Inspection on 03/06/05 for Truscott Manor

This inspection was carried out on 3rd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Truscott Manor 26/07/07

Truscott Manor 16/05/06

Truscott Manor 19/12/05

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 Friday 3rd June 2005, 8:00am 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. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Truscott Manor Address Lewes Road, East Grinstead, West Sussex, RH19 3SU 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) 01342 314458 Frannan International Limited Mrs Caroline Joan White Care Home 41 Category(ies) of Care Home with Nursing registration, with number of places Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2004 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 facilities although showers are not connected to the mains. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken in 10 hours by three inspectors, one a pharmacy inspector. Prior to the inspection the inspectors looked at previous reports and reviewed letters, complaints 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. Three visitors were spoken with. Other relatives and representatives will be contacted by letter for their opinions. Mrs White The Registered Manager was present during the inspection. Due to outstanding environmental requirements an environmental audit was undertaken during the inspection. All rooms were visited. Case tracking from records to care given was carried out for a number of residents. Staff records and relevant records relating to the management of the home were examined. Residents and visitor’s comments about the home and the way the staff care for residents was mainly positive although some did say staff were very busy and they could not always respond to calls very quickly. Since the last inspection one complaint has been received by The Commission, this was investigated by the provider and found to be partially substantiated. Action was taken as a result of the findings. There were a number of concerns highlighted during the inspection and requirements have been made. Further visits will be made to the home to monitor compliance. What the service does well: Staff strive hard to meet the needs of the residents in a caring and friendly manner. There was a friendly and homely atmosphere in the home and residents were complimentary about the staff and the way they care for them. Visitors spoken with said that they were always made welcome at the home. The chef provides well-balanced and nutritious meals which residents were complimentary about. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,5. 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 not continued adequately once residents are admitted. Not all residents have a contract. EVIDENCE: The records of six residents were examined in detail and tracked through to the care given to ensure resident’s needs are met. Three residents did not have a contract setting out the terms and conditions of the home and the fees that they were expected to pay. Four of the residents did not have a photograph. Three of the residents did not have care plans which are necessary to ensure that staff can care for them appropriately; relevant risk assessments to Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 9 identify individual risks had not been done. Two residents who had been living in the home for over 2 months had not had assessments completed. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Not all of the residents needs are reflected in the care plans and it could not be concluded that they are met. Communal use of medicines and the administration of inadequately labelled medicines are potentially unsafe practices. Residents are treated with respect by the staff but privacy cannot be protected environmentally. EVIDENCE: When the records were examined they did not all contain the information needed for care to be tracked through to ensure needs were being met. Of the six sets of records examined, three residents had not been assessed when admitted to the home, three did not have care plans and five did not have relevant individual risk assessments to identify a risk of pressure sores, falls or nutritional risks. Communication about the resident’s condition is given at staff handovers between shifts and staff carry out care from these instructions. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 11 Without adequate records there is a danger of care not being consistent. Care staff completes daily logs of care. Although the records are not up to standard residents who could offer an opinion were in the main positive about the staff and the care given. Locks are not routinely provided on bedroom doors so privacy cannot be protected. Medicines were mostly supplied with dispensing labels and printed recording charts on which administration was recorded. On the medicines trolley, there was only one container of each of two medicines, prescribed for several named residents, which indicated communal use. Prescribed creams for topical application were not recorded on the medication charts. A supply of medicines received for and administered to a resident had handwritten labels, which were not dispensing labels. Mrs White the Registered Manager and her deputy usually have to work hands on with the residents and do not have the time to deal with the administration involved. This has been an ongoing problem in the home. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 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: Visitors spoken with confirmed that they are always made welcome when visiting Truscott Manor. Residents who could offer an opinion did tell inspectors 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. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18. The protection for residents is poor due to the recruitment and induction and training procedures not being robust. These shortfalls have the potential to put residents at risk. 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. EVIDENCE: The recruitment, induction and training procedures in the home are not robust. Records were not available to indicate that appropriate checks have been carried out and that training in this area is up to date for all staff. One complaint has been received by CSCI this was investigated by the providers and found to be partially substantiated. Following this action was taken to address the issues identified by the complainant. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,24,25,26. There is a homely atmosphere and the resident’s accommodation and communal areas are kept hovered. However the home does not provide a clean, safe and well-maintained environment. EVIDENCE: An action plan to address previous requirements was submitted by the providers in 2002. The work to be undertaken was to be completed by July 2004. The majority but not all of these requirements have been complied with. During this inspection all areas were visited by two inspectors the home looks neglected due to the exterior windows, doors and paintwork that are in need of repair and decoration. Old mattresses and chairs were stored in an outhouse which was visible from the driveway for all to see and could be a potential hazard. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 15 Many internal areas, for example resident’s rooms and corridors are in need of decoration and repair. A large number of doors to resident’s rooms were in poor repair where hoists and wheelchairs had damaged them and they have not been repaired. A number of resident’s carpets had been vacumed but are 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. Residents did have call bells but when staff are in one part of the house they cannot hear call bells in the other part of the home. One resident was calling an inappropriate length of time during the inspection and the inspectors had to alert staff because they were not aware. Mrs White did say that they did used to have bleepers which would alert staff, but these were no longer available. This does put residents at risk. Not all rooms are accessible by a passenger lift; Mrs White said 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. The laundry although decorated last year does not have impermeable floors or walls and it was noted that heavily soiled undergarments were lying on the floor which was a potential infection control risk. The majority of radiators in the home are not covered. In one room a resident’s head had fallen against the radiator while she was asleep, luckily the radiator was off, but radiators and pipe work not being covered is a potential hazard in the home. No risk assessment for this resident was available. All of the work to the environment that has been carried out over the last three years has been as a result of an emergency or requirements and not as part of a renewal and refurbishment programme. This includes the additional toilet and shower rooms. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 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 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) 27,28,29,30. The procedures for recruitment and training of staff are not robust and so do not offer protection to people living in the home. There is insufficient staff on night duty and Mrs White is unable to fulfil her managerial role due to shortage of skilled staff. EVIDENCE: The staff files of five members of staff recently employed indicated that the home had not undertaken all the necessary recruitment checks to ensure the protection of residents. New staff had not had appropriate induction or training for the roles they are expected to carry out. A number of overseas staff are employed at the home and have language difficulties. Due to this Mrs White has to supervise them closely and work with them to ensure that they know what to do. This does take a lot of time up which means that she cannot carry out her managerial role effectively. No records were available to indicate that the providers are committed to a formal staff training and development programme and the National Vocational Programme is not available to staff. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 17 Some informal training is provided by staff in the home and courses are available on an ad hoc basis. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 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 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) 31,32,36,37,38. Resident’s best interests are not safeguarded by the home’s policies and procedures and their health, safety and welfare are not promoted and protected. EVIDENCE: Mrs White is very caring and does have the interests of the residents at heart. Unfortunately she is unable to fulfil her role as she would wish and which the home requires. This is due to the lack of managerial time she is able to allocate because she has to carry out caring duties in a regular basis. This has been an ongoing problem in the home for a number of years and previous requirements had been made. This has been discussed at length with Mrs Kassam and Mrs White but no lasting action has been taken. CSCI will now contact Mrs Kassam under cover of a separate letter to discuss this issue, the lack of investment in staff training and the environmental concerns in the home. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 19 Health and safety risk assessments were carried out when The Commission first made environmental requirements but when examined on this occasion they had not been kept up to date. Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 2 1 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 1 2 3 1 3 1 1 1 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 Standard No 16 17 18 Score 3 3 1 2 2 x x x x 1 1 Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 21 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 2 Regulation 5 1( c) Requirement Each resident should be given a a statement of terms and condition or a contract when moving into the home The registered person shall ensure that service users have been assessed by a suitably qualified person. The registered person shall prepare a written plan as to how the service users needs in respect of health and welfare are to be met. The registered person shall ensure that any risks to the health and safety of service users are identiified and risk assessments completed. The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person shall make arrangements by training staff or by other measures, to prevent service users being harmed or suffering abuse or by being placed at risk of harm or abuse. The registered person shall Timescale for action 14/8/05 2. 3 14 1 (a) 14/8/05 3. 7 15(1) 14/8/05 4. 8 13 4 (c) 14/8/05 5. 9 13(2) 14/8/05 6. 18 13 (6) 14/8/05 7. 19 16-2 ( c ) 14/8/05 Page 22 Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 8. 19 23-2 (b) 9. 19 23-2(d) 10. 22 23-2(n) 11. 25 13-4(a) 12. 26 13-3 13. 27 18-1(a) 14. 28 and 30 18-1(c) 15. 29 19 provide in rooms occupied by service users floor coverings. The registered person shall ensure that the premises are kept in a good state of repair externally and internally. the registered person shall ensure that all parts of the home are kept clean and reasonably decorated. The registered person shall ensure that suitable adaptations are made to the call bell system to enable bells to be heard by staff on duty. The registered person shall ensure that pipework and radiators are guarded or have guaranteed low temperature surfaces. The registered person shall make suitable arrangements to prevent infection, toxic conditions and spread of infection at the care home. The registered person shall ensure 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. 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. 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 14/8/05 14/8/05 14/8/05 14/8/05 14/8/05 14/8/05 14/8/05 14/8/05 Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 23 16. 37 17(a) 17. 18. 37 37 17-2 13-3(b) documents specified in paragraphs 1-7 of Schedule 2. The registered person shall 14/8/05 maintain in respect of each service users a record which includeds the information documents and other records specified in Schedule3 relating to the service user. The registered person shall 14/8/05 maintain in the care home records specified in Schedule 4. The registered person shall 14/8/05 ensure that records referred to in paragraphs (1) and (2) are kept up to date and are available at all times for inspection care home by any person authorised by the Commission to enter and inspect the care home. 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 Truscott Manor H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 H60-H11 S24231 Truscott Manor V229821 030605 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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