Inspection on 10/09/08 for Walberton Place Nursing Home

This inspection was carried out on 10th September 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Walberton Place Nursing Home Yapton Lane Walberton Arundel West Sussex BN18 0AS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Liz Palmer     Date: 1 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Walberton Place Nursing Home Yapton Lane Walberton Arundel West Sussex BN18 0AS 01243554040 01243553726 walbertonplace@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Campbell Type of registration: Number of places registered: Southern Cross OPCO Ltd care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home 0 Over 65 34 Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection included a site visit to the home which took 8 hours. We also received 10 surveys from people living in the home. During the site visit, one relative, three staff and four residents were interviewed. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 6 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 7 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre admission assessments vary in their quality. A more consistent approach to the assessment process would improve the information available to staff to assist them in meeting peoples needs. Evidence: The AQAA states that a pre-admission assessment is undertaken by a registered nurse before each admission. Prospective residents and their representatives are invited to visit the home and sample the service to ensure all aspects of an admission are considered. Four pre-admission assessments were sampled. They varied in details ranging from full care needs and other relevant information about the person including their medical history, current health and nursing care needs, religious beliefs to very little detail about how the home would meet someones needs. Southern Cross have a Care Homes for Older People Page 8 of 24 Evidence: comprehensive assessment process which, if applied properly would be suitable. The new manager is aware of Southern Cross policies and procedures and has plans to train staff in these to ensure their full implementation. Care Homes for Older People Page 9 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all residents are having their health and personal care needs met. Improvements must be made to care planning and to staffing levels to ensure the health and well being of all residents. Evidence: The four care plans looked at varied in the content and detail. One care plan had no information about how to give personal care or support to the individual, another did not follow on from their initial assessment. The AQAA states that every resident has a person centred plan which is reviewed monthly, however, of the four care plans looked at, none were reviewed on a regular monthly basis nor were they person centred. The new manager stated that she was aware of the shortfalls in the care planning and had arranged suitable training for staff to learn about the Southern Cross process for this. One care plan of a resident who had recently transferred from another Southern Cross home was seen to be suitably detailed in providing the information staff would need to deliver their care and meet their needs. This had been reviewed monthly until transfer to Walberton Place. This Care Homes for Older People Page 10 of 24 Evidence: shows that the Southern Cross paperwork for care planning is effective if applied correctly. The training of staff and full implementation of this, including regular reviews should address this. Staff were observed supporting residents in a dignified and respectful manner in the lead up to lunch time. Due to staff shortages the lunch was running slightly late and some residents were getting anxious about this. staff were calm, patient and apologetic to residents for the delay. One relative spoken to said she would give the home 100 for its care and compassion but she had not seen her mothers care plan nor been involved in any review of the care since she moved into the home. People who use the service are all registered with a local GP. Records showed evidence of medical needs being met in a timely and suitable way. Details of follow up and outcomes are recorded. Two residents spoken to during the inspection said they could ask staff to seek medical help when they needed it and said they felt safe and well cared for in the home. Apart from one person, they said their dignity was upheld and they were treated with respect. Care plans reflect personal preferences and refer to upholding dignity. Of the surveys returned to us, in repsonse the whether their care needs are met, residents told us; 1 said always, 6 said usually and 1 said sometimes. With regard to medical needs 6 said always and 2 said usually. One said the medical support is excellent. Manual handling assessments are in place as are risk assessment; for example, for falls, pressure sores and weight loss, these are reviewed and kept up to date. The administration of lunctime medication was observed. The home uses a national pharmacy monitored dosage system. One tablet was found loose in the storage cabinet. The member of staff spoken to said she knew what to do under the old policy but was not sure about the new one. Recording was sampled and the only inconsitency found was that sometimes a residents fortisips were signed for and sometimes not. The member of staff was unsure whether or not they should be signed for. No other errors of omissions were found and the storage was secure, clean and suitable for its purpose. Care Homes for Older People Page 11 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. More consistency in the provision of activities would improve the lives of all people living in the home. Improvements must be made to the meals. Evidence: From the four care plans looked at, talking to staff and talking to residents it is evident that people are encouraged to be independent, pursue their own interests and are able to make choices about how they spend their time. Residents views were mixed on activities due to the changes in ownership some activities have changed. An activities coordinator has been employed by Southern Cross. She was met on the day and gave details of the current activities and plans for the future. As well as organised activities most afternoons, like exercises or music sessions, she told us she spent time every day reading to residents if they need it and chatting to others. She knew the hobbies and interests of individuals and had a clear plan of how she would like to improve the social aspect of life in the home. Some care plans did not contain much detail about peoples preferences with regard to their social needs others had more detail. Greater consistency in this will enhance the lives of all people who live in the home. Care plans stated next of kin and other relationships important to people. Visitors are welcome and no restrictions are made on this. Residents confirmed they had visitors and were Care Homes for Older People Page 12 of 24 Evidence: able to visit friends and family freely. A menu sets out the meals provided four weeks in advance. Views on the food were mixed; all residents said they had enough to eat, however, the standard of food was considered to be not very good and varied from day to day. One resident says they sometimes have to buy their own food because their special diet is not catered for. The menu does not state that an alternative meal can be chosen and residents were unsure as to whether or not they could ask for something else. The area manager from Southern Cross stated they were aware of problems with the catering and had plans in place to address this. Care Homes for Older People Page 13 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to complain and are protected by the homes policies for safeguarding them. Evidence: A suitable complaints procedure is displayed in the entrance hall of the home. All the surveys received and residents spoken to said they know how to complain and some gave examples of having done this. The complaints log contained a summary of a complaints and the outcomes to these, however the complaints forms were not available as the administrator was off work. The new manager is aware of her responsibilities around complaints and what records should be kept and available for inspection. Staff are trained in safeguarding adults (formerly known as adult protection) and the new manager is fully aware of her responsibilities in this area. Care Homes for Older People Page 14 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe, well-maintained environment. Action must be taken to address the flies in the home. Evidence: The inside and outside of the home are maintained to a high standard. Residents say their rooms are cleaned regularly and staff were seen to be wearing suitable gloves and aprons. However, several residents complained about the flies in the home which were noted to be in most of the rooms during the inspection. The manager stated the environmental health had been contacted and the type of fly (from a neighbouring field that had recently been cut) needed specialist paint on windows to deter them, however this paint is toxic and not safe for residents. Normal fly deterrents do not work. Fly papers had been installed. One resident who was in her night dress during the inspection was at particular risk as she had open sores on her leg. The manager agreed to address this immediately. Risk assessments are in place to promote the health and safety of residents and staff are trained in issues relating to health and safety. The AQAA states that policies and procedures are in place in relation to infection control, clinical waste, fire safety and environmental health. Care Homes for Older People Page 15 of 24 Care Homes for Older People Page 16 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The procedure for recruiting staff, when followed completely, protects the people who use the service. Staff receive suitable training, however regular supervision would ensure their competency. Staffing levels need to be addressed to ensure adequate staff numbers are on duty to ensure the health and safety of residents. Evidence: During the inspection the staff said they were a person down. Staff commented that there were not always enough staff on duty to attend to the needs of residents and spend time with them socially. Most residents spoken to said there were enough staff on duty during the day and night to meet their needs. They said call bells were answered promptly, although one survey said the response was slow sometimes. The manager and area manager acknowledged the staff vacancies are addressing this as best they can. Staff were observed interacting in a positive and respectful manner at all times. They responded to requests from service users and were caring and polite. The home has recruited two new staff since being taken over by Southern Cross. We sampled the recruitment records for both. One contained the records required to meet the standards. For example; an application form two suitable references, a criminal record check and a protection of vulnerable adults check. The other had all of these except two written references. There was one reference on file and the request letters Care Homes for Older People Page 17 of 24 Evidence: for three references were seen. As the administrator was off work it was not possible to establish if a second reference had been received. This person was recruited before the appointment of the current manager. Southern Cross have clear recruitment procedures including taking up at least two references prior to employment. It could not be established if these had been fully followed on this occasion. Staff records showed there is on going training provided including mandatory courses such as, first aid, food hygiene, infection control, health and safety and safeguarding adults which are provided to staff. One staff survey said there had been no training other than mandatory courses since Southern Cross took over. The AQAA states that over 50 of care staff have achieved National Vocational Level 2 or above. Mostly residents were positive in their comments about the staff saying they were caring, kind and would respond to their requests. There is always a trained nurse on duty, however due to shortages they often take on caring roles and even cooking at times. Improvements needed within the staffing are acknowledged by the manager of the home. She is planning to increase her numbers of trained nurses and implement training for care staff in the care planning and review processes of Southern Cross. Care Homes for Older People Page 18 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Full implementation and management of the Southern Cross policies and procedures will improve the overall running of the home. Evidence: The new manager is planning to apply for registration with the commission. A period of sustained and consistent management of the home is needed to assure residents that the home is being well run and in their interests. A recent meeting held by Southern Cross was said by staff, one relative and residents to be very reassuring. The AQAA has good information and states clearly the improvements they would like to make and how they will be achieved. Southern Cross undertake their own quality assurance and they say they act on the things that people tell them. Regulation 26 visits are an example of this and the records of the last two were looked at by us. They showed us that Southern Cross have highlighted the same areas of improvement as us and have followed through on concerns raised by residents during the visits. There is a clear line management structure now, however some of the changes due to Care Homes for Older People Page 19 of 24 Evidence: the takeover have unsettled staff and residents alike. The AQAA states that the home has a policy on regular supervision for staff. Records of this were inconsistent and some staff say they have not had regular supervision. The new manager says she is aware of this and it is part of her plans to improve his. Residents said regular testing of the fire alarms takes place, however, one regulation 26 visit highlighted a gap in the records showing a lack of consistency in this. Care Homes for Older People Page 20 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 The registered person must ensure that a full needs assessment is undertaken for each individual before they move into the home. So people can be sure the home can meet their needs. 30/11/2008 2 7 15 The registered person must 30/11/2008 ensure that care plans contain information which sets out how the service users needs in respect of their health and welfare are to be met and these must be kept under regular review. So people know their changing needs will be met by accurate and up to date care plans being in place. 3 9 18 The registered person must ensure that all staff are trained and competent in the policies and procedures for the safe handling of medication. 30/11/2008 Care Homes for Older People Page 22 of 24 To protect residents from errors and abuse. 4 15 16 Suitable, wholesome and nutritious food which is varied and properly prepared must be provide in adequate quantities. So people have a balanced, varied and nutritious diet that suits their needs and tastes. 5 27 18 Adequate numbers of staff must be employed at all times. To ensure the needs of all residents can be fully met at all times. 6 36 18 The registered person must ensure that all persons working at the care home are appropriately supervised. In order to ensure that staff have the support and guidance they require. 30/11/2008 30/11/2008 30/11/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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