Inspection on 19/12/05 for Truscott Manor

This inspection was carried out on 19th December 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

Truscott Manor 26/07/07

Truscott Manor 16/05/06

Truscott Manor 03/06/05

Truscott Manor 23/11/04

Truscott Manor 25/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Truscott Manor Lewes Road East Grinstead West Sussex RH19 3SU Lead Inspector Mrs A Peace Unannounced Inspection 19th December 2005 08:45 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 Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 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. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Truscott Manor Address Lewes Road East Grinstead West Sussex RH19 3SU 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) 01342 314458 01342 317240 info@truscott.wanadoo.co.uk Frannan International Limited Mrs Caroline Joan White Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May admitt one service user between the age of 60 and 65. Date of last inspection 3rd June 2005 Brief Description of the Service: Truscott Manor is a care home providing nursing care and accommodation for 41 people in the category of older people. Frannan International Ltd owns the service and the Responsible Individual on behalf of the company is Mrs N Kassam. The home is located in a rural setting in extensive grounds on the outskirts of East Grinstead, shops and other amenities are a short drive away. Residents accommodation is on two floors, a passenger lift is available but does not serve all rooms. Communal accomodation is available on the ground floor. The majority of the homes bedrooms are single and 19 have en-suite shower facilities although the showers are not connected to the mains. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 19th December 2005. A night monitoring visit was also carried out on 14th November 2005 and information from that visit is included if relevant. An environmental audit was also undertaken at the last inspection. Prior to this inspection the inspector looked at previous reports and reviewed letters and reports held on file. To find out how it is to live and work at the home, staff on duty and residents were spoken with on both visits. Due to the consistent failure to meet National Minimum Standards Mr and Mrs Kassam have attended a meeting at The Commission to discuss the concerns raised during visits to the home. Following the visit to the Commission Mr and Mrs Kassam have invested more money in the home and the environmental, managerial and care practice standards for the residents are improving. Mrs Kassam also submitted an action plan for raising and maintaining standards in the home. Over the two visits the majority of rooms were visited. Case tracking from records, to care given was carried out for a number of new residents. Staff records and relevant records relating to the management of the home were examined. Residents were spoken with at night if they were awake and during the day inspection their comments about the home and the way the staff care for them were positive. On both visits the home was warm, homely and had a nice atmosphere. What the service does well: What has improved since the last inspection? Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 6 Mrs White the Registered Manager is now able to allocate the managerial time that is needed to run a home of this size. A new pager system has been purchased which means that when residents call for assistance, staff can now hear them throughout the home. A decorator has been employed to upgrade the decoration in the home and numerous sundry items to be used in the home have been purchased. Care staff who needed extra help are being supervised and supported more closely and mandatory training is more organised. Risk assessments have been carried out on radiators in all rooms. An action plan states that where there is a high risk radiators will be covered, Mrs Kassam is aware they must all be covered. A small number of automatic door closures that would close in the event of a fire have been bought and are awaiting fitting. 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. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 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 Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,5, Residents have the opportunity to visit the home to ensure that the home is able to meet their needs. The home’s assessment procedure is adequate but not all risk assessments are completed once residents are admitted. All residents have a contract. EVIDENCE: The records of 3 new residents were examined in detail and tracked through to the care given to ensure resident’s needs are met. None of the residents had a photograph, although the inspector was told that they were waiting to be developed. New residents had been suitably assessed, however two of the residents did not have risk assessments despite high risk factors being identified on their assessment records. The Statement of Purpose/Service User Guide for the home was available but was in the nursing office. The Inspector reminded the Deputy Manager that this should be more easily available for residents and visitors. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,11 Residents are cared for at Truscott manor to a good standard and are respected and treated kindly by the staff. EVIDENCE: When the care records were examined, apart from the risk assessments mentioned above they did contain the information needed for care to be tracked through to ensure needs were being met. Social care plans should be more comprehensive. A detailed staff handover was observed during the inspection where staff were given the information they needed to know about the residents. Care staff complete daily logs of care and resident’s basic observations plus weight are recorded monthly. Care plans are also updated on a monthly basis. Residents who could offer an opinion were positive about the staff and the care given. On both visits residents were clean, well cared for and looked comfortable. A number of pressure relieving mattresses are provided but are all allocated out. The Inspector was concerned that in view of the heavy dependency and frail condition of the majority of the residents, if one should deteriorate there would not be a suitable mattress available. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 13,14,15 The home promotes respect, dignity and within their capabilities residents are encouraged to make choices about their lifestyles. A wholesome balanced diet is available. EVIDENCE: Residents who could offer an opinion did tell inspectors on both visits that generally they could make choices about there lifestyles. The kitchens were visited and menus seen. They were well balanced and meals served on the day of the inspection looked nutritious. Residents appeared to enjoy the meals and those spoken with were complimentary. Two dining rooms are available for residents to use or they can choose to stay in their rooms to eat. The majority of bedroom doors do not have locks on. The assessments records did not specify previous lifestyles and hobbies. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 16,18. A clear complaint procedure enables residents and their relatives or representatives to be sure that their complaint would be taken seriously and acted on within an appropriate timescale. The home operates the West Sussex Adult Protection Guidelines and staff are having training to recognise abuse. The home needs to develop more robust recruitment procedures to protect residents. EVIDENCE: The Commission has received no complaints since the last inspection and the deputy manager said there were no complaints outstanding at the home. Adult protection training has started at the home and details of future sessions were seen. Staff are being recruited before confirmation is received that they are suitable to work with vulnerable people which is putting residents at risk. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 19,20,22,23,24,25,26 There is a homely atmosphere and the resident’s accommodation and communal areas are kept as clean as possible. Work has started to improve the environment. EVIDENCE: Since the last inspection Mr and Mrs Kassam have met with The Commission to discuss the outstanding requirements from previous inspection. An action plan has been submitted and more investment put into the home. A new pager system has been provided which has improved the service for residents. During the two visits it was noted that some improvements had been carried out and that work was still ongoing. The exterior of the home looks neglected due to the exterior windows, doors and paintwork that are in need of repair and decoration. However the Inspector was told that the internal decoration is being carried out first. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 13 A number of resident’s carpets had been hovered but are still heavily stained and in need of renewal. A carpet in a communal area off the hall which residents sit in is heavily stained and threadbare in one area. In the rooms that are en suite, residents would be unable to use the showers as they are not connected to the mains. Not all rooms are accessible by a passenger lift; Mrs White said on an earlier inspection that she does take this into account when admitting residents to the home. The majority of bedrooms doors have not had locks fitted. Locks would protect resident’s privacy and possessions. Not all radiators in the home are covered to protect the residents from accidents. Since the last inspection Mrs White has carried out risk assessments and identified those that need covering first. Mrs Kassam is aware they all need to be covered. Service records were examined and it was noted that the main electrical system for the home has not been tested according to health and safety legislation. The last certificate was 1996. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. The procedures for recruitment and training of staff are not robust and so do not offer protection to people living in the home. The staffing levels in the early morning should be reviewed to ensure Resident’s needs are being met with the number of staff on duty. EVIDENCE: Staff meeting are held and minutes available. The staff files of 3 new members of staff were examined, it was noted that 2 staff have been employed before the home has received confirmation that the people are safe to work with vulnerable people, although The Administrator for the home was undertaking POVA first checks while the inspector was there. Records were available to indicate that they had received induction and training for the roles they are expected to carry out. Mrs White has organised mandatory training and notices of the courses were on display. Since the last visit Mrs White is supporting and supervising staff more closely. It was identified at the last inspection that a number of overseas staff were having difficulties with the English language. Mrs Kassam told the Commission that they had started an English-speaking course but the inspector was unable to confirm this during the visits. No records were available to indicate that the providers are committed to the National Vocational Programme of training despite the Commission being informed in June 2005 that this was imminent. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 15 Through observation and in discussion with residents and staff it was found that in the early morning residents have to wait some considerable time to be made comfortable, changed or sat out of bed due to the shortage of staff at that time and Mrs White is advised to look into this. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. The majority but not all of the home’s policies and procedures safeguard Resident’s best interests. EVIDENCE: Registration and Insurance certificates are displayed in the hallway of the home. Since the last inspection Mrs White has been able to allocate managerial time which has benefited the residents and the staff. The Inspector was told that an internal quality assurance system has been started but the results were not yet available. Mrs Kassam has kept the Commission informed of the work already done to meet requirements and plans for future work at the home. Staff said they were supervised on a regular basis and that they felt well supported. Mandatory health and safety training is being provided at the home. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 17 Fire safety risks related to doors being propped open were identified on both visits, although the Inspector could confirm that action is being taken to provide automatic closures on a number of doors. Until these are fitted, doors must not be wedged or propped open. The main electrical system is not being tested according to legislation. COSHH substances are being decanted into inappropriately labelled containers; Mrs White should take advice from the Health and Safety Executive regarding this. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 18 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 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 2 2 x 3 3 2 2 2 STAFFING Standard No Score 27 2 28 1 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 3 3 1 1 1 Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes 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 OP8 Regulation 13 4 (c) Timescale for action The registered person shall ensure 19/01/06 that any risks to the health and safety of service users are identiified and risk assessments completed. CSCI to be informed of action taken by The registered person shall ensure 19/01/06 that the premises are kept in a good state of repair externally and internally. CSCI to be informed when work due to be completed by The registered person shall ensure 19/01/06 that pipework and radiators are guarded or have guaranteed low temperature surfaces. CSCI to be informed when all radiators and pipework will be covered by The registered person shall ensure 19/01/06 that at all times suitably qualified, competant and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. CSCI to be informed of where overseas nurses are receiving help DS0000024231.V273934.R01.S.doc Version 5.0 Page 20 Requirement 2 OP19 23 2 (b) 3 OP25 13 4 (a) 4 OP27 18 1 (a) Truscott Manor 5 OP30 18 1 (a) 6 OP29 19 7 OP38 23 8 OP38 23 4 c (i) with English. The registered person shall ensure that persons employed by the registered persons to work at the care home receive; training appropriate to the work they are to perform; suitable assistance is given including time off for the purpose of obtaining further qualifications appropriate to such work. CSCI to be informed when NVQ training is starting The registered person shall not employ a person to work t the care home unless he has obtained in respect of that person information and documents specified in paragraphs 1-7 of Schedule 2. CSCI to be informed that no person is working at the home unless the home has been informed through CRB/POVA that they are safe. Main electrical systems throughout the home to be tested by a recognised contractor. CSCI to be informed that contractors have been booked by Take adequate arrangements for detecting, containing and extinquishing fires. 19/01/06 19/01/06 19/01/06 14/11/05 Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 21 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 Refer to Standard 8 19 28 Good Practice Recommendations It is recommended that Mrs White audits the pressure relieving mattresses/ aids to ensure the home has an adequate supply. It is recommended that Mrs White contact the Health and Safety Executive for advice on the storage of COSHH items It is recommended that Mrs White reviews the number of staff allocated on duty in the early mornings to ensure residents needs are being met. Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Truscott Manor DS0000024231.V273934.R01.S.doc Version 5.0 Page 23 - 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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