Care Home: Felix Holme RCH

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What the care home does well The atmosphere of the home is relaxed and welcoming and comments from staff were positive and obviously at ease with the Registered Manager. The home is well managed with comprehensive care planning and staff training programmes in the process of being implemented. The Registered Provider has a quality monitoring system in place and this will be an on-going process. People living in the home are encouraged to be independent and all aspects of their health and welfare identified and planned for. Record keeping is good and there is an on-going programme of refurbishment and repair. What has improved since the last inspection? As this service is considered a new service no requirements or recommendations from previous inspections were carried forward. What the care home could do better: There were shortfalls identified as the compilation of care plans for all people living in the home are still in progress and further shortfalls were found in respect of the environment and staff training. However, the Registered Manager was aware of them and has a plan to meet each within the next six months although some maintenance, such as refurbishment of bathrooms and toilets will remain a part of the long term plans to ensure all parts of the home are comfortable and well maintained. No requirements were made in respect of the shortfalls as outcomes for people living in Felix Holme are good and they are not at risk. The Registered Provider is working towards addressing all shortfalls in the service following the purchase of the home, on a priority basis and has agreed to keep the CSCI informed when shortfalls have been addressed. CARE HOMES FOR OLDER PEOPLE Felix Holme RCH 15 Arundel Road Eastbourne East Sussex BN21 2EL Lead Inspector Gwyneth Bryant Key Unannounced Inspection 24 January 2008 07:15 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 Felix Holme RCH DS0000070463.V353195.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. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Felix Holme RCH Address 15 Arundel Road Eastbourne East Sussex BN21 2EL 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) 01323 641848 breel990@aol.com Bree Associates Ltd Mrs Lindsey Bree Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (0) of places Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 20. Date of last inspection N/A Brief Description of the Service: Felix Holme is situated in a quiet residential area of Eastbourne with large well maintained gardens to both the front and rear of the property. The home is located close to the town centre, with a bus stop within walking distance, although no public transport runs past the home. There are nineteen rooms of which fourteen have en-suite toilet facilities. One of the rooms is a double room but it only used as a double for couples. A passenger lift and a stair lift allow easy access to all communal and private areas. There are sufficient bath and shower rooms with appropriate aids and equipment to ensure that residents can use these safely. The home provides two lounge areas with views out to the garden and a separate dining room, which are maintained and furnished to a high standard. The fees from 1 January 2008 range from £350.44 to £430 per week, which includes in-house activities and basic toiletries. Additional charges are payable for chiropody, hairdressing, dry-cleaning and outings. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should note that the is an existing home that was purchased by the new providers 6 months ago and they have identified a range of areas that need to be improved and have developed and action plan to remedy these shortfalls. This was an unannounced inspection and took place in just under nine hours. The purpose of this inspection was to check compliance with key standards. There were eighteen people in residence on the day of which seven were spoken with individually. The Registered Manager, four visitors, a healthcare professional and one carer were also spoken with. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. All of the people spoken with spoke highly of the care given and the kindness of staff and one senior carer was singled out for particular mention. Prior to the site visit information was requested from the provider; this was given and information detailed is used in this report as necessary. Comments from those people spoken with included: they (staff) do as you ask – with a smile! definite improvement across the board. food is much better. I feel well looked after. I am very satisfied with the care. cant fault them (staff) Everything is so good, I am very happy here. Its fantastic, superb. What the service does well: What has improved since the last inspection? Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 6 As this service is considered a new service no requirements or recommendations from previous inspections were carried forward. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Felix Holme RCH DS0000070463.V353195.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 Felix Holme RCH DS0000070463.V353195.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are carried out at the time of admission to ensure the home can meet the needs of people living in the home. EVIDENCE: Pre-admission sheets for the last three people to be admitted to the home were viewed and found to be satisfactory. Discussion with the manager found that as part of the admission process all people who wish to move into Felix Holme are offered a visit and to stay for a meal to enable them to meet staff and others who live in the home. One of the people spoken with confirmed they visited the home and stayed for a meal prior to admission. Care plans included a checklist to demonstrate that each person admitted to the home received a Statement of Purpose, service users guide and a contract. Intermediate care is not provided. Felix Holme RCH DS0000070463.V353195.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The care planning systems ensure that the health, medical and personal needs of those living in the home are identified and planned for in a consistent and comprehensive manner. EVIDENCE: Six care plans were viewed and it was evident that pre-admission assessments are used to inform the care planning process. Care planning documents included information on meeting healthcare needs such as dental, hearing and eyesight checks and also provided clear direction to staff. Each person has a daily care action sheet which outlines their preferred daily routine, including care needs. Staff are required to sign to demonstrate that these needs have been met. Risk assessments had been carried out and they clearly identified the hazards and included sufficient detail for the management of risks. The handover session at the end of one shift was observed and it was evident that staff are familiar with the needs of people living in the home. Observation of staff showed they worked as a team and were clearly comfortable approaching the manager for support and advice. Where work is on-going to create a care plan for an individual templates are in place even if it is not fully completed. Again this was discussed with the manager who explained that Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 10 care plans have been created based on the priority needs of individuals and each person is consulted throughout the process and agree to the contents of care plans. Medication is stored and handled appropriately but some signatures in the medication administration chart had been overwritten, suggesting that medication had been signed for prior to administration; there were also some gaps so it was not clear whether or not medication had been administered. However, these errors had already been noted by the manager as part of the quality monitoring process and she explained that she carries out competency assessments for staff and addresses shortfalls during supervision or staff handovers. Staff were observed to follow good practice when administering medication and it was evident that is it given at appropriate times. Throughout the site visit staff were seen to treat people with care and respect and were seen to knock on doors before entering. People spoken with confirmed that staff were considerate and consulted them as necessary. The healthcare professional spoken with said she felt that the home provided good quality care and that staff follow her advice when required. Felix Holme RCH DS0000070463.V353195.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The lifestyle of people living in the home matches their expectations in respect of activities, choice and meals. EVIDENCE: There is an activity programme including a weekly exercise session, board games, bingo, arts & crafts, sing-a-longs in addition to one-to-one games. The inspector joined in for part of the exercise session and it was evident that those living in Felix Holme enjoyed it very much. A number of people spoken with confirmed that they go out into the community to visit the shops, have lunch or just walk round the garden. Generally those living in the home are encouraged and enabled to maintain their independence and continue with their preferred hobbies and leisure interests. Monthly religious services are provided in the home and arrangements are made for who wish to follow their own religion. At the start of the site visit people were seen to be getting up and/or eating breakfast at times that suited them, including those who preferred breakfast in their rooms. Comments from people spoken with included: Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 12 - we get more choice of meals. the food is marvellous. the food is excellent. the tea is weak and I prefer more sugar. Menus provided by the home show that meals are well balanced, nutritious and varied. Alternatives are offered at each meal times, snacks, drinks are provided throughout the day. People spoken with on the day all said that the food was good. Visitors spoken with confirmed they are able to visit at all reasonable times, are always made welcome and offered refreshments. Felix Holme RCH DS0000070463.V353195.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to and acted upon. People living in the home are further protected by satisfactory adult protection systems. EVIDENCE: There is a complaints log and all complaints are handled in line with the homes policies and procedures. One concern was raised with the CSCI and the person advised to pursue the matter via the homes policies and procedures but chose not to do so. Information provided prior to the site visit confirmed that the service has policies and procedures on both complaints and Protection of Vulnerable Adults. All staff have been trained in Protection of Vulnerable Adults and this is included in the homes’ rolling training programme to ensure all new staff receive this training and updates are provided for existing staff. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The refurbishment and maintenance programme needs to be fully implemented to ensure all parts of the home are comfortable and well maintained. EVIDENCE: A tour of the premises was carried out and a random selection of rooms inspected. Individual bedrooms were attractively decorated and it was evident that many of the people living in the home had taken the opportunity to personalise their rooms with pictures and ornaments. However, communal bathrooms, toilets and some en-suite facilities need refurbishing and call bells need to be easily accessible. This was discussed with the manager who agreed there were shortfalls and explained that this work is part of the long term plan to improve all parts of the home, although the issue of the call bells is noted as a priority. All parts of the home were clean, tidy and free from offensive odours. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 15 Information provided prior to the site visit indicated that there is an on-going maintenance and refurbishment programme for all parts of the home including long-term plans to re - design and up grade the laundry area, ensure all staff recieve training in infection control and to carry out a comprehensive risk assessment for all parts of the building. Staff were seen to demonstrate good practice in respect of infection control by wearing gloves and aprons as necessary. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff with appropriate skills to meet the needs of those people living in the home and the recruitment practice is also sufficiently robust to safeguard those living in the home. EVIDENCE: There are two carers on each daytime shift, in addition to a senior carer and the manager. There is one waking staff and one on call at night and domestics and cooks also employed. Staff were seen to take time when delivering care, indicating that the current numbers of staff were satisfactory. Recruitment records for the last two people employed were viewed and these showed that all the required information had been provided including Criminal Record Bureau and Protection of Vulnerable Adults checks, two written references and proof of identity. There is a comprehensive staff induction and foundation training programme in place that meets the Skills for Care requirements and ensure staff are familiar with working practices at the home. The one carer spoken with confirmed that there was an induction period which she was in the process of completing. Information provided prior to the site visit indicated that of the 7 care staff, two have gained National Vocational Qualification level 2 in care and a further four are in the process of gaining this award, therefore the service is on target Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 17 to ensure 50 of staff have this qualification. The home does not use agency staff but share bank staff with the sister home, Shandon House, ensuring that people living in the home received consistent care from carers known to them. Comments from those people spoken with included: All staff very caring and helpful. staff are extremely good and so helpful. (name) is delightful in every way. some staff let the door slam rather than closing it. they do look after us very well, (name) especially. the staff are wonderful and do ‘over and above’ especially when (name) is ill. There is an on-going staff training programme to ensure they have the skills and competence to deliver good quality care. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home and staff benefit from clear leadership and direction and all aspects of their health, safety and welfare are protected and promoted. EVIDENCE: The manager has the required qualifications in management and care and has many years experience in the care industry. She regularly undertakes additional training to update her knowledge and skills appropriate for her role. In respect of her qualifications she exceeds the standard required. She consults with both those living in the home and staff via regular meetings and throughout the site visit staff, visitors and residents were clearly comfortable approaching her to discuss queries. People spoken with confirmed that the manager listens to them, makes notes and takes action to resolve any issues. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 19 The home does not manage or hold the finances for people living in the home, therefore families or solicitors are expected to provide this facility. A fire safety risk assessment has been carried out and all of the priority requirements have been met, with the remaining shortfalls to be addressed as part of the refurbishment and maintenance programme. Information provided prior to the site visit showed that regular safety checks are carried out on all equipment, electrical and gas appliances and systems. In addition all policies and procedures are regularly reviewed and updated to reflect current services offered by the home. In addition it was confirmed that the current quality monitoring system includes: • Ensuring residents now have the opportunity to make decisions regarding all aspects of the home and individual care • On admission residents are encouraged to choose décor and adaptations made to facilitate any disability • Dietary requirements are discussed during pre-assessment • Links have now been made with the local church to ensure people have access to maintain their religious beliefs; monthly holy communion is now available • Residents now make individual choices for all activities of daily living. A tour of the premises found that some fire doors did not close properly and the manager explained that these were in the process of being addressed as part of the maintenance programme. Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action 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 Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 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 © 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 Felix Holme RCH DS0000070463.V353195.R01.S.doc Version 5.2 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. 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