Inspection on 10/05/05 for Carham Hall

This inspection was carried out on 10th May 2005.

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

Carham Hall 07/08/07

Carham Hall 17/07/06

Carham Hall 15/12/05

Carham Hall 11/11/04

Carham Hall 22/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Carham Hall Cornhill On Tweed Northumberland TD12 4RW Lead Inspector Anne Urwin Brown Unannounced 10 May 2005 09:30 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 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. Carham Hall Version 1.10 Page 3 SERVICE INFORMATION Name of service Carham Hall Address Cornhill On Tweed Northumberland TD12 4RW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01890 830338 01890 830338 Mrs J Baxter & Mr J Baxter Mrs J Baxter CRH 21 Category(ies) of DE(E) Dementia - over 65 (2) registration, with number OP Old age - (19) of places Carham Hall Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration. Date of last inspection 11 November 2004 Brief Description of the Service: Carham Hall is a large detached stone built house standing in its own grounds overlooking the River Tweed. The nearest villages are about a mile away and Coldstream, where there is access to public transport is about five miles. The Home is registered to accommodate up to twenty-one elderly people, two of whom have been diagnosed with dementia. Carham Hall is well furnished and appointed with a large number of en-suite rooms, while others have exclusive use of a bathroom or toilet. A shaft lift is fitted for access to the first floor and a wheelchair lift is available for a short flight of stairs on the ground floor. At the time of this inspection a variation to the registration had been granted to accommodate a person under sixty-five years of age on a temporary basis for respite. Carham Hall Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection lasted four hours and involved talking to residents, the Manager and staff; inspection of records and a tour of the building. Residents said that they were satisfied with the quality of care provided. They spoke highly of individual staff. A good rapport existed between residents and staff. Care plans seen during the inspection contained appropriate information about care needs and the support required. The Home is well furnished and appointed and each resident has his/her own bedroom. There is a shaft lift installed for access to the first floor and a wheelchair lift for access to the bedrooms at the side of the building. What the service does well: What has improved since the last inspection? What they could do better: There is a need to ensure all staff receive supervision six times per year. A planned programme is to be introduced. Regular checks need to be carried out to ensure that the use of fire extinguishers to hold back electronic fire doors is not common practice. In addition checks should be carried out to ensure that fire exits are kept clear of flammable items. Carham Hall Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carham Hall Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Carham Hall Version 1.10 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 standard(s) 3, 4, 5 Residents have their needs assessed before moving into the Home. Arrangements are in place to ensure that residents’ needs are met. Pre visits are arranged to the Home so that prospective residents and their family are aware of the facilities and service provided. EVIDENCE: Records were available that show residents’ needs are assessed before admission to the Home. The Manager said that each new resident has full assessment carried out. Two residents said that they were satisfied that staff knew their needs and had identified them at the time they came into the Home. Detailed care plans were available in residents’ files to provide information about their needs. Four care plans were seen during the inspection and these showed that needs are assessed. Residents receive support from local health care staff to meet their needs and records confirmed this. The Manager described how visits to the Home and initial trial periods are arranged to suit individual needs. Care managers are asked to supply information prior to any unplanned admissions to the Home. Carham Hall Version 1.10 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 standard(s) 7, 8, 9 Care plans providing details of each resident’s needs are in place. Staff promote and maintain residents’ health and ensures access to health care services to meet assessed needs. EVIDENCE: The home has individual care plans, which show a process of assessment, planning of care, evaluation and re-assessment. The model uses a format, which covers the activities of daily living. Those examined were completed effectively and were in sufficient detail to allow the care to be provided according to the required assessment. There is use of a variety of assessment tools, including moving and handling, dependency and assessment of skin integrity. Equipment was available to assist staff in preventing pressure sores and promoting continence. Evidence was available from records that associated health care professionals were consulted and visited both regularly and as needed. A number of residents were spoken to and two who were asked specifically about the care planning were aware of the contents of their own plan and had been involved in its development. Carham Hall Version 1.10 Page 10 The systems for administration of medication were being managed effectively. The use of the pharmacist to provide an auditing service and regular advice was discussed and this is to be considered by the Manager as part of her quality assurance process, she is currently provided with advice on an “as necessary” basis from her supplying pharmacist. The storage is appropriate. Carham Hall Version 1.10 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 standard(s) 15 There is a choice of food and residents can make decisions about where to have their meals. Arrangements for the storage of food need to be reviewed and the kitchen area must have fly screens fitted. EVIDENCE: Each resident’s likes and dislikes are identified before admission to the Home. Menus showed a good range of food is provided with alternatives available. Residents stated that they were satisfied with the quality and quantity of food provided. They are able to have meals served in their rooms if they choose. Food hygiene training has been provided for staff. Staff have access to a specific course on Nutrition and are working on this at the time of this inspection. During the inspection of the kitchen there was food stored in the refrigerator that had not been dated. Inspection of food cupboards showed that storage of some dry foods including cereals does not comply with the Environmental Health Officer’s Report. The fly screens on the outside windows must be replaced as it had been removed so that the staff can regulate the temperature in the home while preventing insects from entering. Carham Hall Version 1.10 Page 12 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 standard(s) 16, 18 Residents feel confident about making a complaint to the staff and know that their concerns will be taken seriously. There is a simple, clear and accessible complaints procedure in place. Residents are protected from abuse. EVIDENCE: Residents said that they could make a complaint to a member of staff or the owners. They said that they were confident that this would be taken seriously. Staff knew that there were written policies and procedures relating to complaints. They were able to give appropriate examples of how they would assist a resident to make a complaint. Complaint records were available for inspection and these provided appropriate information about the investigation and outcome of complaints. Policies and Procedures are in place for protection of vulnerable adults. Staff were able to describe appropriately the action to be taken if an allegation of abuse is made. Carham Hall Version 1.10 Page 13 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 standard(s) 19, 24, 25, 26 The residents live in a well maintained environment. A number of fire doors were propped open. Residents have comfortable bedrooms with their own belongings around them. The Home is comfortably furnished, clean and hygienic. EVIDENCE: The home is well maintained and evidence of a programme of renewal and maintenance was available. During the inspection a number of fire doors were held open with fire extinguishers. There was a mattress stored at the foot of a staircase leading to a fire exit. The grounds are attractive, well maintained and accessible. Some recommendations of the Environmental Health report were outstanding and the Manager stated that these are receiving attention. Only three bedrooms are shared and all these residents have chosen to share. Residents’ rooms were well furnished and decorated and most are carpeted. Others have lino type flooring. A lockable cupboard is provided. Evidence was available to confirm residents have chosen to bring in items of furniture from home. A number of rooms are fitted with a pressure sensor mat for the safety of the person living there. Carham Hall Version 1.10 Page 14 Oil central heating is fitted and residents are able to adjust the temperature in their rooms. Records of water checks were available. A health and safety check was carried out in October 2004 and records were available to confirm this. Carham Hall Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 30 Staffing at the time of this inspection was sufficient to meet the needs of the residents. Staff receive appropriate training opportunities to equip them to meet the needs of the residents. EVIDENCE: There are not less than three staff on duty throughout the day and in the morning there are generally four staff. A senior member of staff is on duty throughout the day. The rotas showed this level of cover is maintained. There is one waking night care assistant. Mr and Mrs Baxter sleep in on the premises and are on call. This level of cover at night is currently adequate, but may need to be re-assessed if the resident group changes. Residents stated that they were enough staff on duty and that staff were aware of their needs. Ten staff have achieved care qualifications. Training records are available and showed that training in Infection Control, Manual Handling, First Aid, Food Hygiene, Protection of Vulnerable Adults and Dementia has been provided or is scheduled for this year. Carham Hall Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 38 The management approach is clear and positive, however there is a need for further attention to be given to improving the arrangements for staff supervision and staff meetings. Health and safety is regularly reviewed. Issues relating to fire safety were identified and the Manager took action to address these during the inspection. The safety and welfare of residents and staff is generally protected. EVIDENCE: Staff stated that the management are approachable and they are able to put forward their views. The Manager indicated that staff supervision has recently been introduced. The documents for recording supervision are good. Evidence was not available to confirm that staff have received supervision at the required intervals. Health and safety policy and procedures are in place. Fire records were available to confirm fire alarm tests, equipment testing and servicing is carried Carham Hall Version 1.10 Page 17 out at appropriate intervals. There is a need that doors fitted with electronic door closures are not chocked back. In addition fire exits must be kept clear of flammable items. Accident records are kept in an appropriate manner and the home is undertaking accident analysis records, which were examined and found to be a good method reviewing risks and taking preventative action as necessary. The use of pressure sensitive pads in the bedrooms is a good proactive method of ensuring staff are alerted to residents who need assistance on getting up at night when they are not able to summon help. During the visit a large television was placed on a “bed table”, this was removed immediately. However it is recommended that a risk assessment be undertaken to ensure that when televisions are in the bedrooms they are standing on a suitably stable stand to reduce the risk of accidents. Carham Hall Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Carham Hall Version 1.10 Page 19 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 15 Regulation 16 Requirement Arrangements for the storage of food must be reviewed to ensure that food is appropriately labelled and stored. The recommendations of the Environmental Health Officer’s Report must be complied with including the provision of fly screens. It is essential that electronically operated fire doors are not held back with fire extinguishers. Fire exits must not be used for storage or for items that could pose a fire risk. Timescale for action 30.06.05 2. 38 23(4) 30.06.05 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 38 Good Practice Recommendations A risk assessment should be undertaken in the residents’ bedrooms to ensure that televisions are on suitable stands to prevent accident. Version 1.10 Page 20 Carham Hall Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Carham Hall Version 1.10 Page 21 - 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!