Inspection on 09/07/08 for Camellia House

This inspection was carried out on 9th July 2008.

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

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

Camellia House 12/10/06

Camellia House 01/02/06

Camellia House 24/03/05

Camellia House 19/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Camellia House 109 Main Street Calverton Notts NG14 6FG Lead Inspector Jill Wells Unannounced Inspection 9th July 2008 09:30 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 Camellia House DS0000040018.V368063.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. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camellia House Address 109 Main Street Calverton Notts NG14 6FG 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) 0115 845 8876 0115 845 8876 camellia.house@ntlworld.com Judith Lakin Care Home 4 Category(ies) of Old age, not falling within any other category registration, with number (4) of places Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2006 Brief Description of the Service: Camellia House was first registered in March 2002 and became operational in September 02.The home is a small care home, which has registration for 4 older persons. One place is used for respite care. The service users accommodation is integrated with the owner’s private house. The service users are provided with a separate lounge and kitchen / dinette. One bedroom situated on the ground floor. An electric stair lift is available for access. A bathroom is located on the ground floor and has an assisted hoist and shower facility. A remote alarm call bell is available for each service user. Professional health care arrangements are organised as required. A magnificent garden to the rear of the property offers a superb view and a relaxing environment. Fees charged are currently £425.00 a week. Hairdressing and chiropody are not included in the fees. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for the service is two star. This means the people who use the service experience good quality outcomes. The inspection visit was unannounced and took place over 5 hours. There were 3 people living at the home on the day of the inspection. All 3 residents, 2 staff, and the owner/manager were spoken with during the visit. We also looked at all the information that we have received, or asked for, since the last key inspection on the 12th October 2006. This included: • • • What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection report The previous annual service review Completed surveys from staff and people living at the home. Records were examined, including care records, staff records, maintenance, policies and procedures and health and safety records. A tour of the building was carried out. What the service does well: People living at the home benefit from a small and homely environment. Facilities available include large bedrooms and several communal spaces, allowing people the choice of where to spend their time. The outside gardens are of a very high standard, with seating areas for people to enjoy the gardens. The owner is also the manager, and therefore very involved with the care of the people living at the home. She was described as approachable, caring and supportive. Food is home-cooked and of excellent quality. People can tell staff if they wish to try new things. Staff work hard to try to stimulate people living at the home. This includes regular activities within the home, including singsongs, games and chair-based exercises from someone specifically employed to do this. There are very regular outings arranged, including lunch trips paid for by the owner/manager. Staff are well trained and knowledgeable about each persons needs. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 6 Communication between staff team is very good, with daily handover meetings. It was evident that the team worked well together to meet the needs of people living at the home. A staff member said, we have a laugh with residents they enjoy the fun. People responded to our surveys by saying that they always received the care and support that they needed and staff listened and acted on what they said. One person told us that, they choose staff well, they are tactful and good at listening. The owner/manager is careful to choose only new residents that will fit well into the existing group of people living at the home. 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. Camellia House DS0000040018.V368063.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 Camellia House DS0000040018.V368063.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): 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. EVIDENCE: Each person at the home had a completed assessment before being admitted as a resident. The care manager from Social Services completed one, and a separate assessment was also done by the owner/manager of the home. These were detailed and covered all aspects of each persons needs. Prospective residents or their family and friends were encouraged to visit prior to making a decision about whether the home will meet their needs. The owner/manager wrote to each prospective resident, informing them that their needs could be met at the home. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 9 There were copies of contracts in each persons file. This included the terms and conditions and the fees. One of the bedrooms was used for respite care. At the time of the inspection visit there was no one staying for respite. A person recently admitted to the home was spoken with and said that, I’m glad that I came here, staff are very nice and caring . The home does not provide formal intermediate care and therefore standard 6 was not assessed. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples health and personal care needs are met and the principles of respect, dignity and privacy are put into practice. EVIDENCE: The care records of all three people living at the home were seen. The care plans were written in a person centred way, for example they included each persons daily routines. Records included individuals life history, preferences, as well as information about their health. They were written in plain language, and were easy to understand. Individual records also included moving and handling risk assessments and plans as well as a nutritional screening tool. Care plans and risk assessment tools were not always reviewed regularly. However, due to the size of the home and staff team, it was evident that good communication concerning each persons health and social care needs ensured that all staff knew the detail of each persons needs. A staff member wrote in Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 11 a survey, All information is received during handovers, but is available to reread in the residents care plans. There was evidence in each persons file that GPs, dentists, optician and district nurse were regularly involved when needed. People’s weight was being checked as part of monitoring their health. Care staff wrote daily diary reports to support the care plans. These were detailed and person centred. At the time of the inspection visit no one at the home had high dependency needs. Medication in the home was stored securely in each persons bedroom. No one at the home administered their own medication. There were not records in place to show that each person had been assessed concerning their ability to self-administer medication or a record of their wishes. The owner/manager and staff had undertaken accredited medication training since the last inspection visit. The medication administration records were seen and were correctly completed. At the time of the inspection visit there were no controlled drugs at the home. The owner/manager had obtained a copy of the ‘Royal Pharmaceutical Societys Guidance on Administration of Medication in Care Homes’ since the last inspection visit as recommended, to ensure the most up to date guidance is available. There was a safe system in place for medication administration. Care staff spoken with were very aware of the importance of respecting peoples privacy and could give examples of how they did this, particularly when providing personal care. People spoken with said that staff always knocked on their bedroom door before entering, however staff were observed entering before knocking at times. Staff were seen showing kindness and patience to people living at the home. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The range of activities and standard of meals offered was excellent, which met the needs and wishes of people living at the home. EVIDENCE: The owner/manager explained that the people presently living at the home enjoyed television and radio. Staff at times needed to work hard in order to encourage other activities. The owner/manager had recently employed someone to come into the home to do chair based exercises with people. This was described by people as, good fun. Outside games had recently been purchased and activities such as reminiscing and sing-songs were also encouraged. Staff tried to encourage people to walk in the extensive and attractive grounds. Going out for lunch was a popular activity and was organised regularly and paid for by the owner/manager. A staff member said that staff and residents went out for lunch three times the previous week. A 6-seater vehicle was available. A staff member in our survey said that, being small we are able to cater to individuals Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 13 requirements. The residents are able to choose where they would like to go for outings. People were encouraged to bring their own personal possessions with them and bedrooms that were seen were comfortable and had been personalised. The day’s menu was displayed in the lounge area. All three people living at the home spoken with were very pleased with the quality of food. One person said, The food is very good. Fresh fruit and vegetables were used at all times. The quality of food seen during the inspection visit was very good. A staff member spoken with said that people were asked what they wanted for breakfast and could have whatever they wanted. One person living at the home spoken with said that they preferred to have their meals in their room, and staff were happy for them to do this. One person living at the home was diabetic, and their dietary needs were met. They also had a care plan reflecting their dietary needs. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and are protected from abuse. EVIDENCE: The complaints procedure was displayed at the entrance. This did not have the revised address and telephone number of The Commission for Social Care Inspection, so that people could contact us if they wished to do so. People spoken with said that they would talk to the owner/manager if they had a complaint. One person said that, If things werent good we would tell them, but it always is. Training records showed that care staff had attended training in safeguarding vulnerable adults and care staff confirmed that they had attended this training and were aware what to do if they suspected abuse of a vulnerable adult. There were written policies and procedures concerning adult protection and ‘whistle blowing’ if staff ever had concerns about other staff. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 15 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, 20, 23, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live in a safe, homely, well-maintained and comfortable environment. EVIDENCE: The home is a detached house in a residential area. There are 4 single rooms, 2 with a wash hand basin. One bedroom is on the ground floor. The home was clean and well maintained. People spoken with said that they were happy with the level of cleanliness at the home. People living at the home benefit from the small, homely environment. There was an electric stair lift so that people living at the home could easily access the first floor. There was a small ramp at the front door for easy access. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 16 Two bedrooms were seen. They were large rooms, above the minimum space requirements, well decorated and furnished, comfortable and homely. People had personalised their own room. Each person had a television in their room and could spend as much or as little time in their room as they wished. One person that was spoken with said that they did not have a key to their room. The owner/manager said that everyone had a key. There was not a record in peoples files concerning offering and providing keys to bedrooms. There was a selection of communal areas, including a residents’ kitchen/dining room, a conservatory, and lounge area, which means that people living at the home have a choice of where they wish to sit and above the minimum communal space requirements. The kitchen/dining room can be used by people living at the home to make their own drinks and snacks if they wish to do so. As the owner/manager also lives at the home, there is a private lounge for them, which is clearly marked. The main kitchen is large and well equipped. There is an extensive, well kept garden with seating areas for people to enjoy. There was ample car parking facilities. There were security gates at the front entrance that were opened electronically from the inside of the house. This ensures a good level of security. The environment is warm, welcoming, comfortable and secure. One person spoken with said, I would describe this place as homely. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were sufficient numbers of competent, well-trained, dedicated staff to support the people who use the service. EVIDENCE: On the day of the inspection visit there was the owner/manager and 2 care assistants on duty. One carer was new and was shadowing the experienced worker. The duty rotas showed that there was usually the owner/manager and one carer on in the morning, and one carer in the afternoon. However, as the owner/manager lives at the home, they were usually around throughout the day. The owner/manager covered the night time. A carer spoken with said that staffing increased if people’s needs increased. It was evident from observations that there were sufficient staff on duty to meet peoples needs. Two people living at the home returned our survey. Both said that there were always staff available when they needed them. A relative was spoken with after the inspection visit. They were very satisfied with the care provided and felt that their relative has been much happier since moving to this smaller home and receives more individualised care. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 18 Staff records that were examined showed a safe recruitment procedure. New staff were supervised and supernumery until all satisfactory checks had been received. One staff member wrote in our survey concerning their induction, I shadowed the manager for two weeks prior to working alone, this included a full induction. The owner/manager had obtained the induction and foundation standards and intended to use them for new staff recently recruited to enhance their induction. There were certificates to show that staff had undertaken all relevant mandatory training including manual handling, fire training, adult protection, first aid, health and safety, food safety and control of substances hazardous to health (C.O.S.H.H.), evidencing that staff were well trained. Of the five staff working at the home, one had completed NVQ (National Vocational Qualification) 2 Care, two had started this course, and one was doing NVQ 3. People spoken with during the inspection visit were very positive towards staff. One person said that, I am very pleased with the way staff look after me and another said, I press my bell and someone comes quickly. No one that was spoken with was able to say how the service could be improved, which shows a high level of satisfaction. A staff member spoken with said that, it is a great staff team, we all help each other. The carer also said that they enjoyed putting sunshine into someones life and giving them a lift when theyre down. This showed a caring, committed staff team. A staff member wrote in our survey, appraisal systems are in place, but on the whole communication is very good on a daily basis anyway, and any issues are dealt with at the time, appraisals are mainly reflective. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 19 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, 32, 33, 37 and 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 very well managed, with effective strategies for enabling staff and people living at the home to affect the way that service is delivered. EVIDENCE: The owner/manager is registered with the Commission for Social Care Inspection. She is also a registered nurse and has the Registered Managers Award. Everyone spoken with was very positive about the owner/manager. A member of staffs described her as, caring, supportive and always there to help. A Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 20 person living at the home said, I have lots of confidence in the owner, she is exceptional, shes become a friend. The owner/manager had obtained a formal quality assurance auditing system that she intended to use. However due to the size of the home and daily contact that she had with everyone, it was advised that full implementation of the system was not necessary. She had however obtained surveys that she intends to distribute to families and outside professionals as well as people living at the home. Consultation was generally done in an informal way at the time, for example people were asked their views of the meal during and after each meal. When time for activities were planned, people were asked at the time what they would like to do. This meant that staff could be more flexible and responsive to individuals wishes. When people were admitted to the home they were given a letter informing them that they could access their records and information about them held by the home. A representative from the Health and Safety - Food Hygiene Department had recently visited. Although the report was not available, we were told that no requirements were made and the officer was satisfied with the standard of food hygiene and infection control. There were records to show that water temperatures were regulated, all accidents and injuries were recorded and relevant policies and procedures concerning safe working practices were in place. Portable appliance testing was being undertaken and recorded. The owner manager had not yet completed the fire risk assessment as recommended at the last inspection visit. Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 x x 3 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 4 3 3 X X x 3 3 Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 22 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. 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. 1. Refer to Standard OP7 Good Practice Recommendations Care plans and individual health risk assessments/trigger tools should be regularly reviewed to ensure that they accurately reflect each person’s needs. There should be a record in each persons file that an assessment has been made as to their ability and wishes concerning administering their own medication to encourage the promotion of independence where possible. The up-to-date address and telephone number of the Commission for Social Care Inspection (CSCI) should be on the complaints procedure and any other documentation that the home provides. There should be a record in each persons file in respect of people being offered and provided with a key to their own bedroom if they wish to have one for security. 2. OP9 3 OP16 4. OP24 Camellia House DS0000040018.V368063.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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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