Inspection on 12/04/05 for Callands Care Home

This inspection was carried out on 12th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Callands Care Home 19/04/07

Callands Care Home 30/10/06

Callands Care Home 23/05/06

Callands Care Home 12/09/05

Callands Care Home 27/09/04

Callands Care Home 20/05/04

Callands Care Home 11/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Clover House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE CALLANDS CARE HOME CALLANDS ROAD CALLANDS WARRINGTON WA5 5TS Lead Inspector A GILLIAN MATTHEWSON UNANNOUNCED 12 APRIL 2005 09:30 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 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. CALLANDS CARE HOME Version 1.10 Page 3 SERVICE INFORMATION Name of service CALLANDS CARE HOME Address CALLANDS ROAD CALLANDS WARRINGTON WA5 5TS 01925 244233 01925 413433 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) HIGHFIELD HOME PROPERTIES LIMITED CARE HOME 120 Category(ies) of DE(E) Dementia - Over 65 - 60 registration, with number OP Old Age - 30 of places PD Physical disability - 30 DE Dementia - 1 LD(E) Learning dis - over 65 - 1 CALLANDS CARE HOME Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 120 service users to include: • • • • • Up to 30 service users in the category of PD (physical disability) who may be accommodated in Lakeside Unit. Up to 30 service users in the category of OP(old age not falling within any other category) who may be accommodated in Coniston Unit. Up to 1 named service user in the category of LD(E) (old age with learning disability) who may be accommodated in Windermere Unit) Up to 60 service users in the category of DE(E) (old age with dementia) who may be accommodated in Grasmere, Ullswater and Windermere Units. Within the 60 DE(E) beds (old age with dementia), 1 service user in the category of DE (dementia under 65 years of age) may be accommodated. 2. Service users who require nursing care may not be accommodated in Windermere Unit 3. The registered person must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 27/09/04 Brief Description of the Service: Callands is a care home providing personal and nursing care and accommodation for 90 older people, 60 of whom have dementia, and 30 younger adults with physical disabilities. The home is located in the Callands area of Warrington, close to shops, a post office and a pub. Gemini retail park is close by, as is the Westbrook Centre which has a large supermarket, more shops, a restaurant and cinema complex. Callands is on a bus route and close to the M62 motorway. The home is a two storey, purpose built home and is divided into five units. Three of the units, including the younger adults’ unit, are located on the ground floor. All bedrooms are single with an en-suite shower. There is a passenger lift. The home has extensive grounds, which are easily accessible. CALLANDS CARE HOME Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by three inspectors of the Commission. The lead inspector spent two hours planning the inspection by reviewing previous inspection reports and the service history over the last twelve months. The inspection took place over six hours and include a tour of the building, inspection of records and discussion with twenty one service users, eight relatives, twenty six staff and two community nurses. Since the last inspection there has been a change in manager and several changes in senior staff. Also, the company registered in respect of Callands has merged with another care home provider. Feedback was given to the Home Manager, Regional Manager and Facilities Manager three days following the inspection. What the service does well: The manager is very approachable and creates an open, positive and inclusive atmosphere. Good verbal information is provided to prospective service users and they are actively encouraged to visit the home and stay on a trial basis prior to making a permanent choice. Full and comprehensive assessments are carried out to ensure the home will be able to meet the service users’ needs. Staff recognise changes in service users’ health and respond quickly and effectively to address the changes. Staff are mindful of service users’ privacy and dignity. Service users benefit from a varied, balanced diet with plenty of choice. Policies and procedures are in place to ensure that any complaints are promptly investigated and addressed and service users are protected from abuse. CALLANDS CARE HOME Version 1.10 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. CALLANDS CARE HOME Version 1.10 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 Standards Statutory Requirements Identified During the Inspection CALLANDS CARE HOME Version 1.10 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 standard(s) 1, 3 & 5 The home provides service users with the information and access they need to make an informed choice about whether they wish to live there, although this could be improved upon by giving each prospective service user a copy of the home’s statement of purpose and service user guide. Full assessments are carried out to ensure that service users know the home will be able to meet their needs. EVIDENCE: The home had a satisfactory statement of purpose and service user guide, which were on display in the reception area of the home. Service users on Lakeside Unit confirmed that prior to admission a nurse from the home had visited them and given them verbal information about the home. They were then able to visit the home and stay on a trial basis before making a decision to take up residence. However, they had no recollection of being given any written information. See Recommendation 1. Relatives visiting Ullswater Unit said they had been invited to visit the home prior to their family member being assessed for admission and had been impressed with the information provided to the them. Case files were examined on all units. All contained evidence that preadmission assessments had been carried out by an appropriately qualified CALLANDS CARE HOME Version 1.10 Page 9 nurse prior to admission to determine whether the home could meet the individual’s needs. These assessments covered all aspects of physical, psychological and social need, but some had not been signed or dated. See Recommendation 2. CALLANDS CARE HOME Version 1.10 Page 10 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 standard(s) 7, 8 & 10 Service users health, personal and social care needs are met by staff who enable them to maintain their privacy and dignity. EVIDENCE: Each service user had a case file in an individual A4 ring binder. This contained assessment documentation, a care plan and progress sheets. Care plans were drawn up based on the service user’s assessed needs and risks. Risk assessments were completed in relation to pressure areas, moving and handling, nutrition, continence and falls. In some cases, additional risks had been identified. Care plans were reviewed and updated on a monthly basis. They contained evidence that service user’s health needs were assessed and that they were referred to other health care professionals as necessary e.g GP, community mental health services, chiropodist, optician, dietitian. Some care plans were signed by the service user and/or their representative to indicate that they had been consulted on and agreed to the care plan, but a number of service users said they were unaware of the existence of a care plan. See Requirement 1. Each service user has a single room. Some have telephones installed in their room. Time was spent on each of the five units in the company of service users. Staff interaction with service users was positive and friendly. Throughout the day various practices that could potentially impact on service CALLANDS CARE HOME Version 1.10 Page 11 user privacy and dignity were seen to be undertaken by staff. These were carried out in a way that provided service users with the privacy they required. Service users and visiting relatives said they were pleased with the attitude of staff. One service user said ‘The staff respect me and I respect them.’ CALLANDS CARE HOME Version 1.10 Page 12 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 standard 15 Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users’ tastes and choices. EVIDENCE: The kitchen was was clean and tidy at the time of inspection. Records of fridge, freezer and hot food temperatures were maintained. Also records were kept of daily, weekly and monthly cleaning schedules. Catering staff were aware of hygiene procedures and had up to date food hygiene certificates. Modern popular meals and traditional meals were included in the menu, reflecting the diverse age groups within the home. The staff were also familiar with various special diets needs such as diabetec, soft, pureed and weight increase/decrease. Staff observed serving meals in Windermere and Grasmere Units ensured that it was a sociable and pleasant experience for service users. Service users commented positively on the choice, variety and quality of the meals. One service user said that they liked a plate of chips at 4pm each day and this was provided. Another service user said that if he didn’t like the choices on the menu he could go and see the chef and request anything he wanted and it would be provided. The inspectors sampled the roast turkey and salad available for lunch on the day. The turkey was both tasty and tender and the salad was attractively presented. CALLANDS CARE HOME Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18. The home has a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon. Staff have excellent knowledge and understanding of adult protection issues and appropriate action is taken to protect service users when there is any suspicion of abuse. EVIDENCE: The home had a satisfactory complaints procedure that was included in the service user guide and displayed on a notice board in each unit. There had been one complaint since the last inspection, which was unsubstantiated. Records were maintained of the complaint and the investigation. Staff training on adult abuse and protection had been provided by the Regional Manager. Qualified nursing staff and care staff on each of the units visited confirmed that they had either received recent training or were scheduled to undertake such training within the next two months. When asked, staff could describe the ways in which service users could be abused and what their responsibilities were in protecting them. The home manager had taken appropriate action in relation to allegations of abuse in line with locally agreed adult protection protocol. CALLANDS CARE HOME Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 In the main the home provides a clean, comfortable and pleasant environment for service users to live in. To improve safety for service users, maintenance matters remaining outstanding from the previous inspection must be addressed. EVIDENCE: Improvements had been made to the environment since the last inspection in that there had been redecoration of some bedrooms and some bedroom furniture had been replaced. Requirements remained outstanding from the last inspection in relation to the regulation of hot water temperatures, improvement of the corridor lighting in the upstairs units and replacement of the damaged flooring in the en-suite bathroom of Room 51. The regulation of hot water temperatures was of particular concern because an immediate requirement had been served following the previous inspection and a programme of installation of mixer valves had been agreed. Fifty percent of these should have been fitted by the time of this inspection, but only ten percent had been completed. The lead inspector returned to the home on 18th April and met with the Facilities CALLANDS CARE HOME Version 1.10 Page 15 Manager, who explained that the mixer valves were not compatible with the hot water system and a whole new system would have to be installed. A replacement programme was agreed, with priority to be given to the five percent of hot water outlets that were still delivering water at temperatures above the required 43 degrees Celsius. At the time of the return visit new lighting was already being fitted and an assurance given that the bathroom flooring would be replaced by the end of the week. See Requirements 2,3 & 4. In addition, in Coniston Unit there were cigarette burns to one bedroom carpet and an area of the corridor carpet near a side exit door. See Requirement 5. However, the home was clean and free from unpleasant odour throughout. The lawns outside had been mown and the paths were clear but the flowerbeds were very overgrown and in need of weeding. The home manager had obtained an estimate for clearing of the gardens for the spring and planned for the handyman to maintain them when that had been done. The laundry was clean and tidy on inspection. There were an adequate number of washing machines and tumble dryers to meet service users’ laundry needs. Washing machines had pre-programmes for sluicing and hot and cool washes. One service user commented that he could take his own washing to the laundry and it would be done the same day. CALLANDS CARE HOME Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 & 30 Staff training and continuity has improved since the last inspection. Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. Staffing levels and skill mix need some minor adjustments to enable service users on Lakeside unit to have more freedom of choice in the evenings, and ensure that service users on Grasmere and Ullswater Units have access at all times to appropriately skilled staff to meet their mental health needs. EVIDENCE: Staff were welcoming and helpful. Service users confirmed that staff were always pleasant. The manager had recruited several new members of staff since the last inspection, resulting in less reliance on agency staff and greater continuity of care. Rotas revealed that staff numbers complied agreed minimum staffing levels, with the exception of evenings on Lakeside Unit where, after 7pm there were only three staff on duty. Service users confirmed that they sometimes had to wait for staff to assist them with personal care at this time and were unable to go out of the home if they wished without prior arrangement. See Requirement 6. At the time of the inspection the home only employed three registered nurses with a mental health qualification. The clinical nurse manager also had a postgraduate qualification in the care of people with dementing illnesses. This did not provide twenty four hour cover on the two dementia nursing units every day. The manager stated that two registered general nurses would be CALLANDS CARE HOME Version 1.10 Page 17 supported to undertake the training in care of service users with a dementing illness. See Recommendation 3 Approximately thirty percent of the care staff had achieved an NVQ Level 2 in Care. Since the last inspection five of the senior staff had qualified as NVQ Assessors and the manager stated that all remaining care staff would be enrolled on a training programme to undertake an NVQ Level 2 by the end of the month. New staff received induction training that met Skills for Care induction standards. Since the last inspection staff had received training in adult protection, dementia care, defensible documentation, fire safety and moving and handling. The registered nurses working on Lakeside Unit had attended training on caring for service users with spinal injuries. Further training updates had been arranged for infection control, control of substances hazardous to health and customer care. CALLANDS CARE HOME Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 & 37. The manager provides clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities to promote and protect service users’ wellbeing. His position needs to be formalised with the Commission. On the whole, records are well maintained, but recording of furniture brought into the home by service users needs to improve in order to protect their interests. EVIDENCE: At the time of the inspection the manager had been in post for over four months. During the inspection he demonstrated knowledge of his responsibilities and a commendable level of commitment to providing a good service. The Commission had not received an application for his registration. See Requirement 7. Service users and staff spoken with confirmed that the manager was very approachable and kept them informed and consulted with them on all matters pertaining to them. Minutes were recorded of meetings with staff, service users and relatives. CALLANDS CARE HOME Version 1.10 Page 19 Records were maintained in accordance with legislation apart from a record of service users’ furniture. This had been completed in some cases, but not completed or updated in others. This matter is outstanding from the previous inspection. CALLANDS CARE HOME Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 1 x x x x x x 3 STAFFING Standard No Score 27 2 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 4 x x x x 2 x CALLANDS CARE HOME Version 1.10 Page 21 YES Are there any outstanding requirements from the last inspection? 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. 1. Standard OP 7 Regulation 15 Requirement Consultation must be carried out with all service users and /or their representatives regarding their individual plan of care. The hot water system must be regulated to eliminate the risk of scalding, giving priority in the first month to showers with a hot water temperature exceeding 43 degrees Celsius. (Previously agreed programme of timescales not met.) The lighting in the upstairs corridors must be improved. (Timescale of 31/12/04 not met) The flooring in the en-suite bathroom of Room 51 must be replaced. (Timescale of 31/12/04 not met.) The carpets identified in Coniston Unit must be replaced. Another member of staff must be employed in the evenings for Lakeside Unit. An application for registration of the manager must be submitted to the Commission for Social Care Inspection. Timescale for action 12/04/05 2 OP19 13(4) 30/09/06 3 4 OP19 OP19 13(4) 23(2)(p) 13(4) 16(2)(c ) 16(2)(c ) 18(1)(a) 8 30/04/05 30/04/05 5 6 7 OP19 OP27 OP31 30/09/05 30/06/05 31/05/05 CALLANDS CARE HOME Version 1.10 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 3 Refer to Standard OP1 OP7 OP27 Good Practice Recommendations Supply a copy of the service user guide to all service users and prospective service users. Ensure that staff date and sign all entries in service user files. Take steps to recruit more nurses with a mental health qualification. CALLANDS CARE HOME Version 1.10 Page 23 Commission for Social Care Inspection UNIT D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI CALLANDS CARE HOME Version 1.10 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!