Inspection on 19/04/07 for Callands Care Home

This inspection was carried out on 19th April 2007.

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 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

Callands Care Home 30/10/06

Callands Care Home 23/05/06

Callands Care Home 12/09/05

Callands Care Home 12/04/05

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 Cheshire WA5 5TS Lead Inspector Denis Coffey Unannounced Inspection 19 April 2007 09:00 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 DS0000042162.V332420.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. DS0000042162.V332420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Callands Care Home Address Callands Road Callands Warrington Cheshire WA5 5TS 01925 244233 01925 413433 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) www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited Emma Louise Ellis Care Home 120 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (60), Learning disability over 65 years of age of places (1), Old age, not falling within any other category (30), Physical disability (30) DS0000042162.V332420.R01.S.doc Version 5.2 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 PD (Physical disability) who may be accommodated in Lakeside Unit * Up to 30 service users in the category 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 LD(E) (Learning disability over 65 years of age) who may be accommodated in Windermere Unit * Up to 60 service users in the category DE(E) (Dementia over 65 years of age) who may be accommodated in Grasmere, Ullswater and Windermere Units * Within the 60 DE(E) beds (Dementia over 65 years of age), 2 named service users in the category DE (Dementia under 65 years of age) may be accommodated. * 1 named service user under the age of 65 years in the category of DE who requires nursing care. 2 Service users who require nursing care may not be accommodated in Windermere Unit 30th October 2006 Date of last inspection Brief Description of the Service: Callands is a care home providing personal and nursing care for 90 people - 60 older people who have dementia, and 30 younger adults with physical disabilities. The home is 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 purpose built with two storeys and is divided into five separate units. Three of the units, including the younger adults’ unit, are on the ground floor. All bedrooms are single rooms with an en-suite shower. There is a passenger lift between the two floors. The home has extensive grounds, which are easily to reach for all the residents. The weekly fee for care and accommodation at the home ranges from £309 to DS0000042162.V332420.R01.S.doc Version 5.2 Page 5 £800. The manager provided this information on 19 April 2007. DS0000042162.V332420.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of the home considers events that have occurred since the last inspection. The inspectors (Denis Coffey & Helena Dennett) visited the home on 19 & 20 April 2007. They toured the building, looked at care and general records, spoke with people who live at the home and with staff. What the service does well: People who are thinking of moving into the home and those living there are given information about the services the home provides. Assessments to find out people’s needs are done before they move in so they know that their needs can be met at the home. Medicines for people who live at the home are managed well to make sure they receive them safely and as prescribed. Staff showed a good awareness of how to provide care so that people’s dignity and privacy is maintained. People who live in the home who were spoken with said they were well cared for by staff. A range of activities for people to take part in is offered so they can keep active and stimulated. People spoken with said they could make choices about their daily lives and how care was given to them so they could stay as independent as possible and have control over aspects of their lives. Complaints are dealt with effectively with records kept that show what has been done to deal with them so that the people who live at the home can be confident that their concerns will be listened to. Staff are given training about how to protect adults from abuse, and there are policies and procedures for them to follow so that the people who live in the home are protected from possible harm. More than 50 of the care staff have achieved an NVQ level 2 in care and a programme of staff training is arranged so staff can develop their knowledge and skills to provide good quality care for the people who live at the home. The manager has developed a effective system for the gathering and passing on relevant information to the staff employed at the home so they are aware of what is happening in the home and to the people who live there. DS0000042162.V332420.R01.S.doc Version 5.2 Page 7 Health and safety matters are well managed so people living in the home and staff are protected. 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. DS0000042162.V332420.R01.S.doc Version 5.2 Page 8 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 DS0000042162.V332420.R01.S.doc Version 5.2 Page 9 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): 1, 3 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s care needs are assessed before they move into the home so that they know their needs can be met there. EVIDENCE: The home has a statement of purpose and service users guide. These both contain information about the home, the staffing structure and the services provided. The manager said that both documents are put into people’s rooms when they move into the home. A relative of this person said they had visited the home on this person’s behalf before they decided to move in. The care records of three people who had moved into the home since the last inspection were looked at. They all contained an assessment that had been carried out before the person moved in by a nurse from the home. These identified the needs/strengths of each person. Where a need/problem had been identified, a plan of care had been drawn up to show what needed to be done to meet these needs. Assessments carried out by other health care DS0000042162.V332420.R01.S.doc Version 5.2 Page 10 professionals, such as doctors, specialists; nurses were also included in two of the records seen. Calends care home does not provide intermediate care so Standard 6 does not apply. DS0000042162.V332420.R01.S.doc Version 5.2 Page 11 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 adequate. This judgement has been made using available evidence including a visit to this service. There were care plans for people living in the home but these did not always cover all of their care needs to make sure that all their care needs were met appropriately. EVIDENCE: Care records for people living in each of the five units of the home were checked. All contained plans of care where a problem/need had been identified. The plans listed the care to be given, and what the intended results should be from this care. However, some of the records were found to be incomplete. Two of the records seen were those of people who had diabetes. The acceptable blood sugar ranges had not been identified and the monitoring records of the blood sugar levels of one person were incomplete. One person’s weight records showed that they had lost a small amount of weight each month over the past three months, but their nutritional plan of care had not been effectively amended to reflect this. Another person was receiving strong pain relief medicine for a physical condition but a plan of care was not in place to guide DS0000042162.V332420.R01.S.doc Version 5.2 Page 12 staff on how this person’s pain was to be managed. Staff were advised to cross reference each person’s Medicine Administration Record (MAR) sheets when preparing the care records to make sure that the plans of care followed these accurately. All of the records checked contained nutritional, safe moving and handling, skin care and continence assessments. All the people living at the home are registered with a general practitioner and can use the facilities of the NHS. One GP filled in a CSCI comment card before the inspection visit took place that confirmed they were satisfied with the overall care provided, that the staff showed a clear understanding of people’s needs, and that advice given is acted upon. The CSCI pharmacy inspector inspected the arrangements for the administration, record keeping and safe storage of medicines on Grasmere and Lakeside Units. The medicines storage rooms were seen to be clean, tidy and well organised. Records of medicines administered to people were accurately filled in, the medicines refrigerator was kept at a suitable temperature, and correspondence from doctors was kept with the record sheets. Staff were seen to help people who live at the home in a friendly and supportive way, and were heard to address them appropriately. The inspector saw one lady on Coniston Unit had been left asleep in a wheelchair in front of the television in the lounge. The unit manager said this lady had only been left temporarily, and that she was then going to the activities lounge. When a member of staff went to escort a gentleman from this lounge in his wheelchair the inspector noted that there were no footplates fitted to the chair for him to rest his feet on. When advised about this, the member of staff went off to get a wheelchair with footplates attached. In the meantime another member of staff went to move the person and had to be asked not to do so until footplates were found. One person living at the home commented that their privacy is respected at all times, and a relative agreed with this. The home manager has recently registered with the Department of Health’s initiative ‘dignity in care’. This will enable the home to receive information and work books for staff to use to give them information about how people receiving care should have their dignity and privacy respected. DS0000042162.V332420.R01.S.doc Version 5.2 Page 13 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 good. This judgement has been made using available evidence including a visit to this service. People living at the home are helped to take part in activities to keep them stimulated and active. EVIDENCE: A full time activities organiser has been employed at the home since the last inspection. There is also a part time organiser who works three days a week to help provide activities. The activities lounge has a computer terminal for people to use and a large wide screen television for showing films. Evidence was seen around the home of people taking part in a variety of activities and people who were spoken with said they enjoyed the range of activities provided. One person living at the home is gong to start a magazine for the home. One to one activities are also provided for those people who cannot take part in group activities. People living at the home can have visitors at any reasonable time and can choose to see them in private in their own rooms or in the various shared room in the home. DS0000042162.V332420.R01.S.doc Version 5.2 Page 14 People living at the home can make choices about what they do each day, within the limitations of their condition. One person said, ‘my choices are always respected’. A multi cultural/religious calendar was on display in all of the units and in the main entrance of the home. A choice is offered for the main courses at each meal. Lunch on the first day of inspection was fish or chicken pie, mashed potatoes and mixed vegetables. The evening meal was to be a choice between soup and sandwiches or spaghetti carbonara. A dessert is also provided at the lunch and evening meals. One person said that they did not enjoy the food provided, but all other people spoken with said that they were happy with the meals and the choices offered. DS0000042162.V332420.R01.S.doc Version 5.2 Page 15 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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information so they know how to make their concerns known and there are thorough procedures to make sure that people are protected from harm. EVIDENCE: There have been five recorded complaints received at the home since the last inspection. The records of these included details of each complaint, who investigated them, actions taken, and the response given to the complainant. The home’s complaints procedure was on display in the foyer, and this procedure is also included in the service users guide. A copy of the Department of Health’s document ‘No Secrets’ was available at the home. This contains information and guidance for staff about protecting vulnerable adults from harm and abuse. Records showed that thirty members of staff had received training on adult protection this year. The home manager said that this training is ongoing and all staff do refresher training annually. Each member of staff is given an employee handbook that has a copy of the company’s whistle blowing procedure in it. This procedure provides guidance for staff on how to make their concerns known if they witness or suspect poor care practices. DS0000042162.V332420.R01.S.doc Version 5.2 Page 16 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, 21, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and clean so people live in comfortable surroundings. EVIDENCE: A number of bedrooms, lounges and corridors in various units at the home have been recarpeted since the last inspection. The bedroom doors on Lakeside and Ullswater Units have been re-stained, and a number of bedrooms on Grasmere Unit have been redecorated. Maintenance staff are employed at the home for the routine maintenance of the building. Each of the bedrooms has an ensuite shower, toilet and wash hand basin. There are baths on all units for those people who prefer a bath to a shower. The hot water supply to a bath on Windermere Unit was found to be running cold, and the manager said this would be attended to. DS0000042162.V332420.R01.S.doc Version 5.2 Page 17 A number of bedrooms on all of the units were visited during the inspection. They were seen to contain personal items such as pictures, ornaments and small items of furniture that had been brought in by the people who lived in the rooms or their families. All areas of the home were visited and found to be clean, tidy and free from unpleasant smells. DS0000042162.V332420.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. Staff receive training in order for them to maintain and develop their skills when providing care. Recruitment procedures are well managed to ensure that people are protected. EVIDENCE: The staffing rotas showed that there are enough staff on duty to meet the needs of people living at the home. Trained nurses are on duty at all times and are supported by teams of care staff. Maintenance, domestic, laundry, catering and administrative staff are also employed at the home. During the course of the inspection a number of staff were spoken with, some of whom were foreign nationals. There was a communication problem with some of these staff as they appeared not to have a good command of the English language. This observation was also made by some of the people living at the home. It is recommended that the communication skills of future employees are fully assessed to make sure they can communicate effectively with the people who live at the home and each other. One person commented that ‘nothing is too much trouble for the staff’ and another said ‘staff are supportive, maintain your confidentiality and make you feel secure’. DS0000042162.V332420.R01.S.doc Version 5.2 Page 19 A total of fifty care staff are employed at the home. Twenty-seven have an NVQ level 2 in care, so more than 50 have a qualification in care. The manager produced information on recent staff training that included encouraging people with dementia to eat and drink, infection control, safe moving and handling practices, challenging behaviour, and care of the skin. Future planned training will include visual impairment awareness, health and safety, nutrition and adult protection. The personnel records of three members of staff were examined. All of these contained completed application forms, two satisfactory references, induction records, and satisfactory security checks. DS0000042162.V332420.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that ensures the health and well being of people living at the home are promoted. EVIDENCE: The registered home manager is a trained nurse who has had experience of managing another care home before taking up this post. She is supported in the daily running of the home by a deputy manager. At the time of inspection the deputy manager was on holiday, and a project manager from the company that owns the home was spending time there to support her. A representative of the company carries out an unannounced inspection of the home each month. They review a selection of care records, the home’s general records, speak with people living at the home and tour the premises. DS0000042162.V332420.R01.S.doc Version 5.2 Page 21 The manager holds a heads of department meeting each morning to discuss any issues, inform staff of new people due to move into the home, and provide ‘feedback’ from her observations. Records are kept of these meetings, and the heads of department are expected to pass on this information to their staff team. Any personal money handed in for safe keeping for people living at the home is pooled in a joint non-interest making bank account. Receipts are given for money handed in, and signatures obtained for any money paid out to or on behalf of people. The records of this money are held on computer at the home and people can ask for an individual statement of their cash balance. The system was audited by someone from the company’s financial department in the week before this inspection visit. The manager said that they were satisfied that this was being managed properly. Risk assessments were seen in people’s care records and where a risk had been identified, a plan had been drawn up as to how this could be managed safely. Records were seen of the fire alarm and emergency lighting systems being tested regularly. Up to date certificates for servicing and safety were seen including landlord’s gas safety, passenger lift, mobile hoists, and portable electrical appliance testing. DS0000042162.V332420.R01.S.doc Version 5.2 Page 22 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 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 17 X 18 3 3 X 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 DS0000042162.V332420.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15(1) Timescale for action Plans of care must be in place for 18/05/07 all of the identified needs/ problems of people living at the home to make sure that all their needs are met appropriately. Requirement 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 Refer to Standard OP27 Good Practice Recommendations It is recommended that the language skills of new employees are assessed to ensure that they can communicate effectively with people living at the home. DS0000042162.V332420.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000042162.V332420.R01.S.doc Version 5.2 Page 25 - 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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