Inspection on 28/05/09 for Eastwood House

This is the latest available inspection report for this service, carried out on 28th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eastwood House 06/12/07

Eastwood House 19/10/06

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Eastwood House 7 Eastwood Avenue Grimsby North East Lincs DN34 5BE     The quality rating for this care home is:   two star good 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: Rob Padwick     Date: 2 8 0 5 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 27 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 27 Information about the care home Name of care home: Address: Eastwood House 7 Eastwood Avenue Grimsby North East Lincs DN34 5BE 01472278073 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Christine Lyte Name of registered manager (if applicable) Debbie Lisa Stephenson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 18 The registered person may provide the following category of service only: Care home only - Code PC, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 18, Dementia - Code DE, maximum number of places 18 Date of last inspection Brief description of the care home The home is situated in a residential area of Grimsby. It is a converted domestic house and has been extended; there is large conservatory to the rear of the house and a small garden. The home is easily accessible and is on a bus route. The home provides care for 18 elderly people, some with dementia. Bedrooms are Care Homes for Older People Page 4 of 27 care home 18 Over 65 0 18 18 0 Brief description of the care home provided on both the ground and first floors; there is a lounge and the conservatory is used as a dining room. Fees for living in the home vary from £370 to £475 a week with additional charges for toiletries. 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 peterchart Environment Staffing Management and administration Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by us since its last key inspection, which took place on 30th May 2007 and includes information gathered during a site visit to the home. As part of the inspection process, we send out a self assessment document that the Registered Person must complete and return to us. This Care Homes for Older People Page 6 of 27 helps us know how well the home is meeting regulations and national minimum standards and what has been done to improve it and what still needs to be done. The self assessment was completed by the new manager and information from this used as part of the inspection process. Other information used, included feedback from people living in the home, Professional people who know them well and official notifications sent to us by the home. This information helps us to reach judgments about the service provided. The site visit took place on 28th May 2009 and lasted for 6 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit and as well as speaking to her, we talked staff who were on duty and people living in the home. We looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. 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 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 9 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. The needs of people moving into the home are appropriately assessed before they are admitted to the service and information is available to help them reach a decision and make an informed choice about the home. Evidence: The case files of people living in the home contained Local Authority assessments of their needs which had been obtained as part of their admission to the home. The new manager told us she visited people to carry her own assessment and ensure the service is appropriate for them and we saw confirmation of this in the case files we inspected. A new Service Users Guide was available to help people make an informed decision about using the service and the manager told us the Statement of Purpose was in the process of being updated to provide them with further details about the home. Social services staff who we spoke to confirmed people are able to visit the home before they decide to move in and that they had no concerns in this respect. Care Homes for Older People Page 10 of 27 Evidence: The new manager told us that intermediate care is not provided by the home. Care Homes for Older People Page 11 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. The health and personal care pf people living in the home are met by staff who are trained and respect their individual wishes for the way they are supported. Evidence: People living in the home indicated their health and personal care needs were met and told us that staff were Very nice and caring. Social Services staff who we spoke to said they had no concerns and a local Doctor confirmed the home did well in providing good Quality of care and had a Good holistic approach. Since the last time we visited the new manager had developed the care plans as previously recommended and these now provided more details about the individual strengths and needs of people living in the home. The manager told us she was hoping to encourage and involve people using the service to be more fully in the development of these and their was evidence of this with use of pictures and photos to help them understand them and ensure they are in agreement with how they are supported. We saw evidence that care plans were being regularly audited and updated and that reviews of support were taking place to ensure they remain accurate and reflect current needs. We observed staff working in a Care Homes for Older People Page 12 of 27 Evidence: friendly and professional manner and observed they respected the privacy and individual feelings of people using the service. The manager indicated she hoped to encourage this further and showed us details of a course booked on the promotion of dignity for staff to attend. The case files of people living in the home contained details and assessments about the management of known risks. There was evidence of professional advice sought on these and that they were now being reviewed and amended as needed. The support plans detailed information about the health needs of people living in the home together with regular daily recording and monitoring of their associated conditions. The last time we visited a number of requirements and recommendations were made concerning medication given to people living in the home. There was evidence of good work taken to implement these and a check of the records showed them to be accurate and appropriately kept. The provider had worked with a local pharmacy since our last inspection visit and regular checks were now being made. A new medication policy had been developed by the manager and we saw evidence of staff training on the safe use of medication and updates for these as needed. Care Homes for Older People Page 13 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. People living in the home can participate in a variety of opportunities to ensure they can experience a lifestyle that meets their needs although further development of these would help their wishes and choices for these to be better met Evidence: Since the last time we visited, a further part time activities organiser had been recruited, and although one had recently left, we were told the manager was due to interview a replacement for this post. There was evidence of work carried out to develop the opportunities for people using the service to ensure they can experience a lifestyle that meets their wishes. The service has now joined a National Association for the Provision of Activities for Older People and there was evidence of good involvement with relatives and the continued development of life story or memory lane books to help staff know more about individual interests and hobbies. People living in the home said they were generally very happy with the service and observed some playing board games together, with others choosing the privacy of their own company. Staff told us the home Provides a very high standard of care with numerous activities to keep the residents stimulated and we saw evidence of various Singalong, music and entertainment sessions provided. Some comments however indicated these could still Care Homes for Older People Page 14 of 27 Evidence: be improved and a recommendation is made about this. The manager told us that friends and relatives are welcomed to take part in the home and that following consultation, fundraising was taking place to buy transport to help people using the service to go out on trips and get into the community more. People living in the home told us they enjoyed the food that was served and confirmed alternatives were provided if they wanted. Case files contained nutritional assessments for people using the service, together with regular monitoring of aspects of these. The homes menus indicated a wholesome and nutritional diet involving home cooked meals and fresh vegetables was provided. The home has recently been awarded a 3 star rating from the Local Authority Environmental Health Department and the manager confirmed recommendations following this visit have been fully complied with. Care Homes for Older People Page 15 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. The concerns and complaints of people living in the home are taken seriously and staff training has been provided to ensure they can protect them from potential harm. Evidence: People living in the home told us they were generally Very happy and Quite satisfied with the service they received and we saw evidence the manager listens hard to any concerns and ensures action is taken about these. Whilst the complaints policy listed information about how people using the service can make a formal complaint, there were no details included about how long the provider would take for resolving these and a recommendation is made about this. A copy of the complaints policy was available in reception together with a number of letters and cards of thanks. Neither we, nor the service had received any concerns or complaints about the service provided since the last time we inspected it. Staff training had recently been completed to ensure people using the service are safeguarded from potential harm. People living in the home indicated they felt comfortable and safe and told us that staff were all very good. Policies and procedures were available to ensue people using the service are protected from potential abuse and staff we spoke to about these confirmed they would take appropriate action should they have any concerns. New policies and procedures had been developed since the last time we visited to ensure the finances belonging people Care Homes for Older People Page 16 of 27 Evidence: using the service are kept safe. We saw evidence of monthly checks for these now being completed and that two staff members were now signing for all entries made. We made a random check of the records for these and found them to be accurately kept. Care Homes for Older People Page 17 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 in the home are provided with an environment that is comfortable, clean and well maintained to ensure it can meet their needs. Evidence: The home was clean, bright and tidy and had a pleasant and homely atmosphere. There was evidence the owner was continuing to maintain the building to ensure it provides an environment that can comfortably meet the needs of the people living in the home. Since the last time we visited, a new annexe had been built with two further ensuite bedrooms and a new down stairs bathroom. The building has a passenger lift that gives access to the top floor for people with limited mobility and there was evidence of regular maintenance checks and fire precautions to ensure they are safeguarded from potential harm. People living in the home told us they liked their rooms and there was evidence they can bring items of personal possessions to help them feel at home and many contained pictures and photos that reflected their interests and personalities. The manager showed us a new sensory garden, which had been developed since our last visit and we were told about plans to develop this further. On the day of our visit some of the people using the service were observed relaxing peacefully in the garden and we were told some had been involved helping to plant a herb garden. The owners self assessment for the home indicated visitors had commented on the cleanliness of the home and the improvements that have been Care Homes for Older People Page 18 of 27 Evidence: made. Care Homes for Older People Page 19 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. People using the service are supported by staff who are trained to meet their needs and whilst recruitment procedures are generally satisfactory to protect them, their welfare and safety could further protected by more robust development and following of these. Evidence: People living in the home told us that staff were all very good and we observed a friendly and supportive atmosphere throughout the service. Staff told us they work together as a good team and that the service Provides on going training to ensure We give our service users the best care. Some staff told us poor communication had sometimes been an issue in the past, but we saw evidence the manager had taken action about this and that systems were now in place to resolve this. Other staff told us their were times when more were needed and this was confirmed by the rota, which indicated occasions when no one was immediately available, due to the need for two of them to lift some people using the service. A recommendation is made about this. Good progress had been made in developing the training programme to ensure staff have the skills needed to do their work. A training plan was displayed on the office wall and the manager told us that over 50 of them now had an NVQ at level 2 or above and that new staff were inducted to the home properly. Staff files inspected contained evidence of this, with an induction that met Skills for Care standards together with Care Homes for Older People Page 20 of 27 Evidence: appropriate mandatory training and a range of additional courses to ensure the specialist needs of people living in the home can be met. We saw in addition, the manager was carrying out regular audits to ensure staff skills are kept up to date. Recruitment policies and procedures had been strengthened since the last time we visited to ensure staff are safe to work with people living in the home. The file of a new member of staff contained all of the required checks and documentation, and whilst this individual had begun work with only a preliminary Protection of Vulnerable Adults (POVA) check, there was evidence they had been closely supervised until their Criminal Records Bureau clearance had been received and were in addition to the regular staff team. The manager was reminded this practice should only be followed in exceptional circumstances and a recommendation is made about this. The staff file of another individual, transferred from a different service run by the same owner however, contained no evidence of any formal check of their identity and a requirement is made about this. Care Homes for Older People Page 21 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. Appropriate management and administration systems are in place to ensure the smooth and efficient running of the service and enable the health, safety and welfare of people living in the home to be promoted and protected. Evidence: Since the last time we visited, a new manager had been appointed and formally registered to manage the home as required. The new manager has previous experience of managing care homes for older people and is appropriately qualified and is currently taking her NVQ 4 in management and care. Information in the homes self assessment indicated the manager has an open and inclusive style and staff comments received about her were very positive. One member of staff told us In June when new management took over the care standards and training have improved. The cleanliness is of a high standard, staff moral has improved greatly whilst another said Since getting a new manager, the Eastwood has turned around and is a pleasant and fulfilling place. There was evidence the new manager had worked hard to develop and Care Homes for Older People Page 22 of 27 Evidence: improve the home since we last visited and all of the requirements made previously had now been met. People living in the home said they were Quite satisfied with the home and we saw evidence their views are taken seriously and that the new manager was working hard to ensure action is taken about any concerns they have. Regular meetings were now being held to ensure people using the service can contribute ideas to develop the home and we saw questionnaires in the process of being developed to gain feedback from both them and others who know the service well. The new manager has a clear understanding of her role and there was evidence she provides a good sense of direction and leadership to staff, who were now receiving regular professional supervision and appraisals of their work. Management and administrative systems had been developed since we last visited and there was evidence of audits and regular checks to ensure the service can monitor its progress against its aims and objectives and be efficiently run. Record keeping was generally of a good standard and a range of policies and procedures had now been developed. The records of finances belonging to people living in the home that we checked were accurately kept and the maintenance records were in good order, with training provided to ensure staff can promote and protect the health, safety and welfare of people living in the home. Care Homes for Older People Page 23 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 24 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 1 29 19 The Registered person must ensure staff files contain evidence of formal identity checks. This is to ensure people using the service are protected from potential harm and that staff are safe to work with them. 30/06/2009 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 1 The Registered Person should ensure the Statement of Purpose for the home is updated and available. This is to ensure people thinking about using the service can be further informed about it. The Registered person should ensure the activities for people living in the home are continued to be developed and that specialist training about this is provided to staff. The Registered Person should ensure the complaints policy gives details and timescales for action so that people using the service have information about how long these will take to be resolved. Page 25 of 27 2 12 3 16 Care Homes for Older People 4 27 The Registered Person should review the staffing levels to ensure their are sufficient numbers of them available to meet the needs of people living in the home. The Registered Person should ensure new staff are only allowed to start working in the home with only a preliminary Protection of Vulnerable Adults (POVA) check in exceptional circumstances and that the Care Quality Commission is formally notified of such occasions. 5 29 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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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