Inspection on 21/10/08 for Cameo Rest Home

This inspection was carried out on 21st October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cameo Rest Home 24/04/08

Cameo Rest Home 05/06/06

Cameo Rest Home 19/12/05

Cameo Rest Home 06/07/05

Cameo Rest Home 12/01/05

Cameo Rest Home 23/06/04

Cameo Rest Home 05/02/04

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Maple Lodge

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Breme

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Inspirations

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Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cameo Rest Home 14 Hopleys Close Glascote Tamworth Staffordshire B77 3JU     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Amanda Hennessy     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Cameo Rest Home 14 Hopleys Close Glascote Tamworth Staffordshire B77 3JU 0182753906 0182764458 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Yvonne Patricia Aikens Type of registration: Number of places registered: Mrs Yvonne Patricia Aikens care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 4 Dementia (DE) - Minimum age 57 years on admission Date of last inspection Brief description of the care home The home provides accommodation and care for ten older people. The home is a two storey detached house which has been converted into a residential home and stands in its own grounds. There is a garden at the rear of the home. Within the home is a small office, one lounge and one dining room. Cameo has eight bedrooms , one of which is a double bedroom, no bedrooms have en-suite facilities. There is a bus stop on the main road at the bottom of the cul de sac that the home is situation in. Car parking is located at the front of the home. As the fee information has not been included in this report we advise the reader to contact the service for this information. Care Homes for Older People Page 4 of 28 Over 65 4 10 4 0 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. The last full inspection of this service was undertaken over two days the 24th April 2008 and the 29th May 2008. One Inspector Mrs Amanda Hennessy carried out this key unannounced inspection in one day. The home was visitedbon the 21st October 2008 between 10.00 and 15.00. The service did not know we were coming. The manager/ Proprietor was present during the majority of our inspection. The home has also had other unannounced visits on the 2nd September 2008 and the 22nd July 2008 to assess their compliance with requirements made at the previous key inspection and their compliance with a statutory requirement notice. Care Homes for Older People Page 6 of 28 Information for the report was gathered from a number of sources: a questionnaireAnnual Quality Assurance Assessment (AQAA) was completed before the inspection by the homes manager/ proprietor; We looked at the environment including looking at the communal areas and a sample of the bedrooms, discussion with the manager and care staff and people who live at the home. Surveys were also sent to people living at the home and staff working at the home and were returned before our visit. We looked at how the service responded to any concerns and how the service was protecting people from abuse including looking at how the service recruited and trained staff. We also looked at the number of staff available to care for people at the home. Two people who live in the home were case tracked this involves establishing peoples experiences of living in the care home by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes of the care that they receive. Tracking peoples care helps us understand the experience of people who use the service, how they spend their time and whether the service was promotes peoples privacy and dignity. We looked also looked at the arrangements for administering medication. What the care home does well: What has improved since the last inspection? What they could do better: The home has just one requirement as a result of this inspection. There is a need to ensure that a risk assessment is completed should staff be employed with just a protection of vulnerable adults check and before the return of the criminal records check. This would give greater assurance that there is less risk of unsuitable people working unsupervised at the home. There is a need for care records to more fully identify peoples needs, their choices and capabilities. Risk assessments are needed to highlight how people should be safely moved, their risk of pressure sores, poor nutrition and promotion of continence. If risk assessments are completed and available they can minimise the risk of harm or potential harm to people living at the home. Care Homes for Older People Page 8 of 28 Improvement highlighted at the previous inspection have been undertaken although further yet minor improvements are needed to further minimise the risk of medication error. Activities are taking place more frequently although there would be greater assurance of their regularity if there is a plan of activities available. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming to live at the home have their needs assessed but are not provided with the required information which may make it difficult for them to decide if it will be suitable for them. Evidence: The homes statement of purpose and service user guide were not available as the manager told us that they are being updated. We advised that the service user guide should be accessible and readily available as it provides information for people about living at the home. People wishing to live at the home have an assessment of their needs before they come to live in the home by the Manager and Deputy Manager. The assessment of needs contained only limited information for example did not identify peoples interests and choices. The manager told us that more information is given when people move Care Homes for Older People Page 11 of 28 Evidence: into the home. We advised the manager to ensure that required information is sought before they move to the home as then staff will have the information about peoples needs and how they prefer them to be met. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met but improvements in care planning will give greater assurance that peoples needs are consistently recognised and met. Evidence: People who live at the home have a plan of care. We did find that plans of care seen only provided basic information and did not always give staff details about all peoples needs, choices and capabilities. One person case tracked was a diabetic but care records did not tell staff anything about their diabetes and how it should be cared for. It is positive though when we spoke to staff they were aware of peoples needs and changes to their health. The home had a statutory requirement notice following the previous inspection for unsafe bed rails that put people at risk of injury, a lack of bed rails when required and inadequate risk assessment for the use of bed rails. The home now has good risk assessments in place for when bed rails are needed. There is a need however that Care Homes for Older People Page 13 of 28 Evidence: other risk assessments should be available such as moving and handling risk assessment and pressure sore risk, nutrition and continence when needed to highlight any problems. We saw records to confirm that staff ensure that people are visited by their Doctor if they are unwell. Other professionals such as District Nurses, Chiropodists, Opticians and Dentists also visit. Relatives told us that they are always informed if their relative is unwell and the outcome of any visits by their Doctor. We did find that people are not all weighed regularly. A record of peoples weight can provide good information about their general health and it is good practice that people are weighed regularly. Staff said that they were unable to weigh some people as they were unable to stand on the scales. There is a need for alternative such as sit on scales to be provided. The home has appropriate and safe systems in place for the ordering, administration and storage of medicines. Medicines are only administered by care staff who have had training in the safe handling of medicines. We did advise that there could be further but albeit minor improvement. Staff do not always confirm the accuracy of handwritten entries of medication which would when undertaken minimises the risk of medication error. We also advised that when medicines are prescribed when required instructions should be available that details when the medicine should be given. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There would be greater assurance that daily life at the home meets peoples needs if their needs and interests are explored and recorded. Evidence: Staff told us that activities take place usually in the afternoon. There is no activity plan with staff saying it depends how people are after lunch, what activities that they do with the residents it might be a quiz or games. The home has recently had a visit from the Shoe Box Theatre. The Manager said it had been so popular that she has also booked a return visit for November 2008. The home has a singer who visits regularly throughout the year, which people living at the home also enjoy. There are no records of what leisure interests people have and have had in the past which would help staff plan activities that people are interested in. There was limited information in care records about peoples choices such as the time that they like to bed. It was positive that staff were aware of what people liked to do during the day and their preferred daily routines. People living at the home agreed that they were able to spend their day as they liked. One person that said although she liked to go up to bed early she likes to read her books when she is in bed. Care Homes for Older People Page 15 of 28 Evidence: Several people enjoy reading and are able to choose their own books as the mobile library visits the home regularly. People living at the home often go out with their families although other visits out are not organised by the home. Visitors also told us that they visit whenever they want to and are always made welcome. The local vicar also visits the home and there are services arranged throughout the year. A harvest festival service was proposed the week after the inspection. There is a four week menu, although it identifies one main choice. Staff said that people could always have some different if they did not like the meal of the day. A cooked breakfast is available everyday should people want one, alongside cereals and toast. At teatime there is usually sandwiches and cake. The main meal on the day of the inspection was egg and chips, although one lady did have mashed potatoes instead of chips. There is always a choice of pudding available. Staff showed a good awareness of people preferences and said that one person did not like milk puddings but we saw that fruit and ice cream were also available. People have their meals in the dining room together and appeared to enjoy the experience. Staff were seen to assist people to cut up meals when needed and also feed those people who are unable to feed themselves. People told us that they liked the food: Yes the food here is lovely. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements made give greater assurance that peoples concerns will be listened to if listened to and acted upon. Staff act in peoples best interests and protect them from harm and abuse. Evidence: The complaints procedure is displayed on the main notice board in home. There is a need to ensure that the complaints procedure is more accessible and is also available in alternative formats such as large print. The home has had no complaints since the previous inspection. The manager told us that there are appropriate systems in place should any complaints be made and all concerns would be recorded and responded to as the homes complaints policy. We have not received no complaints about the home since the previous inspection. People living in the home told us that they would speak to staff if they had any concerns. One person did say she was not sure how to raise any concerns but said her daughter would do it for her if needed. Staff said that if people highlighted any concerns they would highlight the concerns to either the the Homes owner/manager who lives next door to the home or the Deputy Manager. Staff on duty told us that they have received training to highlight what abuse is. We asked following the previous inspection that all staff were made aware of the Care Homes for Older People Page 17 of 28 Evidence: Staffordshire Safeguarding policy to assist and them to make safeguarding referrals if they need to. Staff we spoke to said that they had read the policy and found it very informative. There is a note on the noticeboard in the office asking that staff read the policy and confirm that they have read it. We would advice that all staff have training in safeguarding as there is no record that any training has taken place. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and comfortable although addition adapted bathing facilities should be provided twhich are suitable for people who live there. Evidence: The home is homely, clean and maintained to an adequate standard. We did find that there are areas of the floor which are uneven and could represent a tripping hazard. Problems with the central heating and hot water sytem have been addressed since the previous inspection meaning that the home has more effective heating and more consistent hot water. A new carpet has been provided in one bedroom. There is a large lounge where people spend their day and a separate dining room where they have their meals. The home has eight single bedrooms and one double room non of the bedrooms have ensuite facilities. Bedrooms are clean and comfortable and hold peoples personal pictures and other treasured items. There are two bathrooms but staff say that they only use the downstairs bathroom as only that bath is suitable for people with mobility difficulties. It would enhance choice if a bathroom for people with mobility problems was available upstairs. Care Homes for Older People Page 19 of 28 Evidence: There are several toilets around the home close to bedrooms and the communal rooms. The majority of the home was free from any odour although an offensive odour was noted in one bedroom. We did advise that tto improve infection control procedures that liquid soap and paper towels should be provided in peoples bedrooms to enable staff to wash their hands after they have given any personal care, this has not been undertaken. Staff do use aprons and gloves to minimise the risk of cross infection. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sufficient staff who are aware of people needs. Further improvement should be made to staff recruitment processes as this will greater protect vulnerable people. . Evidence: The staff have appropriate staff numbers to meet peoples needs. There are two care staff on duty during the day alongside the cook. There is one carer on duty at night and although no person needs two staff to assist them at night should there be a problem staff on duty can contact the Home Manager who lives within the homes grounds. We observed a good interaction between staff and people living in the home. People who returned surveys said: Staff are very caring. The home has four of its nine care staff with a minimum of national level two in care. Other staff are currently undertaking a care qualification which means that the recommendation of fifty per cent of care staff with a care qualification will be met. Staff on duty said that they had been having loads of training recently and even said it had been too much: We have been doing the safe handling of medicines course and will start the dementia awareness next month. We were not able to ascertain what Care Homes for Older People Page 21 of 28 Evidence: training newer staff had had who were not on duty at the time of the visit and there is a need for records to be improved in this area. Staff recruitment has been improved since the previous inspection. All staff files seen contained appropriate checks such as a protection of vulnerable adults check prior to the return of the criminal records check and references. There was no record of a risk assessment when staff are employed with a protection of vulnerable adults check before the criminal records check is returned. We had also advised the manager of a need to do a risk assessment when staff are employed before the criminal records check is returned at the previous inspection. There was a record of an induction checklist although this did not appear to meet the Skills for Care. We advise that induction training is to Skills for Care standards. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management processes are generally adequate although there is a need for more proactiveness to ensure that people health and welfare will be consistently and adequately protected at the home. Evidence: The registered manager has been in the caring profession for a number of years and has been the registered provider for Cameo for 18 years. The staff on duty demonstrated a good awareness of peoples needs and were informed of the general running of the home. The home did return their Annual Quality Assurance Assessment (AQAA) when required. The AQAA gave us basic information about the home and not all areas had been completed so we were not able to gain an adequate picture of the home. The home needs to develop it audit systems to improve its quality rating and give greater assurances that improvements are being made without a need for visits from us. The Care Homes for Older People Page 23 of 28 Evidence: home does not have a quality assurance system which we have previously recommended. It is however positive that the manager has started to send out surveys of peoples views of the home (including professionals who visit the home). The home does keep small amounts of money for people living in the home within the homes safe. There are records of all transactions and receipts to confirm the transactions as we advised at the last inspection. Information supplied by the Manager has confirmed that all maintenance contracts are up to date. Maintenance contracts that we randomly selected during the inspection also confirmed this. Staff do undertake mandatory training although we found not at the recommended frequency and not all records were available at the time of the inspection. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 A risk assessment must be undertaken when staff are employed with a protection of vulnerable adults check and before the criminal records check has been returned. A risk assessment will ensure that recruitment is safe to protect people living at the home and that staff will always be supervised when working until their criminal records check has been returned. 21/11/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 1 3 The service user guide is available for both current and prospective people wishing to live at the home. The assessment of needs undertaken before people come to live at the home provides more information about peoples needs choices and capabilities. Care Homes for Older People Page 26 of 28 3 4 5 6 7 8 9 10 7 8 12 15 16 18 19 38 Care plans should be person centred and reflect peoples individual needs choices and capabilities People should be weighed an regularly and preferably at no more than monthly intervals. Care records identify peoples interests to form the basis for a social needs plan of care. The menu identifies two main meal choices each day. The complaints procedure is available in alternate formats such as large print. All staff receive training in what is abuse and actions they should undertake if abuse is alleged. The upstairs bath is provided with aids to enable its use for people living at the home. Records or a training matrix that identify the overview of all training that staff have received should be available. Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!