Inspection on 17/07/06 for Carham Hall

This inspection was carried out on 17th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Carham Hall 07/08/07

Carham Hall 15/12/05

Carham Hall 10/05/05

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 Key Unannounced Inspection 17th July 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carham Hall Address Cornhill On Tweed Northumberland TD12 4RW 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) 01890 830338 01890 830338 admin@carhamhall.wanadoo.co.uk Mrs J Baxter Mr J Baxter Mrs J Baxter Care Home 22 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (12) of places Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate one identified resident - category MD for periods of respite care. 15th December 2005 Date of last inspection 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, ten 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. Fees are from £407.00 to £600.00 per week. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over seven hours. Before the visit the Inspector used information from the pre-inspection questionnaire to assist in planning the inspection. The inspection involved talking to the Manager, six residents and five staff, one visitor, a tour of the building and inspection of records. What the service does well: What has improved since the last inspection? The complaints procedure has been amended to show residents have the right to complain directly to the Commission for Social Care inspection. Criminal records bureau checks are carried out before staff start work in the home. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service No resident moves into the home without having had his/her needs assessed and being assured that these will be met. Intermediate care is not provided at Carham Hall. EVIDENCE: Appropriate assessments are carried out and a good level of information is available about residents’ needs. A full assessment was completed for a resident admitted one week before the inspection. Intermediate care is not provided at Carham Hall and records confirm this. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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, 10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents’ health, personal and social care needs are set out in an individual plan of care. Residents’ health care needs are met. Residents are protected by the home’s policies and procedures for dealing with medicines. No residents administer their own medicines. Residents feel that they are treated with respect and their right to privacy is upheld. EVIDENCE: Individual plans are available that provide information about personal, health and social needs. Residents said that staff are aware of their needs and that the support they receive is appropriate. One resident said staff are “very kind and willing”. Risk assessments are in place for falls. Regular reviews of residents’ care plans are carried out to reflect changing needs. Records of how residents’ health care needs are met are kept. These show identified needs and any treatment provided. There are regular assessments carried out of the risks of pressure sores, continence and nutrition. Any visits by the general practitioner, district nurse or any other health care professional Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 10 are fully recorded. Records show that residents are able to access dental, chiropody, hearing tests and other specialist services. Policies are in place for the administration of medicines. None of the residents administers their own medicines. A monitored dosage system is used and appropriate records are kept of medicines given. Staff giving out medicines have had recognised training. All staff have completed training given by the pharmacist. Arrangements for the storage of medicines in a lockable trolley are satisfactory. Staff respect residents’ privacy and dignity. Examples given by residents included knocking on residents’ bedroom doors before entering and personal care given in the privacy of residents’ own rooms. Staff spoke respectfully to residents during the inspection. Residents’ clothing is labelled and care is taken to ensure clothing is returned quickly when it has been washed. Residents can have a telephone fitted in their rooms at their own expense and a telephone for public use is available for others. Residents said that their privacy is respected. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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, 13, 14, 15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents find the lifestyle experienced in the home matches their expectations and preferences. Their social, cultural, religious and recreational needs are met. Residents are encouraged to maintain contact with family, friends, representatives and the local community. Residents are helped to exercise choice and control over their lives. Residents have a balanced diet with well cooked food provided in pleasant surroundings. EVIDENCE: Residents’ records show that residents’ routines are identified in care plans. Residents said that they were able to make choices about their day to day routines, including when they get up and go to bed, where and how they spend their time and where they have their meals. Information supplied before the inspection included a list of varied outings and activities available including musical events, seasonal parties, gardening, outings and trips. Residents said that they enjoyed bus trips out and had recently been to civic week events in the local community. Visitors are welcomed at any time and one visitor was having lunch during the inspection. She said that the staff are very welcoming and that she is able to Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 12 visit whenever she wants. Information about visiting is available in the brochure about Carham Hall. Residents are encouraged to handle their financial affairs for as long as they are able. The manager is able to refer residents or their relatives to an advocacy service if they wish. Residents said that they had been able to bring personal items including furniture with them when they came to live at Carham Hall. Residents have three meals per day and hot and cold drinks and snacks are available. Food is well presented and cooked. Residents said they could choose from two items on the menu and they can request something else if they don’t like the food available. The menus showed a varied and wholesome diet is provided. Special diets are available and one resident said that she had been supported with a low fat diet and was pleased that she had lost weight. Staff discreetly helped residents who had difficulty with feeding themselves. The dining room is well arranged and comfortably furnished. Staff have had food hygiene training. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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, 17 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: The complaints procedure has been updated since the last inspection. Residents said that they felt able to talk to staff about any concerns or complaints they have. Staff were aware of the procedures to be followed in the event of a resident making a complaint. There is an appropriate system in place for recording complaints. Six staff have had training in Protection of Vulnerable Adults. Guidance is in place for staff about protection of vulnerable adults and about dealing with any allegations made. Staff were able to give an appropriate account about how they deal with an allegation that includes supporting residents. No protection of vulnerable adults referrals have been made since the last inspection. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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, 20, 26 Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service. Residents live in a safe, well-maintained environment. Residents have access to safe and comfortable indoor and outdoor facilities. The home is clean, pleasant and hygienic. EVIDENCE: Carham Hall has a programme of redecoration and renewal in place. The home is well maintained and a handyman is available to carry out day-to-day maintenance. Since the last inspection new carpets have been laid in three bedrooms and four bedrooms have been redecorated. New lighting has been provided in the sitting room and a new television as part of the general programme of improvements. The extensive grounds are well maintained and accessible for residents. The building complies with the requirements of the fire service and environmental health department. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 15 The sitting and dining areas are well furnished and decorated. The rooms are comfortable and well used by residents. All furnishings are of good quality and are appropriate to meet residents’ needs. There is a large lawn to the front of the house with paths around it. To the rear there is parking and the driveway to the main road. All the outside areas are well maintained and the garden is very attractive. The home was clean, hygienic and free from any odours during the inspection. Appropriate cleaning regimes are in place and staff are clear about this. The laundry is well equipped and can be accessed without having to take soiled linen through the kitchen. The washing machine has appropriate cycles to thoroughly clean linen and control the risk of infection. Hand washing facilities are provided appropriately. Staff are aware of procedures for infection control. Each resident has his/her own toilet either as an en-suite or near to his or her bedroom. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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, 28, 29, 30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The numbers and skill mix of staff meets residents’ needs. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices, although only one reference had been received for a staff member who recently started work. Staff are trained and competent to do their jobs. EVIDENCE: There were three care staff and the manager on duty at the time of this inspection. The rota showed that sufficient staff are available to meet the needs of the residents. One waking night staff is on duty throughout the night and the owners are on call on the premises. No staff members under twentyone years of age are employed. No agency staff are employed. There are sufficient catering and domestic staff. Residents said there were enough staff on duty throughout the day to meet their needs. Staff said staffing levels are adequate to meet the needs of the current residents. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 17 50 of staff members have national qualifications in care and four staff are working towards this. There are no agency staff working in the home. Information supplied before the inspection showed that all staff have a clear Criminal Records Bureau check. Recruitment policies and procedures are in place. One staff record showed that only one reference had been received before the person started work. Appropriate information is available in staff records, although only copies of staff qualifications are needed as the qualifications’ certificates belong to staff. There is a staff training plan in place. Training provided includes Infection Control, Dementia, Moving and Handling, Continence, Safeguarding Adults. Induction training is provided for all new staff. Staff said that there are sufficient training opportunities and that new staff are given sufficient information when they start work. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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, 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Residents 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 her responsibilities fully. The home is run in the best interests of the residents. Residents’ financial interests are safeguarded. The health, safety and welfare of residents and staff is promoted and protected, although fire alarm tests have not always been tested weekly EVIDENCE: The manager who is also one of the owners of the home has been at Carham Hall for eighteen years. She is experienced in caring for older people and has the registered manager’s award and is an enrolled nurse. Evidence was available from records that she undertakes updating training. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 19 An annual development plan is available and this shows there is regular review of the operation of the service. There is a development plan in place that clearly identifies priorities and confirms that practices are reviewed and records are audited regularly. There are also identified goals for future development of the physical standards within the home. Satisfaction surveys are carried out with relatives and residents and the information gained is used to prepare the development plan. Records are maintained of any money held on behalf of residents. Written procedures are in place for staff handling residents’ money. Arrangements for the storage of money are satisfactory. Samples of the money held were checked and these balanced with the records. Staff said that there is regular updating training provided in safe working practices and records provided evidence of this. Records showed that regular servicing and testing of equipment including central heating boiler, electrical appliances and hot water temperatures is carried out. There were some gaps in the weekly testing of the fire alarm system that occurred when a staff member was on holiday. Fire equipment is regularly serviced and tested. Fire training is provided to staff at appropriate intervals. Health and safety policies and procedures are available for staff. Risk assessments are in place for safe working practices. An accident book is kept and there is monitoring of accidents. Induction training is provided for all new staff and records confirm this. Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 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 4 X X N/A 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 X 18 3 4 4 X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 2 Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 2 Standard OP29 OP38 Regulation 19 23 Timescale for action Two references must be obtained 30/09/06 before a new member of staff starts work. Weekly fire alarm tests must be 30/09/06 carried out. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Carham Hall DS0000000511.V295041.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cramlington Area Office 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 DS0000000511.V295041.R01.S.doc Version 5.2 Page 23 - 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. 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