Inspection on 14/02/06 for Cameron House

This inspection was carried out on 14th February 2006.

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

Cameron House 01/12/08

Cameron House 07/02/07

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

CARE HOMES FOR OLDER PEOPLE Cameron House 78 Pellhurst Road Ryde Isle Of Wight PO33 3BS Lead Inspector Annie Kentfield Unannounced Inspection 14th February 2006 10:30 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 Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 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. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cameron House Address 78 Pellhurst Road Ryde Isle Of Wight PO33 3BS 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) 01983 564184 01983 811798 Make All Ltd Miss Sarah Margaret Floyd Care Home 18 Category(ies) of Dementia - over 65 years of age (18) registration, with number of places Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Manager must achieve NVQ Level 4 in Care and NVQ Level 4 Registered Manager’s Award by December 2007 Date of last inspection Brief Description of the Service: Cameron House is registered to provide care for up to 18 older people who have a dementia. The home is a detached period property that has been converted to provide accommodation on the ground and first floors and is situated in a residential area of Ryde. The bedrooms are mostly single with some double rooms, and access to the first floor is via a stair lift. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home has recently changed ownership and because of this, has only had one inspection in this inspection year. A new manager has recently been registered, however, the manager and all of the staff have worked in the home for some time and have continued to work there during the change of ownership. This inspection included a tour of the premises, discussion with some of the staff and inspection of some of the home’s records. It was not possible to fully engage with the residents in the home due to levels of cognitive impairment. Comment cards were left during the inspection for relatives and visitors to complete and return if they wished to. What the service does well: What has improved since the last inspection? What they could do better: Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 6 The manager has been registered subject to a condition requiring her to achieve the minimum management qualifications by December 2007. The manager is currently enrolled with the local college to achieve the NVQ level 4 Registered Manager Award and there are plans for further professional training to be provided for the manager in the areas of dementia care and supervision skills. 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. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 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 Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home does not provide intermediate care or day care. No new residents have been admitted to the home but the manager confirmed that there are systems and procedures in place for doing a pre-admission assessment of care needs. EVIDENCE: All prospective residents have their care needs assessed before moving into the home to ensure that the home can meet their needs. Records were not inspected, as the home has not admitted any new residents. However, the manager confirmed that the assessment process gathers information about residents from family and others involved in the care of the resident. Relatives are encouraged to visit the home before their relative is admitted. Residents may be admitted to the home from hospital or their own home and the home liaises with the community and hospital services to ensure that as much information as possible is available about the individual care needs of each person before they move into the home. The home does not offer day care or respite care. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Every resident has an individual plan of care that is regularly reviewed to ensure that the residents’ health and personal care needs are being met. Medication is regularly reviewed with the relevant GP. EVIDENCE: The inspection looked at records for 2 residents and these set out the plan of care and what action needs to be taken by staff to meet care needs. Care plans are usually reviewed every month, with a more detailed review every six months. The relevant local authority care manager reviews the care of residents funded by the local authority annually. All care plans contain a photograph of the resident. Relatives are asked to complete a pre-admission questionnaire listing special requirements and care needs. The manager is responsible for the medicines that are received into the home and these are checked daily. Medication is reviewed every 3 months by the prescribing GP who also makes regular visits to the home. The manager explained that the home has a good working relationship with the local GP Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 10 practices and the community mental health services to ensure that residents’ health care needs are met and advice and information is always available. Medication is appropriately stored and recorded and all staff that dispense medication have done an accredited distance learning course in the safe administration of medicines. The home also maintains a record of all visits to the home of GP’s, Psychiatrists, and Community Nurses. The individual care plan includes an assessment and management plan for continence care, nutritional care needs and mobility. The manager confirmed that there are no residents who require the assistance of a hoist, at present. It was not possible to gain feedback from residents about their experience of living in the home, however, during the inspection, it was noted that residents appeared well cared for and staff were seen to knock on doors before entering bedrooms and bathrooms. Comments received from relatives and visitors demonstrated that residents are well cared for in the home and the manager and staff are available to speak to relatives when they visit. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 It is not possible to gain feedback from the residents on whether the home meets their expectations and preferences. The home does provide some activities for residents such as musical entertainment, and birthdays and special events are celebrated with parties. Visitors are welcome EVIDENCE: Residents are encouraged to be as mobile as possible and residents are encouraged to walk to the dining room to take their meals wherever possible. All of the residents have a level of dementia and need assistance or prompting with all activities of daily living. Whilst residents are not able to actively make choices about menus or social activities, the manager explained that they rely on observation of residents’ likes and dislikes and information from relatives. The chef has worked in the home for some time and prepares a 4-week rolling menu that takes into account special dietary needs and preferences. Staff were seen providing residents with assistance at lunchtime and the manager explained that specially heated plates are provided where residents need time to eat their meals and for them to be kept warm or will provide different eating utensils for residents to eat their meals. The home provides some social activities for residents such as a musical entertainer and gentle exercises and staff are encouraged to spend time with Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 12 residents in the afternoons. Visitors are welcome to spend as much time with relatives as they wish and to assist with eating meals if they want to. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 - 18 The home has policies and procedures in place to ensure that residents are protected from abuse. EVIDENCE: The home has a complaints procedure but no complaints have been received. The home ensures that residents are safe in the home and residents are not able to leave the home without a member of staff or relative as the front door opens onto a busy road. All visitors to the home have to be admitted by a member of staff and sign the visitors’ book. The back garden is secure and private and in the warmer months residents can walk into the garden and seating is provided. The manager demonstrated that the home has a policy on protecting vulnerable adults and staff are encouraged to read the policies and procedures to update their knowledge. The home has not taken on any new staff but the manager demonstrated during the recent registration process that she is aware of the current regulatory requirements for recruitment procedures to ensure that residents are protected and new staff are subject to a number of preemployment checks. It is the policy of the home that staff are not involved in any way in residents’ finances or legal affairs. Residents are either supported by relatives or independent advocates. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home is well maintained, clean and tidy, and provides a safe and attractive environment for the residents. The home is clean, pleasant and hygienic. EVIDENCE: A tour of the premises found the home to be well maintained and decorated and all areas of the home were free from any offensive odours. The home employs a cleaner for 6 days per week and night staff also do some of the cleaning tasks. The home has separate laundry and sluicing facilities and these were very clean with clear instructions for staff on health and safety and safe working practice. Some of the bedrooms have en-suite facilities and others have washhand basins and shared bathrooms close by. Shared toilets and bathrooms contain suitable hand washing facilities. Although not all of the bedrooms are single, those rooms that are shared by two people have screening in place to ensure privacy. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 15 The home does not have a passenger lift and residents access the first floor via a stair lift. On the first floor there are additional steps to access some of the first floor bedrooms. This does mean that residents are not able to move around the home independently as the residents need to be assisted by staff to use the stair lift and negotiate any steps. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Residents are supported by staff that are experienced and competent and sufficient numbers of staff are employed to meet the needs of the residents. EVIDENCE: The staff rota shows that there are usually 3 care staff on duty in the mornings with 2 or 3 care staff during the afternoon and evening, with the manager, finance administrator, cook and cleaner in addition. There are two wakeful staff on duty at night. The home employs 20 care staff and at least 50 have achieved the national minimum qualification of NVQ level 2 in care and some of the care staff have higher qualifications in care. There is an ongoing staff training programme in all aspects of health and safety and safe working practice. The home provides a specialist service in caring for residents with dementia and some of the staff have done some training in dementia care and the manager maintains a file of information for all staff with updates of good practice in dementia care. Care staff are regularly observed in their practice and the home has a supervision system in place of self-assessment, observation and formal supervision every 3 months. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 17 The manager is newly appointed and has still to establish her own systems of supervision and training, however, some staff reviews have already been completed and further training for the manager in supervisory skills is to be arranged. The staff team is constant with very little staff turnover and the new registered manager has worked in the home for a number of years as a senior carer. Recruitment procedures have already been discussed in a previous section and the manager has confirmed that she is aware of current regulatory requirements for carrying out pre-employment checks on all new staff before they can start working in the home. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 The registered manager is newly appointed and has yet to achieve the qualification requirements for registered managers. However, the inspection found the home to well run in the best interests of the residents. EVIDENCE: The new manager has an open and positive approach to managing the home and is able to call on support and advice from a number of sources. The manager is aware of the responsibilities involved in managing the home and is committed to developing her professional training and practice. The new registered owner of the home visits the home on a regular basis and submits her own inspection report to the Commission (as required under Regulation 26 of the Care Homes Regulations 2001) and also provides line management to the registered manager. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 19 Records show that regular checks are maintained in the home of all equipment and fire safety equipment and the cook is responsible for health and safety checks in the kitchen. The last food safety inspection was in 2005 and there were no requirements. Advice given to install new extractors and filters has been actioned. The residents are not able to actively give feedback about their experience of living in the home as part of the home’s quality assurance system. The home does encourage feedback and contact with relatives and visitors, and professional visitors, and this could be developed into a formal system of consistently obtained and objective review of the service provided. Policies, procedures and practice should be regularly reviewed in light of feedback from carers and visitors and from good practice advice from specialist and professional organisations. This should be considered as the new registered owner and manager settle into their new roles and have the opportunity to develop the good practice in the home. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X 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 2 X 2 X 3 X X 3 Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 21 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 OP31 Regulation 9 Requirement The registered manager must achieve the minimum qualifications for registered managers by December 2007. (The manager is currently enrolled to achieve these qualifications) Timescale for action 30/12/07 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 OP33 Good Practice Recommendations The registered manager needs to develop effective systems of quality assurance that takes into account the views of family, friends and professional carers that are consistent and objective and demonstrate that policies, procedures and practice are regularly reviewed in the light of continuous monitoring of the service provided. Cameron House DS0000065253.V269619.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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