Inspection on 13/09/06 for Upper Mead

This inspection was carried out on 13th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Upper Mead 04/07/07

Upper Mead 23/01/06

Upper Mead 27/10/05

Upper Mead 23/09/04

Upper Mead 20/05/04

Upper Mead 25/11/02

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

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 Upper Mead Fabians Way Henfield West Sussex BN5 9PX Lead Inspector Mrs S Gawley Key Unannounced Inspection 13th September 2006 09:30 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 Upper Mead DS0000024232.V307973.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. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Upper Mead Address Fabians Way Henfield West Sussex BN5 9PX 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) 01273 492870 01273 494946 uppermead@sussexhealthcare.org Dr Shafik Hussien Sachedina Mr Shiraz Boghani Mrs Elizabeth Nellie Kandi Care Home 48 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (37), of places Physical disability (7) Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Accommodation is provided in two separate units. A maximum of 48 Service Users may be accommodated. Unit one is for 11 Service Users in the category dementia, over 65 years of age - DE(E). Unit two is for 37 Service Users in the category older persons not falling within any other category (OP). Unit two may include in its number of Service Users up to seven persons in the category physical disability aged 50 years and over (PD) 23rd January 2006 Date of last inspection Brief Description of the Service: Upper Mead is a care establishment that provides nursing, and is registered to accommodate a total of 48 residents. This includes one unit which accommodates 11 residents in the category DE(E) Upper Mead is a large detached property located in the West Sussex village of Henfield, close to housing and shops. It has pleasant accessible grounds. The home is Privately owned by Sussex Health Care and the responsible person acting on behalf of the company is Mr S Boghani Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 13 09 06 and was facilitated by the nurse in charge and the manager who was called into the home from leave. The home was inspected against the National Minimum Standards. Comments were elicited from residents and professionals prior to the inspection. Head office was visited, policies seen and discussed with the heads of care. Residents, visitors and staff and visiting professionals were spoken to and many but not all expressed satisfaction with the quality of care in the home. Eight comment cards were returned from residents, eight from relatives and one from a professional. These comments as well as observations from the inspection will be used in compiling this report. The majority of the comments and observations made on the home were positive in that the care is good and staff are welcoming. Some deficiencies were highlighted such as difficulty in communication with staff. One relative commented that staff are not always available to give update on care and also not stimulating residents, that her relative is found usually alone in room or garden. Three of the eight comment cards from residents highlighted a lack of satisfaction in the food. Most residents able to comment stated that they are happy with the activities but the commitment to activities in the dementia unit seems less that that in the main unit. These areas are further explored in the body of the report. What the service does well: What has improved since the last inspection? There have been material improvements to the home with carpeting on the downstairs corridor having been replaced. The manager stated that this is an ongoing programme. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 6 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. Upper Mead DS0000024232.V307973.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 Upper Mead DS0000024232.V307973.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. No resident moves into the home without having had his/her needs assessed and been assured that these will be met. 6. This standard is not applicable EVIDENCE: There is evidence of pre assessment in the care plans and the manager confirmed that this is always done even in emergency situations to ensure that the home can meet the needs of residents. One resident stated on a comment card that he had been in the home for ten days last year and when re admitted this year was greeted very warmly and that he was happy to be back. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7. The resident’s health, personal and social care needs are set out in an individual plan of care. 8. Residents health care needs are fully met. 9. Residents, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. 10. Resident feel they are treated with respect and their right to privacy is upheld. EVIDENCE: Care plans are in place and health and social need are mostly recorded. The needs of one resident who is immobile are not met in that bruising was not reported to the General Practitioner for several months and although it is noted that this resident needs careful handling she continues to have bruising and torn skin flaps. The need for this situation to be assessed, both on a health and handling level, with reference to the adult protection procedures and interventions to be put in place was stressed to the Registered Manager. This will be a requirement of this inspection. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 10 The mental health needs of the residents in the dementia unit may not be met as the unit is being staffed with carers who have not had any dementia training. The carer on the unit on the day of the inspection did not have any training and was not interacting in any way with the residents. She did not demonstrate any knowledge of activities in the unit. This was discussed with the registered manager Two GPs have informed the Commission that there are communication difficulties with the staff in the home, one stating particularly on the telephone. The majority of residents stated that they are happy with the care given in the home but one stated that sometimes there is a delay in getting a response to the call bell. All stated that they are treated with respect Medicine administration charts inspected were up to date. Topical items seen in room were properly labelled with that resident’s name. Medicines including controlled drugs were appropriately stored. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12. Resident find the lifestyle experienced in the home matches expectations and preferences, and satisfies their social, cultural, Recreational interests and needs. 13. Residents maintain contact with family/ friends/ representatives and the local community as they wish. 14. Residents are helped to exercise choice and control over their lives. 15. Residents receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: There is an activities programme in place and the majority of residents stated that they are happy with these. There were not any activities planned for today as the activities coordinators were at a conference. See comments in previous section regarding residents in the dementia unit who seem under stimulated. Residents and relatives were spoken to and all stated that there is freedom of movement in the home and relatives are welcome at all times. The majority of residents spoken to stated that they enjoy the food but some said that it varied in quality. Of the eight comment cards returned three expressed dissatisfaction with the food, one stating that the food very poor and badly cooked. There is a menu in place but the food served was not that on the menu. There is not a second hot choice of meal advertised on the menu. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 12 The chef was spoken to and she stated that if a resident does not like the meal on offer then an omelette or salad is offered. The need for a second hot choice was discussed. Kitchen documentation was not up to date. Food is stored directly on the floor and the catering sized cereal bag in use was ripped open with cereal spilling out around the box, which was also open. The likelihood of contamination of this cereal presents a risk to the health and safety of residents. This was discussed with the chef and the Registered Manager. There is only one refrigerator, which is not adequate for the needs of 48 residents. Sandwiches for suppertime were already made up and were not refrigerated. This is the subject of a requirement of the Environmental Health Officer following a recent inspection. This was discussed by telephone with the environmental officer who confirmed that he will be following this up. The chef stated that head office has been in communication with the Environmental Health Department and she is not sure when this can be replaced. Nutritional provision and the need to comply with statutory agencies will be requirements of this inspection Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. will 17. 18. Residents and their relatives and friends are confident that their complaints be listened to, taken seriously and acted upon. Resident’s legal rights are protected. Practices in the home may not protect residents from abuse. EVIDENCE: There is a complaints procedure in place and a recent complaint was discussed. The complaint was investigated as per timescales stated but the complainant has not yet stated whether she is satisfied with the outcome. Residents spoken to stated that they felt able to complain if necessary and that the problem would be rectified. Residents have access to solicitors and are enabled to vote using mainly the postal system. Abuse procedures are in place but one member of staff stated that allegations brought to the attention of the management were not acted on. Training is in place but staff spoken to did not demonstrate a clear knowledge of adult protection procedures. Social and Caring Services recommended after a recent adult protection investigation that all allegations are referred to them as per West Sussex Adult Protection Procedures. This was discussed with the Registered Manager. Please also refer to the comments relating to adult protection in the section Health and Personal care. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 14 Quality in this outcome area are adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. Residents live in a safe, well-maintained environment. 20. Residents have access to safe and comfortable indoor and outdoor communal facilities. 21, Residents have sufficient and suitable lavatories and washing facilities. 22, Residents have the specialist equipment they require to maximise their independence. 23, Service users’ own rooms suit their needs. 24, Residents live in safe, comfortable bedrooms with their own possessions around them. 25, Residents live in safe, comfortable surroundings. 26, The home is clean, pleasant and hygienic Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 16 EVIDENCE: The home is clean and well maintained. It is a safe environment for residents. All doors have automatic door closures. There are sufficient hoists, wheelchairs and specialist equipment to meet resident’s needs. The home was clean and free from offensive odours today. Residents rooms are comfortable and personalised where possible. All areas of the home are well and the ground floor corridor has had new carpet fitted. There are suitable bath and toilet facilities. The laundry facilities are appropriate and one resident stated that the laundry assistant is excellent. There are environmental health issues in the kitchen with lack of refrigeration capacity, the storage of food on the floor and opened cereal not being sealed between use. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. The numbers and skill mix of staff does not meet all resident’s needs. 28, Residents may not be in safe hands at all times. 29. Residents are mostly supported and protected by the home’s recruitment policy and practices. 30. Not all staff are trained and competent to do their jobs. EVIDENCE: There are suitable numbers of staff on duty and staff spoken to confirm this. As staff are rotated between both parts of the home there is an issue of appropriate skill being utilised. The staff member on duty in the dementia unit was junior and had not any training in dementia care and had undertaken little mandatory training. There was not any interaction observed between the staff member and the residents. The senior on duty had left the unit and was putting away an order of pads. The issue of staff deployment was discussed with the manager. This will be a requirement of this inspection Residents may not be in safe hands at all times as staff spoken to did not demonstrate a clear knowledge of West Sussex Adult Protection Procedures. Two General Practitioners in response to surveys expressed concern about patient care and communication with staff which they believe can have a negative effect on residents care. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 18 There is still a high turnover of staff with 18 care staff recruited to date. The total for last year was 32.This was discussed with the Registered Manager who feels that the situation is improving. The issue of adaptation nurses was discussed as they move once qualified. One staff file showed that the carer had commenced work on 06 07 06 without full Criminal Records Bureau Clearance and only one reference. This was an issue that was discussed with the heads of care at a meeting at headquarters on July 18th 2006 therefore there is an expectation that this practice will cease. There is a staff-training programme in place which staff spoken to confirmed. The Registered Manager to develop a method of recording training to make tracking training for individuals clearer. All staff to undertake training appropriate for the residents being cared for. Supervision is in place which staff confirm, also staff meetings but there is the perception amongst staff that problems raised are not addressed. Of the six staff spoken to only one was enthusiastic and stated that this home was a good place to work. The others indicated a lack of morale among the staff. This was discussed with the Registered Manager. Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31. Residents 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. 32. Residents benefit from the ethos, leadership and management approach of the home. 33. The home is run in the best interests of residents. 34. Residents are safeguarded by the accounting and financial procedures of the home. 35. Residents’ financial interests are safeguarded. 36. Staff are not appropriately supervised. 37. Residents’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. 38. The health, safety and welfare of residents and staff are promoted and protected. Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager is registered by the Commission as being fit to run a Care Home Residents able to express an opinion stated that they were happy with the way the home was run and that they are happy here. Fewer staff expressed this opinion. Residents are safeguarded buy the accounting and financial arrangements of a large organisation. The home does not hold any monies or bank accounts for Residents. Staff supervision is in place but staff do not feel this issues raised are acted on. The health, safety and welfare of service users and staff are promoted and protected by policies, procedures and training. The manager needs to ensure that all staff are aware of these procedures and that they attend the training The home has yet to comply with requirements of a recent Environmental Health Report in relation to the Kitchen facilities Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Upper Mead DS0000024232.V307973.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 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 3 3 3 2 2 3 Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 22 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 OP8 Regulation 12 Requirement Timescale for action 30/11/06 2 OP15 16 3 OP27 18 The registered person promotes and maintains service users’ health and ensures access to health care services to meet assessed needs. The registered person ensures 30/11/06 that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements, and that meals are taken in a congenial setting and at flexible times. Staffing numbers and skill mix of 30/11/06 qualified/unqualified staff are appropriate to the assessed need of the service users. The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. 30/11/06 4 OP26 13(3) 23(5) Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 23 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 Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 Page 24 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 Upper Mead DS0000024232.V307973.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!