CARE HOMES FOR OLDER PEOPLE
Midtown House Caldbeck Wigton Cumbria CA7 8EL Lead Inspector
Paula Malaney Unannounced Inspection 15th March 2006 10:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Midtown House Address Caldbeck Wigton Cumbria CA7 8EL Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 016974 78528 Mrs Julie Ann Tickle Mrs Julie Ann Tickle Care Home 20 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (19) of places Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th October 2005 Brief Description of the Service: Midtown House is registered with the Commission for Social Care Inspection to provide accommodation to up to twenty older people. Midtown House is owned by Mrs Julie Tickle who is also the registered manager, responsible for the dayto-day running of the home. The home is situated in the centre of the village of Caldbeck and is close all the local facilities available in the village. The premises are a larger period property which have been adapted for use as a care home. Accommodation for residents is provided on the ground and first floor of the home. The home has twenty bedrooms with ensuite toilet and bathing facilities. When suitable rooms are available arrangements may be made for two residents to share a bedroom. Short-term respite care is provided in Midtown House when accommodation is available. The home has a range of adaptations and equipment to assist residents including stair lifts, assisted bathing and toilet facilities and a call bell system. The home is set in attractive, well maintained grounds which are accessible to the people living there. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out on 15th March 2006. The inspection focussed on how well the services provided in the home meet the needs of the people living there. This was assessed by speaking to residents, care staff and the manager, observing activity in the home and examining the records held. What the service does well:
Midtown House is a good home. Residents receive a high standard of care which meets their needs and takes account of their preferences. Residents are supported to maintain control of their lives and the decisions they make are respected. Residents said the support provided in the home is “Excellent, it couldn’t be better”. Care staff have developed positive relationships with residents and they are comfortable receiving support from the staff in the home. Care staff take appropriate actions to protect residents’ privacy and to maintain their dignity. Admissions to the home are well managed. Prospective residents have the opportunity to visit the home to assess whether it is suitable for them. The home only offers accommodation to people who’s needs can be met by the care provided. Appropriate action is taken when the home can no longer meet a resident’s needs to ensure that they continue to receive the support they require. Residents make choices about their lives in the home including how and where to spend their time. The location of the home allows residents to access the facilities in the local community. Many residents lived in the local area before moving into Midtown House and enjoy visiting friends in the village. The atmosphere in the home is open and welcoming and residents receive visitors as they choose. Residents are provided with a well-balanced and varied diet. Residents said, “The meals are lovely”. The home is well managed and residents’ rights, safety and welfare are protected. Thorough checks are made on new staff to ensure they are suitable to work with residents. Care staff receive regular training to give them the skills and knowledge to meet residents’ needs. Over fifty percent of care staff have achieved a National Vocational Qualification level 2 or above in Care. This exceeds the level required by the National Minimum Standards. Midtown House provides a comfortable and pleasant environment for residents to live in. Residents said the accommodation is “very nice” and said, “I like my room”. The home has appropriate equipment and adaptations to maintain residents’ independence and safety. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 and 5. Admissions to the home are well managed and residents know their needs will be met by the services provided. EVIDENCE: The home has a good system for handling admissions which includes residents’ needs being assessed before they are offered accommodation. Prospective residents and their families are given the opportunity to visit the home so they can assess the service before making a decision to move there. Appropriate action is taken when the home can no longer meet a resident’s needs to ensure that they continue to receive the support they require. Residents said the support provided in the home is “Excellent, it couldn’t be better”. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10. Residents receive a high standard of care which meets their personal and health care needs. Residents are treated with respect and their privacy and dignity are protected. EVIDENCE: Care staff are knowledgeable about the support residents need and provide this in a patient and friendly manner. Care staff have developed positive relationships with residents and take time to talk to them as they carry out their duties. Residents are comfortable receiving care from the staff in the home. Care staff treat residents with respect and take appropriate actions to protect their privacy and maintain their dignity. Residents receive health care from local GP practices and from health care specialists as they require. Residents are supported to attend routine health care appointments including chiropody and dental services. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. The home is run in the best interests of the people who live there and residents maintain control of their lives. Activities and meals are well managed and are varied and take into account individual preferences. EVIDENCE: Residents make choices about their lives in the home including how they spend their time and the visitors they receive. Residents are supported to follow a range of activities in the home and local community. The atmosphere in the home is relaxed and welcoming and residents know they can see their friends and families as they wish. The location of the home allows residents to access the facilities in the local community, with support from care staff if they need. Meals are varied and provide choice and a nutritious diet. Residents said, “The meals are lovely”. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Residents are protected from harm by the home’s procedures and staff knowledge and awareness. EVIDENCE: Care staff know the procedures to follow if they are concerned about a resident’s safety or welfare. Advice is taken from appropriate agencies outside of the home if concerns are identified. Residents’ financial interests are protected by the procedures followed in the home. Money and valuables held on behalf of residents are stored securely and receipts kept for purchases made on their behalf. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 and 26. Residents live in a comfortable, clean and safe environment which is suitable to meet their needs. EVIDENCE: The home is well maintained and is decorated to a high standard and provides comfortable and pleasant accommodation for residents. Residents have their own possessions in their bedrooms and have personalised their accommodation as they wish. Residents said the accommodation provided is “very nice” and said, “I like my room”. Residents choose whether to spend time with other people or on their own. The home has a range of equipment to assist residents to stay independent including specialised equipment provided for individual residents. There are appropriate toilet and washing facilities close to all accommodation used by residents. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29. Residents are protected by the home’s recruitment and training procedures. EVIDENCE: New staff are recruited using thorough recruitment procedures which include taking up of references and Criminal Record Bureau and Protection of Vulnerable Adults list disclosures. The procedures ensure that staff are suitable to work with residents and maintain their safety. New staff undertake thorough training to give them the skills to provide a high standard of care. Care staff receive regular training to update their skills and knowledge to ensure they are able to meet residents’ needs. Over fifty percent of care staff have achieved a National Vocational Qualification level 2 or above in Care and the National Minimum Standard is exceeded. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 and 38. The home is well managed and residents’ rights, safety and welfare are protected. EVIDENCE: Mrs Julie Tickle is the owner and manager of Midtown House. Mrs Tickle has completed appropriate training to update her skills and knowledge, including the Registered Managers Award. The home is well managed. Procedures are in place to ensure that residents’ rights and financial interests are protected. The atmosphere in the home is welcoming and inclusive. Many residents lived in the local area before moving into Midtown House and are familiar with the home and the staff working there. The manager and care staff ensure that residents who are not from the local area do not feel excluded in the home. The home’s management team focus on promoting residents’ independence and right to maintain control of their lives. Staff receive training to ensure that residents’ safety and welfare are protected. Advice has been taken from the
Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 15 local fire safety and environmental health officers regarding providing a safe environment for residents to live in. Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 X 28 4 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Not applicable. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Midtown House DS0000022609.V283532.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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