description of the Service: The Old Malthouse is a care home with nursing and is registered to provided accommodation for up to thirty two service users in the category older persons, six of who may also be aged 50 years and over in the category physical disability. It is a large detached property, which is located off the main road in Selsey village. The local shops, amenities, and the sea front are within walking distance of the home. Accommodation is provided in thirty single and one double bedroom located over two floors. There is a passenger lift between the floors and levelled access to all rooms. All bedrooms, except for one, have en suite facilities and in addition, assisted bathing facilities are also provided. There is a choice of sitting areas including two lounges and a dining area. Timothy Whites Ltd is the registered provider. The responsible individual, acting on behalf of the company is Mr David Appleby; Mrs Laura Bow is the registered manager. The fees charged are £450- £550 The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This site visit as part of the inspection was carried out on 11/02/08. The Registered Manager facilitated the inspection. The Commission for Social Care Inspection was in receipt of an Annual Quality Assurance Assessment from the home, which contained the information we required. Prior to the inspection all files held by the Commission including comments and complaints were reviewed. Any records or documents required on the day were made available. On the day two visitors completed surveys, the homes own surveys were available and where possible people who use the service were spoken to, all comments were positive. Two visitors were spoken to. Two specialist nurses were also spoken to on the telephone. What the service does well: Residents spoken to all stated that they are treated with kindness and respect. Meals are nutritious and varied. The changing needs of people who use the service are assessed and relevant action is taken. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, Standard 6 is not applicable People who use this service experience good outcomes in this area, as there is a clear assessment and admission process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service have their needs assessed prior to admission. These assessments were seen in the care plans inspected. Areas assessed include medical history, medication, nursing needs, routines, food likes, sleep, religion, mobility and moving and handling needs. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 People who use this service experience good outcomes in this area because all needs are assessed and met, set out in a plan and residents are treated with respect. Medicines are handled appropriately This judgement has been made using available evidence including a visit to this service EVIDENCE: All residents had a plan of care. Three people who use the service were case tracked their care plans and medicine administration charts were inspected. The care plans inspected contained information on health, nursing, personal and social need. The care plans were drawn up following an assessment of these needs. This included nutritional assessments, mobility, hygiene, continence, and pressure areas, and risk assessments. The risk assessments covered falls, nutrition, choking, wandering, skin assessment, nursing and personal care needs such as the number of carers to move the person or the The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 10 need for hoist to be used. The care plans were up to date and had evidence of monthly review. Weight is monitored. Blood glucose monitoring is in place for those people with diabetes as documented in the care plan. Access to specialist health support is available as required including general practitioner, chiropodists, and the palliative care team. Two nurses on the palliative care team were spoken to on the telephone. They stated that the nursing care offered to those people at the end of their lives was as they would recommend, one also went on to say that the home worked well with them and always contacted them appropriately. Care recommendations and instructions are followed correctly. Staff were observed offering care in a respectful and encouraging manner and people who use the service spoken to stated that they are treated with respect although one resident was seen being moved in a wheelchair without footplates and the absence of a functioning sluice poses a risk to the health of people who use the service. People who use the service and relatives spoken to stated that care is offered as assessed. Medicines are received, stored, administered and recorded appropriately. Medicine administration charts inspected were up to date. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use this service experience good outcomes in this area, because lifestyle in the home meets their expectations with activities in place to meet social needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One of the carers carries out activities with people who use the service from 24 pm every day. She stated that this is protected time. There is an improved activities programme in place and this is displayed on the notice board. This includes in house activities such as themed meals, sherry mornings, afternoon games/crafts and some external entertainers. There are also trips to the library, seafront and shopping. People who use the service spoken to stated that they were happy with daily life in the home. Activities participated in are recorded on an activities log. People spoken to also stated that they could receive visitors as they choose. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 12 People spoken to stated that they have freedom in daily routines such as when to go to bed and where to take meals. Visitor spoken to stated that they are made welcome in the home. The chef was spoken to. There is varied menu in place and choice is offered to residents. The meal seen prepared and served today appeared nutritious and people who use the service said they enjoyed it. Staff were seen offering assistance to those who required it to eat their meal. They were relaxed and chatting to the people who use the service. There were shortfalls in kitchen practices and hygiene and these are detailed in the environment section of this report. Two visitors were spoken to and they stated that the meals served always appear nutritious and appetising. One also said “This is a lovely home, I wouldn’t mind coming here”. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People who use this service experience good outcomes in this area, as there are policies and procedures in place for complaints and safeguarding adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure in place, which is on display. People who use the service spoken to stated that they were aware of the procedure, although all stated that they did not have reason to complain. Two visitors spoken to also stated that they did not have reason to complain but would know how to do so. There is the facility to record any complaints including actions and outcomes. There are policies and procedures in place regarding safeguarding adults and whistle blowing. Staff spoken to were clear about the procedures to follow in safeguarding adults allegations. Training records show that staff have training in safeguarding adults policies and procedures. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,25,26 People who use this service experience adequate outcomes in this area because they do not live in a safe and well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has neat and clean communal areas, two sitting rooms and dining areas. One sitting room is not easily accessible to people who use the service as it is accessed either via a bedroom or negotiating two stairways. A small number of bedrooms have been redecorated. Bedrooms are personalised. Carpets are worn in places and are stained. All rooms except one have ensuite facilities. Not all en suites are accessible to people who use wheelchairs. In most cases the grab rails had chipped paint, The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 15 some had ill-fitting linoleum, some had old stained mirrors and missing tiles or grouting behind the sink. Many rooms were without toilet roll holders. Several rooms do not have natural ventilation and two of these were malodorous. The kitchen was inspected and there were shortfalls in practice and hygiene. Food in fridges and freezers was unlabeled and undated. Some tiles were missing near the boiler flu. The sides of the cooker and an adjoining cupboard were dirty and stained. The cooker Knobs were stained. The floor under the dishwasher and cooker was dirty. There was not any soap in the dispenser for hand washing. Tea making facilities are kept in this area next to the sink and under the soap dispenser and therefore could be dripped on by anyone hand washing there. The need to ensure that people who use the service are protected from the risk of infection will be a requirement of this inspection. Aids hoists and wheelchairs are in place, however a resident was seen being moved in a wheelchair without footplates. Another was moved in a chair inappropriate for the task. There is a sluice room but the sluice does not work. Staff spoken to stated that it has not worked for years. The registered manager had documentation showing that the proprietor had been informed of this but action had not been taken. The provision of a sluice and the need to ensure that people who use the service are protected from the risk of infection will be a requirement of this inspection. This was discussed with the registered manager. Some doors are equipped with automatic door closure devices but these, as well as those without closures were wedged open. This was discussed with the registered manager who stated that some rooms are not suitable to fix these door closures. The need for the Registered Manager to seek clarity on this issue from the fire authority will be a requirement of this inspection. The plans to renovate and refurbish the home that the Commission and the Environmental Health Department had been informed were to take place, which included addressing the rooms without windows and refurbishing the kitchen, have not occurred and the registered manager when asked stated that these had been put on hold. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 16 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use this service experience good outcomes in this area because needs are met by a staff trained and qualified to do so. This judgement has been made using available evidence including a visit to this service EVIDENCE: There was sufficient staff on duty to meet the residents care needs as detailed in the care plans. Most staff spoken with confirmed that they were happy with staffing levels and that this was good place to work, one did say however that she felt an extra staff member could have been called in at the weekend when the admission of a person with high need occurred. People who use the service and their visitors spoken to stated they were happy with the number of staff at the home and found them to be kind and caring. They confirmed that they were well cared for. Training files were seen and staff confirmed that induction, mandatory and National Vocational Qualifications are provided. An external training provider gives all mandatory training. The registered manager operates a Policy of the Month system whereby a policy is chosen and staff must read and sign that they have read and understood. Two staff files were checked they showed that the home had undertaken all the necessary checks to ensure protection of residents. Two references were The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 17 in place and Criminal Records Bureau Clearance and POVA checks had been undertaken. The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 36,38 People who use this service experience adequate outcomes in this area because the home is run in the home is run in the best interests of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 19 The Registered Manager has been in post three years and is a Registered Nurse. She undertakes the training required to maintain registration with the Nursing and Midwifery Council. She also holds the Registered Manager Award. The care practices she has put in place for the people who use the service offer good outcomes. Discussion with the Registered Manager could not evidence clear lines of accountability. The registered manager often has to talk to the general manager before speaking to the registered provider. She feels this is a barrier to the efficient running of the home and has hindered the upkeep of environmental standards. That the Registered Manager be enabled to fulfil her duties in relation to the upkeep of the home and the provision of facilities required by a care home offering nursing will be a requirement of this inspection Quality assurance systems are in place to elicit opinion from the residents on how the home is run. There are quarterly staff meetings. Regular management meetings have not resulted in the improvement of the physical environment. The home has facilities if requested to, hold money for people who use the service separately, securely and it would be recorded. Staff are supervised and records of this were seen in staff files. The health and safety of residents and staff are ensured by the provision of mandatory training and policies on health and safety. Evidence of utility and equipment testing and maintenance is held and was available for inspection The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 2 The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 21 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 OP19 Regulation 23 (4) (C) (i) Requirement The registered provider must ensure the home meets the requirements of the local fire department in relation to the containment of fires. The premises must be kept clean, hygienic and free from offensive odours throughout, including the kitchen area and areas likely to harbour infection such as chipped tiles, damaged flooring to be repaired The registered person must provide a sluice. Timescale for action 10/03/08 2 OP21 13 (3) 10/03/08 3 4 OP26 23 (2) (k) 13,16,23 10/03/08 OP31 The registered provider must 10/03/08 ensure that there are clear lines of accountability in the home and that the job description of the Registered Manager enables her to fulfil her duties The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Malthouse DS0000062340.V357073.R01.S.doc Version 5.2 Page 24 - 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. 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