Inspection on 20/01/10 for April Cottage

This is the latest available inspection report for this service, carried out on 20th January 2010.

CQC found this care home to be providing an Good service.

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

April Cottage 04/01/07

April Cottage 01/11/05

April Cottage 11/08/05

April Cottage 08/12/04

April Cottage 31/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 10/04/2010.

Key inspection report Care homes for older people Name: Address: April Cottage 54 Belvoir Road Coalville Leicestershire LE67 3PP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Keith Charlton     Date: 2 0 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: April Cottage 54 Belvoir Road Coalville Leicestershire LE67 3PP 01530451452 01530451452 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Gaynor Borland,Mr Ian Borland care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: No one falling within category OP may be admitted into the home where there are 12 persons of category OP already accommodated within the home. To be able to admit the named person of category OP, aged under 65 years old named in variation application V32040/S51804 dated 07/05/2006. Date of last inspection Brief description of the care home The last key inspection of this service was on 23/3/09. April Cottage care home cares for twelve older persons in two converted detached properties converted into one building for its present purpose. The home is situated in a residential area and within walking distance of the market town centre of Coalville. Residents have access to a variety of shops and other amenities in the town centre. There is easy access for private and public transport. There is a small area on the front of the drive for parking. The home is situated on a main road. The accommodation is over two floors accessible by use of the vertical lift. There are twelve single bedrooms; Care Homes for Older People Page 4 of 27 Over 65 12 0 Brief description of the care home some bedrooms have en suite facilities. There are two lounges and dining space for residents use. A garden is situated to the rear of the premises. The fees at the home range from GBP 347 to GBP 405, and these do not include personal newspapers, hairdressing or chiropody. The certificate of registration and the Employers Liability Insurance are displayed in the entrance hallway of the home. Care Homes for Older People Page 5 of 27 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: two star good 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: This key inspection included a visit to the service. We (the CQC) visited April Cottage on the 20th January 2010. The Manager and Deputy Manager and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by: - talking to the people who live in the home and relatives, - talking to staff and management, - watching how people are given support, - looking at records. Care Homes for Older People Page 6 of 27 We spoke with seven people who live in the home and two relatives during our visit, who told us that staff were very caring and treated people with respect. One person said, Staff are marvelous and could not be more helpful. None of the people spoken with had any complaints about the attitude of staff. We spoke with two members of staff during our visit to the home who told us about working in the home. They all were enthusiastic about working to help people and thought there was a good staff team and effective management to ensure people had a good quality of life. We have also received surveys from two people who live in the home. They were very satisfied with the care provided: Everyone has been so kind and concerned. There is a lot of love and family atmosphere in April Cottage from all.....caring is of the highest. There was one suggestion: There could be more activities and outings. We received a survey from a staff member who was again very positive: ...all service users are getting care that they require....April Cottage is like one big family....all get on very well. We checked all the standards that the Care Quality Commission has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. Care Homes for Older People Page 7 of 27 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 on page 4. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at April Cottage have had their needs properly assessed before moving into the home so that staff can meet these needs. Evidence: People said they had been provided with sufficient written information prior to admission to make up their minds about the home. I think my daughter was given a brochure when we first came here, one person said. We case tracked a person living in the home who had moved into April Cottage in the past. We checked that she had received information to help with the choice of home, and she said she thought that both she and her relative had received enough information. We also checked that this person had her needs properly assessed prior to moving in, to ensure that the staff at the home could meet their needs and we found that the assessment system was detailed regarding most needs, though past Care Homes for Older People Page 11 of 27 Evidence: health checks had not been included, which are useful to prompt these checks and improve the health and daily quality of life for people. The Manager said this would be included in future. Care Homes for Older People Page 12 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at April Cottage receive good health and social care practice. Evidence: People said that staff provided friendly and sensitive personal care: Staff could not be better. They would do anything for you, one person said, and this was one of the many very positive comments that were made. People and relatives spoken with could recall having a care plan and said that they thought they could see it if they wanted. We checked the care plans of two people living at the home who were case tracked. Plans showed detail regarding the support required by staff to ensure the physical health of people living at the home, though there were also ommissions - no fluid chart for a person who could not eat, no risk assessment in place for a person with a history of epilepsy, and no detailed reference to social and emotional care needs or personal history, or information of preferred daily living routines to ensure peoples social and emotional well being is fully supported. Care Homes for Older People Page 13 of 27 Evidence: Staff said they were asked by management to read Care Plans, which ensures they can deliver proper individual care. Accident records were checked and medical services were generally contacted when a person had a potentially serious injury, though this had not been done on one occasion - the Manager said that staff would be reminded to do this. People said that staff contacted the GP if they were not well, which protects peoples health. We checked the medication records and found that there was good recording of the administration of the medicines in the home, with no gaps and good recording of incoming and returned medication. Staff said they had pharmacy training and we saw certificates to prove this. Controlled medicines storage has a secured cabinet. The Manager said there is an up to date storage cabinet for controlled medication which conformed to the latest legal requirements, which we saw. We spent time watching staff interaction with people living at April Cottage. We saw staff being friendly and caring to people throughout the day with people and visitors confirming that staff respected peoples dignity. There were also records in place from relatives of people who had received care in the past which praised staff, Thank you for all your warmth and kindness you have shown .... during his time with you.....you never gave less than 100 . Care Homes for Older People Page 14 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are opportunities for people at April Cottage to have a relaxed lifestyle of their choosing but more opportunities for stimulating activities need to be evidenced as available. Evidence: The AQAA stated that there were activities every day. People said that there were some activities but they had dropped off lately and they would like some more as there was only bingo each week. The Manager and staff said that activities were offered but when it came to it people werent interested. It was agreed that an Activities Programme would be set up, based on consultation with people and this would be recorded to show the activity offered daily or the lack of interest. The ideas for activities mentioned were playing skittles, more sing songs, quizzes, ludo, beetle drives, gentle exercise, games and cards and outings in good weather. A person said she went out when she wanted as did another person who said she was going out to lunch with friends. She said she liked to be private in her bedroom and this choice was respected and she stayed there all the time. The relations between staff and people were observed to be relaxed and people said Care Homes for Older People Page 15 of 27 Evidence: there were no rules - can get up when they like, choose their clothes and have an alternative to the main meal. Staff said visitors were always welcome and visitors spoken with on this visit confirmed that staff welcomed them and they thought the care the staff supplied was of a very high standard. People said that the food was good. People at the home have a two course meal at lunch time with an available alternative if they prefer. On the day of inspection the meal was toad in the hole or quiche with mashed potato and one vegetable followed by peaches and tinned milk - no choice of dessert. The Manager was asked to have a minimum of two vegetables each day plus a choice of dessert, which he said would be followed up. Visitors are welcomed at the home and we were informed by a visitor that she could come at any reasonable time and she was always greeted in a friendly way by staff and offered a drink. Care Homes for Older People Page 16 of 27 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 are listened to and there are systems in place to protect them from abuse. Evidence: People said if they had a complaint they were confident that Ian or Lisa, the Management, would sort it out. A person said, I am sure it would be quickly seen to. The Complaints Book showed complaints had been properly followed up. The Complaints Procedure was not totally clear that complainants can refer their complaint to the Lead Agency, the Social Services Department, as an option rather than having to go to the Management of the home first. The Manager said this would be altered. We talked to staff to find out how much they knew about protecting people in the home from abuse. Records showed they had received training about safeguarding adults from abuse, and they knew the in house procedure, and Agencies to whistle blow to if the in house procedure failed. Due to a recent situation, management now know to swiftly refer any incident of possible abuse to the Lead Agency, the Adult Care Department. We looked at the staff recruitment records to see whether all the proper checks had Care Homes for Older People Page 17 of 27 Evidence: been made on staff before they started employment at April Cottage and legal checks were in place to help management reach the judgment that people were safe to work at the home. Care Homes for Older People Page 18 of 27 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. People living at April Cottage live in a homely and well maintained environment. Evidence: All the people spoken with they liked their bedrooms: This home is always clean and tidy and there are never any smells, one person said. The AQAA states that touch free bins and paper towels had been put into place to maintain infection control, and we saw this to be the case. We saw people at April Cottage living in a clean and well maintained environment. The furnishings in communal areas are homely, and people said that they were encouraged to bring their personal possessions into their bedrooms. Records show that the home is well maintained, and good measures are in place to keep the home hygienic. There were no odours at all. The AQAA stated that there had been decor to corridors and the laundry and that this upgrade will continue with the bathroom on the first floor. Records show that the home is well maintained and there is a Forecast of Annual Maintenance Improvements in place to ensure maintenance is kept up to date, and Care Homes for Older People Page 19 of 27 Evidence: good measures are in place to keep the home hygienic. Domestic workers have either achieved, or were in the process of achieving, vocational qualifications, which is to their credit. Care Homes for Older People Page 20 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by a competent and generally well trained staff group. Evidence: There were no comments that staff were too busy. Staff are always friendly and helpful whenever we need them, one person said. The staff rota showed three care staff (one of whom is the Deputy Manager) on duty throughout the morning, which then drops down to two staff for afternoon/evening periods, with a staff member on duty at night , and on call staff if needed, until 8.00am the following morning. We asked the Manager whether two staff were needed before 8.00 am to assist in getting people up and preparing the breakfast. He said that currently this was not needed but staff would be put on duty in if this was the case in future. A staff member said that she had been encouraged by management to do further training and had completed her NVQ 3 course and a number of training courses. We also saw that new staff did a thorough induction using the recognised Skills for Care booklet. From information obtained from the Manager we saw that there are over 50 of staff with NVQ training, needed to ensure a good range of knowledge to meet peoples needs. Four management staff have achieved the NVQ 4 care management Care Homes for Older People Page 21 of 27 Evidence: qualification, which is a very high proportion of staff and proves the commitment to achieving a skilled workforce and meeting peoples needs. We found that staff have been on a number of training events to help update their practice on areas such as Food Hygiene, Nutrition, Medication, First Aid, Health and Safety, Dementia, Vision Impairment, Moving and Handling, Fire Safety, Infection Control etc though not for all staff and some issues regarding peoples health conditions were missing - e.g. Hearing Impairment, Stroke, Mental Health conditions, Diabetes etc. We asked that these topics be added to the training programme and the Manager agreed this would be done. Staff records showed that proper checks had been carried out to protect people from unsuitable staff. Care Homes for Older People Page 22 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are management systems in place to protect the health and safety of people in the home. Evidence: Ian and Gaynor Borland are the Managers of the home and both have completed the NVQ 4 Award in management skills. People and their relatives were very positive about the management team, and their management skills. They are very organised here. If I need to ask anything they always find out for me, one relative said. Satisfaction questionnaires were sent around the home last year to check peoples views of the service according to the Manager, who said he would send us an example of these to prove this was in place. This was carried out and we saw that this is in place. The AQAA stated that quality assurance is also carried out by using our AQAA form to ensure all essential policies and procedures are in place. Written records regarding finances for people are properly in place though no monies needed to be checked as the home does not keep monies for people according to the Manager. Care Homes for Older People Page 23 of 27 Evidence: There was no evidence of Residents Meetings discussing relevant issues - activities, food, staff, complaints etc, to show peoples involvement in the running of the home, as the AQAA stated that people are instead spoken to individually regarding their views. It is recommended that this is introduced, with relatives invited as well if this meets the approval of people who live in the service. Safe working practices were observed as we went around the home - e.g. instruction for staff to wash hands in the staff WC to prevent infection, proper transfer of people from chair to zimmer frame etc. Staff informed us that they were able to tell management of the problems they were facing and there were meetings (though not very regularly held, which the Manager said he would follow up) and regular appraisal to support them, which we saw as being detailed and well kept. There are Health and Safety systems in place in the home. We saw that the service has obtained a three star rating with the Environmental Health Department for its food hygiene practices. We also saw risk assessments for safe working practices and COSHH assessments to keep people safe. Some radiators have covers to ensure that people are protected from burn risks, though the Manager acknowledged that the risk assessment was not detailed enough for radiators without covers and said this would be done, and covers put in place swiftly as needed. Proper fire records were in place with regular fire drills. Staff were asked about the fire drill procedure and they all knew what to do. For part of the inspection the kitchen fire door was open. This needs to be risk assessed and kept shut if necessary or an approved device fitted if, to maintain fire safety. The Manager said this would be done. There was a Health and Safety folder with Risk Assessments completed. The lift service record was seen - although there were no requirements, the Manager said he would be following up the recommendations of this report. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 1 2 7 8 Care Plans need to be fully detailed to ensure staff are consistent in meeting all the identified needs of people. Medical services need to be contacted for all potentially serious conditions so that peoples health is always fully protected. An Activities Programme based on peoples wishes needs to be set up to give people the opportunity to have daily stimulation. The Complaints Procedure needs to state that people have a choice to go to either the service or the Lead Agency, to have their complaint investigated. All staff need to be trained in essential topics plus peoples health conditions to have the skills to meet all needs. All risk assessments need to be in place and acted on as needed, in terms of protecting people from burn and fire risks. 3 12 4 16 5 6 30 37 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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