Inspection on 29/03/07 for The Old Malthouse

This inspection was carried out on 29th March 2007.

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 Old Malthouse 10/02/09

The Old Malthouse 11/02/08

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 Mrs J Hough Unannounced Inspection 29th March 2007 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.V331467.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.V331467.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.V331467.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. 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 premises, which is located off the main road in to Selsey village. The local shops and amenities, and the sea front are within easy walking distance of the home. Accommodation is provided in thirty single and one double bedroom located over two floor. 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. the home is about to undergo extensive refurbishment. Timothy Whites Ltd is the registered provider and privately owns the service. The responsible individual, acting on behalf of the company is Mr David Appleby; Mrs laura Bow is applying to the Commission to be the registered manager. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection was undertaken by June Hough Regulatory Inspector on 29th March 2007 from 10:00 hours to 17:20 hours. Information and planning for the inspection was taken from the pre-inspection questionaire completed by the registered person, and evidence from the previouse inspection report. Further evidence for this inspection report was gained during the inspection site visit. A tour of the premises took place and residents and staff were spoken with. Records were read with regard to resident’s care plans and assessments, risk assessments, complaints, accidents, and medication. The current fees are from £359.74 to £798.00 per week. What the service does well: The home employs an activity co-ordinator and residents are offered a variety of activities taking into account their interests and wishes Residents are able to furnish their rooms with their own possessions and small items of furniture. Residents praised the staff saying they were kind and caring and attended to all their needs. Staff are given the training necessary for their work and care assistants are supported and encouraged to obtain the National Vocational Qualifications. The home is managed and run well by an experienced manager who residents and staff say is very approachable and available to speak with when needed. The home has a team of staff who are dedicated to their work and the home at present has no need to use agency staff. The Old Malthouse DS0000062340.V331467.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.V331467.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.V331467.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have a detailed needs assessment carried out prior to any agreement being made for admission into the home. EVIDENCE: Pre-admission assessments are completed for all residents expressing a wish to move into the home to ensure the home is able to meet the needs of residents. The registered manager or deputy manager visit prospective residents to carry out detailed assessments outling the resident’s health, personal and social care needs. The Old Malthouse DS0000062340.V331467.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have a detailed care plan that shows the level of care they need in relation to their health, personal and social care needs. Medication procedures for the home ensure safe practice in the administration, storage and disposal of medicines. Records for adminstration of medicines are well maintained. Residents privacy and dignity is respected by staff. EVIDENCE: Care plans seen were detailed in outling the needs of residents and the level of assistance required. Risk assessments were completed for moving and handling, nutrition and falls. Care plans are reviewed by the keyworker allocated to each resident. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 10 Residents spoken with said their needs were met by the staff who were kind and considerate. One moving and handling assessment identified the need for the use of a hoist or stand aid for transferring the resident. During discussions with the registered manager it was advised that to ensure safe practice when transferring the resident, the assessment could be more detailed in outling what influences the choice of equipment used. The home has three mobile hoists and two stand aids. Wound care charts are completed where appropriate giving a detailed account of dressings used with regular evaluation of the problem. District nurses and the tissue viability nurse are consulted when needed. The home has a good supply of pressure-relieving equipment that includes air mattresses and propad cushions. Residents are supported to access specialist medical services when needed and a chiropodist and optician visits the home. The medication administration records were accurately maintained and each chart contained relevant details about the resident including allergies and a photograph of the resident. Controlled Drugs are recorded and stored appropriately. Medicines that are disposed of are recorded on the used medication administration records and signed by staff. All medicines are administered by the registered nurses. Residents spoken with felt their privacy and dignity was respected by the staff. However some of the resident’s rooms had an observation window along the corridors that was felt could compromise the privacy and dignity of the residents residing in those rooms. This was discussed with the manager who said that blinds and curtains were available if requested. The Old Malthouse DS0000062340.V331467.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a varied programme of activities that are arranged taking into account their interests and wishes. Residents can have visitors at any reasonable times to ensure they maintain links with their families and friends. Residents have a good choice of meals on offer that are nutritious and wellbalanced. EVIDENCE: The home employs a full- time activities co-ordinator who arranges and facilitates the activities within the home taking into account the interests and wishes of residents. An activities board is displayed in the home that shows a varied programme of activities is offered to residents. The home has purchased equipment for specific activities such as floor basket ball, target practice and bingo. Other events include a reminisence session, The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 12 music for health, card games, arts and crafts, shows, parties and outside entertainers. Aromatherapy and manicures are also arranged. For those residents who do not wish to participate in group activities and choose to stay in their rooms , one to one sessions are arranged. A sample of the four-week menus were seen and a varied nourishing diet is offered. The menus are developed taking into account the food likes and dislikes of residents and resident’s dietary requirements were displayed in the kitchenette areas. An alternative is provided if residents do not want the main meal on offer. Menus offer a vegetarian meal and it was noted that some residents choose to have three light snacks during the day instead of a large main meal. Residents spoken with generally liked the food although some made comments that the meat was sometimes too tough to eat. Visiting arrangements for the home are open and visitors can come at any reasonable time. Residents spoken to said that their visitors were made welcome into the home. The Old Malthouse DS0000062340.V331467.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure and residents felt confident and able to speak with the registered manager should they have any concerns or complaints. The home’s policies and procedures and training for staff on abuse ensure the residents are protected from harm as far as practicable. EVIDENCE: The home has a complaints procedure that is displayed in the home for information. The complaints log was seen and the home had recorded three complaints in the last year that had all been resolved satisfactorily. All complaints were recorded giving details of the investigations, actions and outcomes. Residents spoken with said they would not hesitate to speak with the manager should they have any issues or concerns. The pre-inspection questionairre completed by the registered manager shows that staff have regular training in all aspects of care that is provided by an external training group. Staff have attended training in the protection of vulnerable adults within the past three months. The home had policies and procedures in place for the protection of vulnerable adults. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 14 Staff spoken with understood their responsibilities in needing to report any allegations, suspicions or incidents of abuse in the home. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, clean and fresh home. Resident’s private accommodation suits their individual needs. EVIDENCE: A tour of the premises was made and all areas of the home were fresh and clean throughout. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 16 Decorations in the home are generally good except for some corridors that need re-painting. Eight bedrooms have been painted since the last inspection and some toilet seats, commodes and frayed carpets have been replaced. All resident’s rooms are single with en-suite facilities of a toilet and washbasin. Communal space consists of two small lounges and a dining room. Residents are able to furnish their rooms with their own possessions if wished. Resident’s bedroom doors do not have locks unless residents request to have one fitted. At the last inspection it was noticed that some resident’s bedroom doors were kept open with door wedges. Ten door guards had now been fitted for this purpose. However some of the bedrooms are unsuitable to have door guards fitted due to the positioning of the fitted wardrobes. The registered manager confirmed that advice was obtained from the local fire service but no alternative device for these rooms was given. Risk assessments are in place for those residents who choose to have their bedroom doors open. Further research should continue to find an alternative device from door wedges where the present door guards are not suitable. The laundry facilities in the home are suitable for the size and number of residents. There are two industrial washing machines and one drier. A laundry assistant is employed and infection control procedures are in place ensure that linen is handled appropriately to prevent the spread of infection. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff undergo all the necessary checks prior to working in the home to ensure residents are protected from harm. There are sufficient numbers of staff working in the home to meet resident’s needs. New staff have induction training that assesses their competence in all aspects of care. EVIDENCE: Staff rosters show that staffing numbers have been reduced due to the present number of residents living in the home. Staffing numbers are reviewed and changed taking into account the needs and numbers of residents. Staff and residents spoken with felt the levels of staff are sufficient to meet the resident’s needs. Residents said the staff are kind and caring and attended to all their needs. Four staff files were seen of new staff employed in the home. All the relevant checks were carried out on staff prior to them working in the home. The The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 18 recruitment of overseas staff was through an employment agency who confirm that all the necessary checks have been completed. Some information with regard to overseas staff such as application forms and references were not available on staff files, as retained by the agency. Where face to face interviews are not possible prior to employment of overseas staff the home carries out a telephone interview prior to employment. All new staff commence on an induction programme that includes one week of supervised practice. Staff handbooks are completed within the first three months of employment that include all aspects of care. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is managed and run by a competent and experienced manager. The management style practiced in the home is open giving residents, staff and relatives opportunities to speak with the manager when needed. Staff in the home have regular supervision of their work practice. Resident’s and relatives views on the home are gained from satisfaction surveys. The surveys are in the process of being further developed to include the views of other health professionals and people who use the service. Resident’s health and safety is protected as far as practicable. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 20 EVIDENCE: The registered manager Laura Bow has been the registered manager of the home since February 2006. Laura is a registered nurse and has worked in the home for several years as the deputy manager prior to her new appointment. She has also obtained the registered managers award. Staff and residents said she was approachable and they felt able to speak with her on any matters. Some of her time is spent working with the staff and provding care to the residents as well as having her managerial responsibilities. Staff confirmed that they receive formal staff supervision at least every two months that includes observations of work practice and identifying training needs. Satisfaction surveys are given out to residents and relatives twice a year to gain their views on the home. The home is in the process of developing surveys for other health professionals to gain their views of the service. Feedback from surveys is acted upon as needed. Accidents, injuries and incidents are recorded and reported to the appropriate authorities . Staff training and policies and procedures on health and safety issues are in place to ensure safe working practices within the home. The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 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 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 3 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 3 X X X X X X 3 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 3 X 3 X X 3 X 3 The Old Malthouse DS0000062340.V331467.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Old Malthouse DS0000062340.V331467.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.V331467.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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