Inspection on 25/11/05 for Carisbrooke Care Home

This inspection was carried out on 25th November 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

Carisbrooke Care Home 22/04/08

Carisbrooke Care Home 04/10/07

Carisbrooke Care Home 04/01/07

Carisbrooke Care Home 23/02/06

Carisbrooke Care Home 25/02/05

Carisbrooke Care Home 17/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Carisbrooke Care Home 22 Carisbrooke Drive Mapperley Park Nottingham NG3 5DS Lead Inspector Susan Lewis Unannounced Inspection 25th November 2005 10:00 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 Carisbrooke Care Home DS0000026423.V268839.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. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carisbrooke Care Home Address 22 Carisbrooke Drive Mapperley Park Nottingham NG3 5DS 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) 01159605724 01159106613 Mr Abdool Raouf Sohawon Mrs Bibi Sohawon Mr Abdool Raouf Sohawon Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (20) of places Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Maximum number to be accommodated is 20 Any service user admitted under the category of PD will be 60-64 years old on admission 25th February 2005 Date of last inspection Brief Description of the Service: Carisbrooke Care Home is an older converted house set in a residential road in Mapperley Park, in the suburbs of Nottingham about two mile form the city centre. The care home provides care for older people with nursing needs and is registered for up to 20 service users. There are 12 single rooms and 4 double rooms, none of which have en-suite facilities. There are two lounge areas, dining room, opening into a dining area and a conservatory, where smoking is permitted. Two bathrooms and one shower room are provided and toilets are in close proximity to all individual service users rooms and communal areas. The care home has a pleasant outlook, with safe attractive well-maintained gardens to the front of the property, where car parking facilities are available. Carisbrooke Care Home DS0000026423.V268839.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 carried out by one inspector as part of the annual inspection process it took place over 5 hours. A tour of the building took place and staff and care records were inspected. Visitors, staff and residents were spoken with during the inspection. What the service does well: What has improved since the last inspection? 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. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 6 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 Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 7 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): 2, 3 and 4 The needs of current residents are met within this setting. EVIDENCE: Residents have copies of the contract, terms and conditions and evidence was seen to show that the recommendation to amend the complaints section to provide the correct name of the home has now been done. However the registered person must include the room number the resident is to occupy on the contract. Care plans provided evidence that pre admission assessments take place and cover all aspects of daily living. Evidence was seen that staff receive specialist training for dementia care. There is evidence that staff will cater for residents with social or cultural needs. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 8 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 and 9 Individual plans address needs and risk and mostly there are strategies in place to meet them. Risk assessments do not take place for residents to be able to self medicate. EVIDENCE: Three care plans were viewed as part of the inspection and provided evidence that information regarding residents care needs is documented and action is taken to meet changing needs. Healthcare professionals are contacted and visit as required and residents spoken with confirmed that they saw a doctor if they felt unwell. Equipment is provided where the need has been identified and staff spoken with said that there was enough equipment to meet the needs of residents. Care plans provide clear guidance to care staff of what action needs to be taken to meet an identified care need. There was evidence that relatives are involved in care plans and that reviews take place regularly. Nutritional screening takes place and residents weight is regularly monitored, evidence was seen that advise from the dietician is sought where concerns are identified. Persons trained to do so only administer medication and they are stored, recorded and handled follow the homes procedures. Residents Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 9 automatically have their medication administered by the home rather that be risk assessed to see if they are able or wish to self medicate. It is recommended that the registered person carry out risk assessments to see if residents are able to self medicate. It was noted that medication administration records were hand written; where this is the case they must be signed and witnessed so as to confirm they are correct. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 10 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 Residents have lifestyle choices and limited opportunities for leisure activities are available. Residents have a healthy diet provided but recording of this diet needs to be improved. EVIDENCE: Residents spoken with said that they chose when they got up and went to bed and they could choose how they spent their day, there was some evidence that activities took place, on the day of the inspection staff were observed in limited interaction with residents. Some residents spoken with did say that some care staff had limited English, but were very kind. There was some limited information recorded on care plans regarding residents’ interests and hobbies, most residents on the day of the inspection were observed either sleeping, reading the paper or watching television. The meals are taken either in the dining room or where the resident chooses. Staff were observed providing assistance where needed and a soft choice was provided where residents had difficulty swallowing. Some residents did mention that they had sponge pudding and custard a lot for pudding and would like a yogurt or something else as a choice. The menus operate on a four week cycle and these appear to provide a nutritionally balanced diet. Residents spoken with said they had plenty of food and it always tasted nice Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 11 but were not sure if they could have alternatives if they did not want something. In discussion with the cook it was confirmed that alternatives were given but this is not recorded. The registered person must ensure that a record of food provided to residents is made in sufficient detail to determine whether the diet is satisfactory. Some fresh fruit was available to residents and was noted in a fruit bowl in the dining room. The cook confirmed that fresh fruit is bought at least two to three times a week. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 Residents know how to complain and staff know how to maintain residents safety. Residents are protected by the policies and procedures of the home. EVIDENCE: The home has not received any complaints since the last inspection. Any complaint is recorded in a lined work book it is recommended that the registered person looks at alternative methods to ensure that all recording is in line with The Data Protection Act 1998. Residents and visitors spoken with all said that they knew who to complain to and felt confident it would be dealt with. Staff spoken with were aware of what constitute abuse and there was evidence that the registered person is currently trying to arrange adult abuse awareness training. Residents spoken with all said that they felt safe and had never seen or heard staff treat residents unkindly. A copy of the Nottinghamshire Vulnerable Adult Protection Procedures is kept in the main office and is available for staff to access at any time. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 22, 25 and 26 A homely environment is provided, which comfortable, clean and safe. EVIDENCE: The home is well maintained and the registered person carries out a maintenance audit of the home at regular intervals and notes any areas that are in need of repair, a similar book is maintained for the repair and renewal of furniture. The grounds are well maintained and residents spoken with said that they enjoyed looking out at the garden and watching the birds and squirrels. There is sufficient communal space to meet the needs of the residents. There are two lounges and a third area that is used as a smoking lounge for residents, leading off the main lounge area is the dining room. The lighting is throughout the home is domestic in character. There are sufficient baths and toilets to meet the needs of the residents with toilets in close proximity to the lounges and residents bedrooms to ensure easy access. The home has sufficient aids to meet the needs of residents and staff confirmed Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 14 this, there are handrails throughout the building. Radiators throughout the building are either guaranteed low temperature surfaces or guarded ensuring residents do not burn themselves. On the day of the inspection the home was free from odour, however it was noted in the laundry room that the paint on the walls was peeling, therefore the walls were not readily cleanable so as to maintain hygiene in this area. The home has sluicing facilities and the washing machine also has a sluicing programme, this ensures that foul laundry can thoroughly cleaned and the risk of infection can be controlled. Carisbrooke Care Home DS0000026423.V268839.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): 27, 29 and 30 Staffing ratios meet the needs of service users. Recruitment procedures are robust and protect residents from abuse. EVIDENCE: Staffing rotas were looked at and sufficient staff are employed to meet the needs of the residents. Evidence was seen that staff have recently undergone a number of training courses and staff spoken with confirmed that they are able to access training easily. There is always one trained nurse on each shift as well as sufficient carers. A domestic is employed 6 days a week from 8am to 3pm and two cooks are also employed to cover the seven days. Residents spoken with said that staff were always very busy but were ‘there to help when you need it’. Staff files were inspected and all appropriate documentation was evidenced ensuring staff are recruited following regulations that protect residents. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 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 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): 32, 35, 36 and 38 The overall management of the service safeguards the best interests of service users. Records are securely stored and health and safety is promoted within the environment. EVIDENCE: Both residents and staff said that the manager was approachable and staff confirmed that the manager gave a clear direction and lead as to the standard of care to be provided. Care plans stated who had financial responsibility over residents’ money. The manager reported that residents money is not handled by the home and the manager does not act as appointee for anyone. Evidence was seen that the local authority acts as appointee for a number of residents where relatives are unable to and protecting residents financial interests. The manager carries out supervision and staff spoken with said they felt supported by the manager and other trained nursing staff. Evidence was seen that staff Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 17 have undergone mandatory training ensuring the safety of residents and staff. Evidence was seen showing that fire drills are carried out regularly. Food is stored appropriately in the kitchen and the cook confirmed that action had been taken to meet the requirements left following a recent Heath and Safety inspection of the kitchen evidence of this was seen. Water is stored and delivered at 43oC, minimising the risk of residents getting scalded. The manager is aware of his responsibilities to comply with all health and safety legislation and evidence was seen to support this. There were written health and safety policies and risk assessments had taken place regarding safe working practices ensuring the safety of the staff and residents. Staff spoken with confirmed that they felt their health and safety was taken seriously. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 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. 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 2 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X X 3 2 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 X X 3 3 X 3 Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? 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 OP2 Regulation 5 Requirement The Registered Person shall produce a written guide to the care home, which include the terms and conditions in respect of the accommodation to be provided. This should include rooms to be occupied. The Registered Person must ensure that medicine record sheets are appropriately signed and witnessed when hand written. The Registered Person shall having regard to the size of the care home and number and needs of service users consult service users about their social interests and make arrangements to enable them to engage in local, social and community activities. The Registered Person must ensure a record of the food provided for service users are maintained in sufficient detail to enable any person inspecting the record to determine whether the diet is satisfactory, in relation to nutrition and otherwise, and of DS0000026423.V268839.R01.S.doc Timescale for action 01/02/06 2 OP9 13 01/01/06 3 OP12 16 01/02/06 4 OP15 Sch 4 01/01/06 Carisbrooke Care Home Version 5.0 Page 20 5 OP26 13 any special diets prepared for individual service users. The Registered Person shall make arrangements to prevent infection, toxic conditions and the spread of infection at the care home. The laundry walls must be painted to make it readily cleanable. 01/02/06 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 2 3 Refer to Standard OP9 OP15 OP16 Good Practice Recommendations The manager should risk assess residents to see if they are able to self- medicate and record this in the care plan. The manager should consult with residents regarding choice of meals and what alternatives they may want. The manager should look at alternatives methods to record any complaints so as to ensure all record are in line with the Data Protection Act 1998. Carisbrooke Care Home DS0000026423.V268839.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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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