Inspection on 23/08/05 for The Queensmead

This inspection was carried out on 23rd August 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 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 Queensmead 17/11/08

The Queensmead 19/12/06

The Queensmead 23/01/06

The Queensmead 21/02/05

The Queensmead 31/08/04

The Queensmead 19/12/03

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

CARE HOMES FOR OLDER PEOPLE The Queensmead Victoria Road Polegate East Sussex BN26 6BU Lead Inspector Kathy Flynn Announced 23 August 2005 10:00 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 Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Queensmead Address Victoria Road Polegate East Sussex BN26 6BU 01323 487931 01323 488120 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) Chanctonbury Healthcare Limited Mrs Madeleine Marshall Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (OP) 37 of places The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The maximum number of service users to be accommodated is thirty-seven (37). 2. Service users should be 65 years or over on admission. Date of last inspection 21 February 2005 Brief Description of the Service: The Queensmead is registered to provide personal care for up to 37 older people, over 65 years of age. The home is situated in a residential area of Polegate, it is close to the towns high street with shops, the library and public tranport within walking distance. There is a large lounge that is used for social activities, a separate dining room, a conservatory at the front of the building and smaller seating areas near reception and on the first floor. A shaft lift enables residents to have access to all parts of the building and there are attractve gardens surrounding the home with seating areas and a parking area to the front of the building. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the home was informed of the date and time of the inspection several weeks before it was carried out. The requirements from the previous inspection, the information provided in the pre-inspection questionnaire, which is completed by the manager, and the comment cards completed by residents or relatives, were used to plan this inspection. The aims were to assess if the home had met the requirements, identify the aspects of the service that have improved and how the service could be improved for the benefit of the residents. The inspection was carried out over six and a half hours from 10.00am and included an examination of care plans, pre-admission assessments, staff records and a considerable amount of time was spent with residents in the lounge, dining room and their own rooms during a tour of the home. There were 34 residents receiving personal care at the time of the inspection 20 residents, a relative and two visitors were happy to talk about the support provided at the home. The manager, a representative from Chanctonbury Healthcare Limited, the restaurant manager, the cook, housekeeping staff and care staff talked about the services provided for residents. What the service does well: What has improved since the last inspection? A number of requirements from the last inspection have been met. Residents weight is monitored and advice is sought from the dietician as required. It may be appropriate for staff to have training with regard to the nutritional needs of the group catered for in the home. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 6 Staffing numbers are reviewed regularly to meet the assessed needs of the residents. The representative from Chanctonbuty Healthcare Limited explained that if extra staff are needed then the manager is able to employ them through agencies if required. Staff are encouraged to enrol on NVQ courses, two members of staff have recently completed Level 2 and three will start in the near future as a continuation of the induction training provided for all new staff. 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 Queensmead H59 H10 S21260 The Queensmead V229592 230805 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 Queensmead H59 H10 S21260 The Queensmead V229592 230805 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) 1, 2, 3, 4 and 5. Standard 6 is not applicable. The homes statement of purpose and service users guide are good providing residents and prospective residents with details of the services the home provides, enabling an informed decision about admission to the home. An appropriate pre-admission assessment is used prior to the offer of a room at the home to ensure that the home can meet the prospective residents needs. EVIDENCE: The statement of purpose and service users guide provide comprehensive information regarding services offered at the home, they are easy to read and identify the level of support that the home can offer. Pre-admission assessments are used to collect all relevant information concerning prospective residents, prior to the offer of a room, to ensure that the home can meet their needs. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 9 The manager discussed the homes capacity to meet residents’ needs and explained that individuals over 65 years of age who require personal support in terms of assistance with their daily lives are admitted to the home. Prospective residents and their families are encouraged to visit the home to look at the rooms available, meet the staff, discuss the services provided and a room can be taken for a trail period before residents decide to stay on a permanent basis. A number of the residents are from the Polegate area and continue to enjoy local amenities and contact with family and friends after they move into the home. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. There is no clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet residents needs. The staff are protecting residents by following the homes procedures with regard to the administration of medicines. The staff have a good understanding of the residents support needs. This is clear from the positive relationships, which have been formed between the staff and residents. EVIDENCE: A number of care plans were viewed, a considerable amount of work has been carried out to improve the recording of relevant information and risk assessments are now completed and included. Staff were seen to be completing the care plans during the inspection, however some care plans have more information in them that others, while some are not updated on a regular basis. There is little evidence that residents and their relatives are involved in the care reviews and there is no evidence that action is taken for some residents whose weight has increased or decreased. The manager The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 11 advised that training is ongoing for the staff and will continue until all staff complete the care plans effectively. Residents are registered with GP’s and there are links with allied health professionals if required including a dietician, who has been asked for advice for a resident whose food and fluid intake is being monitored. The manager has a good understanding of the needs of residents and recognises if the home can no longer meet their needs. Referral to other agencies is arranged and if appropriate alternative accommodation is organised, with the involvement of the residents and their relatives. Risk assessments are completed for all residents who administer their own medication and they have a lockable facility in their room to ensure they are secure. The staff explained that training is provided for those who administer the medicines and they follow the homes procedures concerning signing the medicine administration sheets after the medicines are given out. It was noted that the relationships between staff, residents and visitors was relaxed and friendly and residents were treated with respect by staff. Residents who expressed an opinion were positive about the care provided and visitors were equally positive, supporting the comments made by the residents. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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, 14 and 15. Residents benefit from a varied programme of activities and visits to places of interest in the local community. The routines of the home are flexible, which enables residents to have control over their lives and encourages them to make choices about all the aspects of their day to day living. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents tastes and choices. EVIDENCE: Residents are encouraged to regard The Queensmead as their home making choices about all aspects of their daily life. During the inspections residents were spending their time as they wish, some using the lounge and conservatory during the day while others prefer to remain in their room. The activity arranged for the day of the inspection was changed as the individual booked could not attend. An alternative activity had been organised and several residents enjoyed the musical session that was provided. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 13 Visitors are welcome at any time during the day, some stay for lunch and relatives play an active role in providing support for residents with the assistance of staff. Relatives and staff who expressed an opinion spoke positively about the care provided, they felt they were consulted and their opinions were important in developing the services provided. The meals offered are varied and appealing, choices are provided and a pleasant lunch was enjoyed with residents in the dining room. The atmosphere was relaxed and residents spoke positively about the food. It was noted that the chef spent some time in the morning asking residents what they would like for lunch and took an active role in serving the meals and checking that the food was satisfactory. Snacks and meals are available throughout the day. A food survey was carried out one month prior to the inspection, this was discussed with the restaurant manager, there were no real concerns highlighted. The home recently organised a 40’s themed evening and several of the residents were complementary and were hoping for other themed evenings to be arranged. One resident suggested a chinese evening, the manager and chef said that this would be easy to organise. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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) These standards were not assessed at this inspection. EVIDENCE: The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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, 20, 22, 23, 24, 25 and 26. The standard of the environment within this home is good providing residents with an attractive and homely place to live. EVIDENCE: The Queensmead provides comfortable, homely, individual and communal space for residents. A lounge and separate dining room on the ground floor are large enough for activities and most of the residents use the dining room for lunch. There are attractive gardens, with seating areas, around the home and these are used by residents, visitors and staff. All rooms have ensuite facilites and are used for single occupancy including the two double rooms, unless these are requested by a couple. Residents are encouraged to bring their own possessions to the home and many have presonalised their rooms with furniture, pictures and ornaments. Several residents said that they are comfortable in their rooms and are provided with anything they required. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 16 A shaft lift and grab rails enable residents to have access to all parts of the home and a number use sticks and wheeled zimmers, some with support from staff to ensure their independence. The home was clean and systems are in place for the prevention of infection. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 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, 29 and 30. Staff morale is high resulting in an enthusiastic workforce that work positively with residents to improve their whole quality of life. Recruitment procedures are followed for the employment of staff to provide appropriate protection for residents. EVIDENCE: There is a dedicated team of staff working at the home, they have a range of skills, which enable them to meet the residents needs. There are low levels of sickness, staff turnover is low and some have worked there for several years. An appropriate recruitment procedure is in place, which includes POVA/CRB checks and references prior to the offer of employment. The manager discussed issues regarding staff who have been at the home for work experience and then apply to take a permanent position. The same checks are required for these members of the team and there is a clear understanding that staff may not provide personal care until they are 18 years of age. Mandatory training is provided and induction training for all new staff. A new member of staff who is 16 years of age and works at the home to assist in the kitchen with drinks and meals and will be working with an assessor to complete the NVQ theory prior to being taken on as a member of the care staff. The expectation is that she will go onto the practical side of NVQ Level 2 when she is 18. She has not received any training in manual handling, food The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 18 hygiene or fire training. The manager stated that she will be attending the next training sessions and is currently being supervised at all times. There are opportunities for staff to work towards the NVQ Level 2 and 3. Two members of staff have recently complete Level 2 and three have applied and will start the programme in the near future. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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, 32, 33 and 38. The management is supported by staff in providing clear leadership throughout the home with staff demonstrating an awareness of their role and responsibilites. EVIDENCE: The manager has been working in the care field for fouteen years and has been the manager of The Queensmead for more that eight years. She has completed the NVQ level 4 in Management and shows a good understanding of the needs of the residents. There have been changes to the staffing structure within the home with each aspect of the service now the responibility of a recognised individual, while the manager continues with the overall management of the home, with clear lines of accountability. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 20 The management approach is open and encourages the involvement of staff and residents in decision about the services provided. The staff said that they are involved and have opportunities to make suggestions to develop the services. Staff meetings are organised two monthly and residents meetings every four to five months, with the one arranged for October to include relatives if they wish to attend. The expectation is that everyone will have an opportunity to discuss the care and support provided at The Queensmead. The management of Chanctonbury Healthcare Limited are working towards an effective quality assurance and monitoring system. Some of the services are assessed on a regular basis, including food provision, and the aim is to extend this to include all the care and services provided. A number of residents prefer to have the doors to their rooms open and some are propped open. This was discussed with the manager and the representative from Chanctonbury HealthCare Limited. It was agreed that the current systems of keeping residents doors open will be addressed and appropriate safe guards will be introduced. The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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 3 3 3 3 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 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 3 3 2 x x x x 2 The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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 OP 7 Regulation 15 (1) Requirement Training to be provided for all staff to ensure continuity of information is recorded in the care plans. Recruitment procedures to be followed for all staff to include two references. Advice to be sought, and acted upon, from the Fire Service concerning the use of safe systems of keeping doors to residents rooms open. A quality assurance and monitoring systems to be developed and introduced. Timescale for action 23.01.06 2. 3. OP 29 OP 38 19 (1)(c) 13(4)(c) 26.09.05 23 01 06 4. OP 33 24 23.01.06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Susssex BN21 4QT 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 Queensmead H59 H10 S21260 The Queensmead V229592 230805 stage 4.doc Version 1.40 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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