Inspection on 28/10/05 for Cams Ridge Nursing & Residential Care Home

This inspection was carried out on 28th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Cams Ridge Nursing & Residential... 15/10/09

Cams Ridge Nursing & Residential... 19/10/07

Cams Ridge Nursing & Residential... 05/06/06

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Winton House

Newbeech House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Cams Ridge Nursing & Residential Care Home 7 Charlemont Drive Cams Hill Fareham Hants PO16 8RT Lead Inspector Sue Maynard Unannounced Inspection 28th October 2005 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 Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cams Ridge Nursing & Residential Care Home Address 7 Charlemont Drive Cams Hill Fareham Hants PO16 8RT 020 7929 3444 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) Ashbourne (Eton) Limited Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (10), Physical disability of places over 65 years of age (37), Terminally ill over 65 years of age (37) Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category of PD must be at least 50 years of age. Date of last inspection 30th June 2005 Brief Description of the Service: Cams Ridge is a care home with nursing for service users over the age of 65 years. The Home is also registered to take terminally ill service users and persons with physical disability. The home has been recently extended to provide accommodation for 51 service users. The Home is situated in a quiet residential area near to local amenities. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the second statutory inspection for the year 2005/2006. The inspection was conducted by one inspector and lasted five hours. The manager was on duty throughout the inspection. During the inspection the inspector spoke to both residents and members of staff. A tour of the premises took place and records were examined. The residents spoken to by the inspector told her that they were very happy with the care they received in the home and confirmed that the staff were very caring and always prepared to give assistance when it was required. They also confirmed that they had freedom of choice over many aspects of their daily lives. What the service does well: What has improved since the last inspection? What they could do better: Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 6 Staff recruitment records must be reviewed. The staff recruitment procedure must be adhered to when considering the application from a prospective new member of staff. Consideration must be given to implementing a more appropriate and varied programme of activities for the service users. Training to provide this programme should be offered to the activity co-ordinator. Service users stated that although they are happy living in the home they would enjoy a more varied programme of activities. 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. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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 Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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): Standard 3 was assessed at the inspection in June 2005-11-09 Standard 6 does not apply to this service. EVIDENCE: Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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): 8 and 10 Communication systems in the home ensure that the health and care needs of the residents are met in a way that respects their privacy and dignity. EVIDENCE: Service users are able to keep their own Doctor if they were living locally prior to admission to the home. The manager of the home undertakes monthly audits of service users records who have pressure sores. This enables staff to monitor any improvement or deterioration of the affected area. At the time of this inspection it was reported to the inspector that two service users have pressure sores. One was admitted to the home from a local hospital with a pressure sore. Dental and optical care is available for all service users who require these services. The chiropodist visits every six weeks and provides podiatry care for all service users. Nutritional assessments are undertaken for all service users. The home is able to liaise with the dietetic department at the local hospital and seek advice for Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 10 service users who are assessed as being at risk for weight loss or poor dietary intake. From discussions with service users and members of staff it is clear that there is an awareness of the needs of the individual for dignity and privacy and choice in this home. Service users confirmed that staff are always pleasant and supportive. The inspector observed staff knocking on the doors of service users rooms and waiting for a response before entering. All service users rooms in the home are single occupancy. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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 and 15 The management of the social activities at this time does not create a positive, varied and interesting life for the residents, and does not meet their expectations for living in the home. The improvements for the arrangements of meals ensure that residents have a nourishing and balanced diet. They are able to choose where to eat their meals. EVIDENCE: Since commencing employment in the home in August 2005 the manager has become aware that social activities are very limited. The home employs an activity co-ordinator. He has discussed with her the very limited programme of events that are in place and how the variety of the programme can be improved. The activity co-ordinator has had no formal training to be able to provide activities that are relevant and suitable for the service users. The manager has identified areas of her role within the home that need to be improved and is arranging for her to undertake relevant training. The manager in consultation with the activity co-ordinator has revised the current activity programme and some new activities have been implemented. At this time all activities are limited to what can be arranged in house as the manager has a very limited budget and transport to take service users to venues outside of the home cannot be arranged. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 12 Service users spoken to by the inspector about activities in the home did not seem unduly concerned that the programme was very limited. They all confirmed that the staff were friendly and sat and talked to them and that they had access to a television and that their families were able to visit them at any time. During a recent meeting between the manager and the residents and their families, concerns were raised about the standard and quality of the food being served in the home. Catering in the home is provided by an external catering company employed throughout the Ashbourne Healthcare group of homes. From the issues raised, which highlighted the lack of variety, items of food and drinks that were on the menu were never available. These and other problems including staffing in the kitchen were put by the manager of the home to the General manager for the catering company. As a result the catering staff structure within the home has changed and the menus reviewed. Service users spoken to by the inspector confirmed that the variety and quality of the meals had improved. The lunchtime meal served during the inspection was well presented and a variety of fresh vegetables were served. A variety of fruit drinks were seen to be available at breakfast and lunchtime. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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): 18 The vulnerable adults procedure should ensure that any allegation of abuse will be addressed appropriately but lack of staff training at this time may be putting service users at risk. EVIDENCE: Robust policies and procedures for the reporting of allegations of abuse within the home are in place and the home has a “whistle blowing” procedure which is made available for all staff. The manager reported that these procedures and policies are discussed with new staff as part of their induction training but formal training updates after induction are not in place at this time. The manager explained that he is awaiting guidance from Ashbourne Healthcare about the formal training programme for the home but that he considered this area of training to be essential and that he would implement some formal training updates as soon as possible. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 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 The ongoing review of services provided in the home ensures that all residents are enabled to live in a clean, safe and comfortable environment. EVIDENCE: On the day of the inspection the home was found to clean, tidy and well maintained. Since coming into post the manager has had regular meetings with the housekeeper and maintenance staff for the home. The manager confirmed that he regularly checks all areas of the home and ensures that the fabric of the building is well maintained. There is a programme for the regular re-decoration of rooms in the home. It was reported to the inspector that recently there had been problems with the supply of hot water and heating to some areas of the home but this had now been rectified and the whole system was functioning well. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 15 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): 28 and 29 The staff undertakes training that enables them to be competent to do their jobs. The homes recruitment policies and procedures have not been adhered to and appropriate checks not undertaken to ensure the safety and well being of the service users. EVIDENCE: Staff employed in the home are supported to undertake training for NVQ levels 2 and 3. At the time of the inspection three members of staff have achieved level 2 and six members of staff are undertaking training for level 2 at this time. The inspector examined recruitment files for four members of staff. All the records were found to have some documents omitted. • None of the records seen contained evidence that a formal interview had been undertaken. • Three of the files had no evidence that induction training had taken place. • Three of the files did not contain a current photograph of the member of staff. • One file contained no evidence that references had been obtained prior to the person commencing employment. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 16 The records for one member of staff contained one written reference obtained prior to commencement of employment, the other reference was written in February 2005, seven years after the member of staff had commenced employment and had been written by the then current manager. • In the file for one trained staff member (RGN) no evidence of a current PIN number could be found. All these omissions were brought to the attention of the new manager who agreed that this was unacceptable and that he would review all staff recruitment records and ensure that any new member of staff that he employed would have all the required documents and checks before being offered employment in the home. • Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 17 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, 35 and 38 The experience and training of the manager will ensure that the home is run in the best interests of the service users and staff. Close monitoring of practices within the home safeguard the health, safety and welfare of residents, staff and visitors to the home. EVIDENCE: The manager for the home has only been in post since August 2005 and has not yet undergone the registered manager interview with the commission. He is a Registered General Nurse (RGN) level 1. He has worked for many years in the armed services and since leaving has had experience in managing a home for retired service personnel. The home looks after money for some service users. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 18 The inspector examined these records and these were found to be in order. There was a record of all transactions, the money was individually stored and receipts were available. All the records were stored in a locked safe. The home has policies and procedures for all aspects of health and safety in the home. Records showed that the fire safety equipment and alarm system is regularly tested and maintained. Staff receive regular fire safety training. A fire risk assessment for the building was undertaken in March 2005. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 19 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 1 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 3 Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 20 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 OP12 Regulation 16 Requirement The routines of daily living and appropriate activities must be made available to suit the expectations, preferences and capacities of the service users. The registered person must make arrangements for training of all staff to prevent service users being placed at risk of harm or abuse. The registered person must operate a robust recruitment procedure to ensure the protection of the service users. Timescale for action 31/01/06 2 OP18 13 31/12/05 3 OP29 19 31/12/05 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 29 Good Practice Recommendations A record of all pre-employment interviews should be kept. Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cams Ridge Nursing & Residential Care Home DS0000065930.V262290.R01.S.doc Version 5.0 Page 22 - 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. 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