Inspection on 07/06/07 for Calderthwaite

This inspection was carried out on 7th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Calderthwaite 25/01/06

Calderthwaite 23/08/05

Calderthwaite 17/03/05

Calderthwaite 05/08/04

Calderthwaite 30/03/04

Calderthwaite 07/04/03

Calderthwaite 27/05/02

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Calderthwaite The Banks Seascale Cumbria CA20 1QP Lead Inspector Nancy Saich Unannounced Inspection 7th June 2007 9:00 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 Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Calderthwaite Address The Banks Seascale Cumbria CA20 1QP 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) 019467 29292 Mrs Mary Rose Watters Mrs Mary Rose Watters Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (6) of places Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include; - up to 6 service users in the category of OP (Old age, not falling within any other category) 25th January 2006 Date of last inspection Brief Description of the Service: Calderthwaite is a Victorian house in a residential area of Seascale. The home is near to all village amenities including the railway station. Accommodation is on the ground and first floor. Bedrooms are single occupancy with ensuite shower and toilet. There is a lounge/ dining room on the ground floor. The home can take up to five older adults. Calderthwaite is owned and managed by Mary Holmes. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the ‘key’ or main inspection for the year. The lead inspector, Nancy Saich sent out surveys to residents and visitors to the home. She received a good number of positive responses. She also asked the provider for information and this was sent promptly. She visited the home, spoke to residents and staff, observed the life of the home and read documents that backed up what was seen and what was said to her. What the service does well: The owner makes sure she only takes people who she knows she can care for and who will fit in with the other residents. The residents get excellent personal and health care. Everyone looked well and this made it obvious that they were getting dignified and suitable care. Here are some of the things they or their families said about their care: • • ‘Quite content …very settled and get plenty of good attention…I am part of the family…’ ‘Calderthwaite is very comfortable and homely I am very happy here…’ The residents in the home have the kind of lifestyles they want, they are part of the local community and go out individually and in small groups. They particularly enjoy the food they get at the home. One person said: • ‘I just have a normal life like other people and get the chance to go out and do things that have always been important to me. Mary will take me anywhere I want to go…’ The residents said that the owner and the staff listened to any complaints they had, that ‘discussion is always available’ and that issues were dealt with properly. They felt the staff protected them from harm. This house provides residents with large bed sitting rooms with ensuite shower and toilet. It is situated in a residential area of Seascale and is very much part of the community. The home was warm, clean and well furnished and decorated on the day of the visit. This home has a small close-knit staff team who enjoy working alongside the owner and who say they ‘love coming to work’. They are suitably vetted and Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 6 trained to make sure they are the right kind of people to work with older adults. A resident said: • ‘The staff are all very caring and supportive. Nothing is too much trouble for them’. The owner takes great care in making sure the home is safe and secure for residents and that she provides them with the best quality care and services she can. 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. The summary of this inspection report can be made available in other formats on request. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner makes sure she only takes people who she knows she can care for and who will fit in with the other residents. EVIDENCE: The inspector met with two people who were in the home on a short-term basis. They and the last permanent resident said they had been given enough information to be able to make a real decision about coming to the home. The files show that the owner goes out and visits new residents and they are invited to visit the home. The owner is aware of how important it is for any new person to fit in with the existing residents and she will not admit someone until she is sure she can meet their needs. There was no one in the home who wasn’t receiving the right kind of care. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive very good levels of personal and health care that allow them to be as well and as happy as possible. EVIDENCE: The inspector read all of the daily diaries kept on behalf of the residents and the plans that explain the kind of daily routines people like. She also saw the new care planning format that the staff were beginning to use that would give even more details of how they helped people to improve things like independence, mobility or managing health care needs. These were of a good standard and had the promise of becoming excellent documents. All the residents had good levels of personal care given to them and their health care needs were well met. Several people said it was important to them to have a daily bath or shower and that they always got this. One person explained how she was being encouraged to do exercises that physiotherapists and the occupational therapist had given her, had the district nursing helping Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 10 with a health need and despite all this was still able to cook for the house and continue to play an important role in the home. Another person’s notes showed that the owner had managed to get her very specialised health care advise and that this had really changed her life. The inspector checked on the medicines kept on behalf of residents and found that generally this was being done quite well. Only two people deal with medicines and they have both had training. One matter wasn’t quite right but was easily dealt with on the day. The team make sure that all medicines continue to work effectively for residents and they ask the doctor to check out medication on a regular basis. Residents said the staff were kind, pleasant, polite and caring. The inspector saw staff working in a very low key and unobtrusive way with residents. They were there for them but were also able to allow people to be as independent as possible. It was clear that the staff had respect for peoples’ preferences to be given personal space and time. No one felt their dignity was ever compromised by the care given. These residents are treated very much as adults with rights and choices. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents in this home have purposeful lives and are part of the local community. EVIDENCE: The visit started before nine o’clock in the morning. Some people were still in bed and others having breakfast. Residents said they got up and went to bed as they wanted, could stay in their own rooms and go out as they wanted. All the residents felt they had the kind of lifestyle they wanted: • I am very happy in this home…’ • ‘Quite content …very settled and get plenty of good attention…I am part of the family…’ • ‘ The care and supervision is good and all my relatives needs are attended to…’ Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 12 During the visit relatives, neighbours and friends came to the home. Everyone was made welcome and it was obvious that this is a very relaxed home where visitors are made welcome. Residents spoke about the local contacts they had. There was plenty of evidence to show that the people who live in the home are very much part of the local community. The residents go out to appointments locally, go to local clubs and churches, attend coffee mornings and other activities. They use local shops and are well known in the area. Neighbours and friends keep a watchful eye on people who like to go for walks in the village. Residents said they sometimes went out as a group but usually they went out individually with the owner. They liked this and saw it as special attention. Residents are encouraged to follow their own hobbies and activities. One person enjoys baking whilst other people just like to spend time watching TV or reading, residents said they had lots of choices and could choose to do very little if they wanted. Residents said they felt they were part of the family and the family dog was very popular with them all. They said they just had a normal life and didn’t feel they were any different from other people. One survey from visiting professionals said the home: • ‘Provides a nice homely atmosphere, good food ….and they are very caring and take residents to appointments and trips out. The home provides really excellent food. Most of it is local, fresh and organic where possible. It is all home cooked – usually by the owner –and she is careful to provide individual residents with the food they want and need for good health. She tries to make sure people have all the right kind of nutrients. People are tempted to eat good foods by the provision of things like home made soups, fresh vegetables that are steamed, nice home baking and lots of tempting little treats that will help with poor appetites. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owner and the staff are good at listening to residents and in protecting them from harm. EVIDENCE: There had been no complaints received by the owner or the inspector. Residents said that if anything worried them ‘ Mary would sort it out’. They also said that things never got to the stage of being a formal complaint. They also said that they had a peaceful life and that there were no disputes amongst themselves or with staff. Individuals were asked about how well protected they felt. They said that there were plenty of visitors and people from the community who came in and that nothing unpleasant could be hidden. They had no concerns about anything or anyone in the house. Staff had received suitable training and knew how to protect residents from harm and said they believed in listening closely to what worried them. They felt they gave people what they wanted and that people were content in the home. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,23,24, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This house gives residents warm, clean, spacious and comfortable accommodation that gives them the privacy and comfort they expect and need. EVIDENCE: Calderthwaite is situated in a residential area of Seascale and is near to the railway station and local hotels and shops. It is a large Victorian house which has uninterrupted views of the beach. Outside there is parking spaces and to the rear a patio where people can sit out. The house has six large bed sitting rooms for residents. They are all at least twice as large as the minimum standard required. Each room has ensuite shower, wash hand basin and toilet. Four of the rooms are on the second floor and two on the ground floor. There is a stair lift to the second floor. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 15 The inspector saw all of the rooms and residents said they preferred to spend time in their own rooms. They had been able to bring their own furniture to the home if they wanted. Residents’ rooms reflected their lives and interests. They were clean, comfortable and warm. They were well decorated and furnished with a double bed in each room and good quality bedroom furniture and armchairs. The inspector saw that the staff were careful about cleaning and dealing with anything that might be infectious. There were gloves, aprons and cleaning materials available. Residents’ clothes were clean and well pressed, bed linens fresh and clean. The residents said that they were happy with the way their home was kept clean and how staff helped look after their clothing and possessions. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staffing levels in the home make sure residents are given the best standards of care and services. EVIDENCE: The inspector saw the staff rosters and spoke to residents and staff. There are always two staff on duty during the day for the six residents. Sometimes this includes the owner and sometimes she is an extra person. This means that residents get high levels of care and services and have individual care and attention. Most of the small staff team have National Vocational Qualifications in care at levels 2 and 3. The owner is an internal verifier for the scheme and is very committed to helping staff to get these qualifications. One person on the team is working on an award at level 4. The provider said she was very careful about taking on new staff as everyone on the team need to work very closely together. She has not taken on any new person since before the last inspection but she has good systems in place to make sure she doesn’t take any one with a criminal record or who has been dismissed from any other care work. This is a close-knit staff group who said they enjoy working in the ‘good atmosphere’ of the home. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 17 The team have had all the necessary training so they know how to keep people safe and give them the right kind of care. The owner makes sure that she gets staff regular updates on things like manual handling, infection control and fire and food safety. She also uses other professionals to help give staff the specific knowledge they need. One staff member said she had learnt a lot from occupational therapists who came to the home. The team has training planned for the next year that covers a range of subjects. One person said they were looking forward to doing a course to understand mental health needs in older people. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home is run as a well managed family home and provides residents with the care and services that makes them feel secure and relaxed. EVIDENCE: The owner manages this home herself and is very much a ‘hands on’ person. She and her family live in the house and she runs Calderthwaite as a family home. She is however aware that her home is also a small business and she has suitable systems in place. She is a mature person with skills, experience and training to care for older adults. Her residents and staff hold her in high regard. Everyone felt that ‘ Mary would sort it out…’ Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 19 The measurement of quality in this home is done both formally and informally. There is a quality monitoring system in place but the home is so small and friendly that residents, visitors and staff felt that they were constantly monitoring levels of care and services. Very much like an open family who talk to each other (and also as one resident said ‘believe in give and take’) the residents needs and wishes are foremost. This is always done on an individual basis so that everyone felt the systems in the home met all their needs. Residents make their own arrangements for managing money. Some people have support from families, others from solicitors and some manage this themselves without support. The owner has no involvement in residents’ financial affairs. The inspector saw the owner’s file that shows what changes and improvements have been made and what is planned. For example she plans to update the telephone based call system so that not only will the residents have access to internal and external telephones but will also have individual radio pager alarms. She also saw the maintenance and repair file, the fire logbook and the food safety record. These were all in order. All of the arrangements showed that the owner bought the best equipment, goods and services possible, didn’t cut any corners and made sure residents had the best and were safe and well cared for. There were no hazards seen on the day. Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X X 4 4 X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NA 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 Calderthwaite DS0000022663.V331187.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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