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Inspection on 15/04/09 for Caythorpe Residential Home

Also see our care home review for Caythorpe Residential Home for more information

This is the latest available inspection report for this service, carried out on 15th April 2009.

CQC found this care home to be providing an Excellent 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The owner has achieved the `Investors in People` Award since we did the last inspection. The owner and staff provide the people with a clean, comfortable, homely environment which caters for their needs and wishes and creates a warm, family-style atmosphere. Staff are well-trained, supported and encouraged by a conscientious owner-manager and are happy coming to work and caring for the people. A comprehensive quality assurance and auditing system is in place to ensure the home is run for the benefit of the people who live there and staff, and to ensure that the people have a say in how the home is run.

What has improved since the last inspection?

The wide range of daily activities now provided by keen and cheerful activity staff support and stimulate the people as they wish and keep them aware of the British calendar of events around them throughout the year. A newsletter is produced every couple of months to keep people, relatives and staff informed of what has been achieved at the home.

What the care home could do better:

We made no requirements or recommendations at this inspection visit. The owner and staff are meeting, and in some areas exceeding, the National Minimum Standards.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Caythorpe Residential Home 73 High Street Caythorpe Grantham Lincs NG32 3DP     The quality rating for this care home is:   three star excellent 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: Vanessa Gent     Date: 1 5 0 4 2 0 0 9 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. 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. 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Caythorpe Residential Home 73 High Street Caythorpe Grantham Lincs NG32 3DP 01400272552 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : caythorpecare@btconnect.com Mrs Christine Lyte care home 14 Number of places (if applicable): Under 65 Over 65 0 7 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 7 0 Caythorpe Care Home is privately-owned and occupies a large, early period town house in the village of Caythorpe. The owner-manager offers personal care for up to fourteen people of either sex over the age of 65 years, some of whom may have dementia. The home was full on the day of our inspection visit. It is situated on the corner of the main street in the village, opposite the parish church. Caythorpe is approximately seven miles from Sleaford and nine miles from Grantham. Within the village there are shops, the church, a village hall, the doctors surgery and pubs. The accommodation consists of ten single and two double bedrooms, none of which are ensuite but all have hand wash basins and some now have a toilet, with a modesty curtain to screen it. Communally, there are three lounges and a dining room. Outside Care Homes for Older People Page 4 of 26 Brief description of the care home is a secluded, enclosed, secure garden for people to sit in and enjoy. There is on-road parking for visitors to the front and side of the home. The weekly fees charged are from £351 - £435. People pay for their own hairdressing and chiropody charges, their own newspapers, magazines and any other personal items. Information about these costs, as well as the day-to-day operation of the home, can be found in the statement of purpose and service user guide. These documents and a copy of the latest inspection report are available to people who live there and for those interested in coming to live at the home. Care Homes for Older People Page 5 of 26 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: three star excellent 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 quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. An unannounced visit was made to the home as part of our key inspection. It started at 11:00 and lasted nearly six hours. As part of our review and assessment of the service, the owner completed a selfassessment questionnaire called the Annual Quality Assurance Assessment (AQAA). The information we received, as well as that which we hold about the service, was used to plan the visit and produce this report. Care Homes for Older People Page 6 of 26 The main method of inspection we used was called case-tracking. This involved choosing selected people, and checking the care they receive through looking at their records, chatting with them, the care staff, any visitors and observing care practices. Our visit to the home focused on whether key standards had been met and how people felt about the service provided. The care received by three people was followed in detail to check that their health, safety and welfare needs were fully met and that they were supported to maintain their dignity, autonomy and choice. We spoke with the owner, staff on duty, a relative and most of the people in the lounge, including those whose care we were following closely. People talked about their experience of living at the home. Any comments we received are mentioned in the main body of this report. Some personal records, known as care plans, general house records and staff records were looked at, and the way care was given to the people was noticed. We saw some areas of the home and watched the lunch meal being served to and taken by the people who live there. The owner-manager was present throughout our inspection visit. 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.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 8 of 26 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 9 of 26 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 have enough information for them to decide whether the home is suitable for them. Assessments are done for everyone interested in coming to live at the home, to ensure that the manager and staff can meet the needs of the people who stay there. Evidence: We saw the homes statement of purpose and service user guide. The manager told us they are given out to people interested in coming to live in the home. A person we spoke with told us that they were given a list of care homes by Social Services but found Caythorpe for themselves. They said they were given a copy of the statement of purpose and service user guide, along with a copy of the latest inspection report. They visited the home before they moved in and were sure that they would be comfortable. They had also heard of the homes good reputation locally and were confident about moving in. Care Homes for Older People Page 10 of 26 Evidence: All the care plans we saw were created by the owner and senior care staff, often also using the assessments done by Social Services. They showed that pre-admission assessments were completed with people coming to live at the home. People living in the home and relatives also confirmed this. The owner-manager of Caythorpe Care Home does not provide an intermediate care service. Care Homes for Older People Page 11 of 26 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. Peoples needs are met by clear care plans, appropriate liaison with other professionals and safe medication practice. They are cared for safely, with dignity and as they wish. Evidence: We selected three people and looked at their care plans. Each contained an initial, substantial assessment, risk assessments and described the care plan issues or needs of the residents involved. Senior staff said they have been trained to write in the care plans and review them. All the staff on duty said they knew what was in the care plans and that they were easy to follow. We saw that they were reviewed regularly to make sure they were up-to-date with the residents changing needs. A relative confirmed that they had been involved with the creation of the care plans but that they were happy for the staff to review them and inform the relative if any changes took place. We also saw the signatures of a relative of one of the people. The owner told us, in her self assessment, We actively encourage relatives to participate in decisions affecting residents care. Care Homes for Older People Page 12 of 26 Evidence: A healthcare professional told us that staff call them if any person has any healthcare needs and that regular contact is maintained to help treat people with needs. We were told that wherever possible people are supported to take their own medicines independently, however during our visit the staff and people told us they all needed some level of support to take medicines safely. Staff told us, and their staff files confirmed, that they do not give medications until they have been trained to do so. The homes supplying pharmacist gives the training as well as reviewing, checking and auditing the medication practices regularly. Their reports showed us that all the medication practices at the home are safe and satisfactory. People told us that all the staff are respectful and treat them with dignity. We confirmed this during the visit as staff were affectionate, gentle and considerate with people. And people responded with smiles and laughter and fond retorts in a close rapport with the staff. Some told us, Theyre lovely. Theyre always there for us. Care Homes for Older People Page 13 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to enjoy activities, choices and a lifestyle which is flexible and what they want. Meals provided are nutritious, well-balanced and appetising. Evidence: We observed that the widely-varied activities that are now offered and taken part in are enjoyed by all who participate. The owner showed us that she has joined the charity NAPA (National Association of the Provision of Activities for Older People), and this has helped them find even more ways to give the people more choice and interest. Some of the activities are calendar-related so that people are kept aware of the events that happen in Britain throughout the year. We saw photos of the ladies wearing their homemade Easter bonnets and during our visit, some people were painting and decorating a green dragon in preparation for St Georges Day. The activities undertaken are recorded in each persons care plans by the people in charge of organising activities. Staff help the activities organisers with keeping people occupied and happy. People said they also get one-to-one attention as well as group sessions. A volunteer who comes in every couple of weeks to do activities with the Care Homes for Older People Page 14 of 26 Evidence: people sits with them in informal resident meetings and feeds back any items they want being implemented or discussed. The people said they like the meetings that take place with her. People said that when the weather is fine, they enjoy sitting outside, and indeed, during the visit, we saw people enjoying the sunshine in the attractive, walled, enclosed garden. The owner said, in her self assessment, that they endeavour to provide A stimulating environment full of meaningful activities tailored to meet individual needs. People told us this has been achieved. A newsletter is produced every couple of months to inform residents, relatives and staff of what has happened and been achieved during that time. Visitors to the home said they are always welcomed by the staff. They said the manager had a chat with them and they felt that her door is always open. Communally, they have visiting performers and groups that come to the home to entertain the people there and during our visit, several people went for a walk around the village with two staff members. People are also taken out in the homes wheelchair-friendly vehicle, fondly known as the Pope-mobile. People told us or indicated that they are given lots of choice all the time and that they can say how they want things to be and they are taken notice of. They have residents meetings where they can voice their opinions and have a say in the running of the home. People told us that the food is lovely and there is always enough of it. We saw a main meal being served and eaten by the people. There was a variety of vegetables served with the main course. People told us that staff know their likes and dislikes and that they are always only given food they like. Anyone needing assistance was helped with dignity, with the staff paying them attention whilst sitting with them. Care Homes for Older People Page 15 of 26 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 feel able to voice any concerns, are taken notice of, and are protected by staff who are trained to prevent abuse and who are committed and caring. Evidence: People and visitors told us that they have never had any concerns or complaints about the service but if they were not happy with anything, they felt they could go to the owner or any of the staff and things would be resolved. They said there was a lovely rapport between the staff and the residents. The owner told us that any concerns that were picked up in the regular survey she distributed were always addressed straight away. Neither we nor the owner of the home have received any concerns or complaints about the service provided at the home since the last main inspection. One visitor said, I can go home and switch off and know that [the resident]s well being is looked after. In the last review we did of the service we found, If anyone had any complaints or concerns, they normally go straight to the staff. Relatives found them very approachable. The owner, in her self assessment, said, They have time to voice opinions, complaints or or suggestions and we ensure these are acted upon. We have not had any concerns reported to us about keeping people at the home safe from harm. Staff told us, and their files confirmed, that they are trained from their induction onwards to put the people first and keep them safe at all times. They Care Homes for Older People Page 16 of 26 Evidence: demonstrated their caring ways with the people living in the home during our visit. Staff said they would be prepared to raise any concerns about the care given by any of their colleagues but that they all worked together really well and were all caring and concerned about the residents. Most of the staff team had worked at the home for a long time and were friends as well as colleagues. Care Homes for Older People Page 17 of 26 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 live in a comfortable, clean, homely environment, which ensures they are cared for safely, as they wish and that they feel at home. Evidence: On the day of our visit, the home was clean, tidy and people told us, it always smells pleasant. Some of the communal rooms are decorated in a style that older people would be familiar with, such as cabinets and niches with ornaments from previous generations. Many of the walls around the home are decorated with art work done by the people themselves and photographs of activities they have taken part in over the previous months and years, that show them enjoying life, smiling and happy. There are ten single and two double bedrooms. Four of these have their own toilet with a modesty curtain to enclose it. It is planned to extend the number of rooms with toilet or ensuite facilities. Communally, there are three lounges, one dining room, two bathrooms, one of which is fitted with a specialist bath for people with mobility limitations and four separate toilets close to either communal areas or bedrooms. Outside, at the side of the home, there is an enclosed, secure garden where, staff told us, the people enjoy sitting out and watching the village life go by. This garden is accessible via French windows in both the main lounge and the dining room. It is filled Care Homes for Older People Page 18 of 26 Evidence: with colourful flowers and plants. People said they like the garden. A visitor said it was an attractive area. There is car parking space on the road in front and to the side of the property. The owner has a vehicle with wheelchair access for those people wishing or needing to use this facility. Reports since our last inspection of the home from both the Environmental and Fire Safety officers said that the home is safe and well-maintained. The owner and staff have achieved a four-star award for their food hygiene. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Enough staff, who are safely recruited and well-trained, are on duty to enable them to give people ample opportunity to engage with them and receive the attention they need. Evidence: The manager and staff told us, We all get on very well together. Some of the staff have worked at the home for a long number of years. Staff told us, I love the job. I worked somewhere else before I came here; this is much better compared with where I was before. A relative said, Staff never seem in a rush. Theyve always got plenty of time for the residents and me. The staff on duty told us, we can spend quality time with the residents when they want. The duty rotas confirmed that enough staff with a variety of skill levels were on duty at all times. We were told and saw that all staff have, or are working towards, the nationallyrecognised qualifications in care studies, some progressing onto higher levels and some becoming assessors of the others working towards completion of their studies. Staff told us, and their record files confirmed, that they were recruited appropriately Care Homes for Older People Page 20 of 26 Evidence: and once working there, had enough time and training in their induction period to enable them to work safely with the people living in the home and their colleagues. Staff said that the training was plentiful and appropriate to the care needed by the people at the home. Their certificates and the managers training matrix confirmed this. Staff also spoke knowledgeably about how well they know the people for whom they give care. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run for the benefit and in the interest of the people and staff. The people feel safe and enjoy living at the home. Evidence: The home has been in the current owners hands for twelve years. She is qualified in mental nursing and has completed further studies to make her practice relevant to the resident group. She has achieved her Registered Managers Award. The staff on duty told us that the owner-manager is always very supportive and that there is a close family-group relationship between the owner and the staff team. A relative said that the owner is often around and always speaks with her whenever she comes to visit. The owner told us, in her self assessment, that she has an open door policy and tries to maintain a family atmosphere. The owner told us in her self assessment and showed us how thorough the quality Care Homes for Older People Page 22 of 26 Evidence: assurance for and auditing of the service was, in the surveys and questionnaires sent out regularly to the people, relatives, visitors and other professionals that have contact with the people who live in the home. The manager then collected the information received and used it to summarise the service and address or improve any issues found. Because of working full-time at the home and by being in close contact with people on an almost daily basis, she also showed us how she closely monitors the staff, training, peoples care, hygiene and safety of the home and keeps records. People or their relatives manage and keep secure their personal finances and allowances. Where the owner and staff have charge of any persons money, we saw it is kept safe and that detailed, monitoring records are kept. Staff told us that they had regular one-to-one meetings with the manager or senior staff and felt very supported by them. They also told us that the owner is there most days and has an open door policy where they can go at any time to her with any problems or issues they may have and she supports them. Staff meetings are held on a regular basis, with minutes being taken and recorded. Staff said they could have their say and felt that the owner always listens to them, discusses things with them and puts things into action where it will improve the lives of the people who live there, for those who have association with the home or themselves as staff members. The report since our last inspection of the home from the Fire Safety officer said that the home was safe and well-maintained. The last Environmental Health Officers report made two recommendations which were actioned upon straight away and the home was found, subsequently, to be safe and hygienic. The maintenance of the home is always kept up-to-date and people told us that the improvements made to the environment has made it more comfortable and pleasant for them. Peoples comments included, thank you for all your kindness and dedication, not only to [the person] and ourselves but to her sister and family when they visited. Nothing seemed too much trouble for you. [She] hated the idea of going into a home but when the time came, it only took a few days for her to settle in and become happy in knowing there were caring people with her day and night. My sincere thanks for all you do for [resident] and the care, kindness and support given to the whole family. Care Homes for Older People Page 23 of 26 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 24 of 26 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. Care Homes for Older People Page 26 of 26 - 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. 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