Inspection on 04/01/07 for Carisbrooke Care Home

This inspection was carried out on 4th January 2007.

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 23/02/06

Carisbrooke Care Home 25/11/05

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 Mary O`Loughlin Key Unannounced Inspection 4th January 2007 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.V325838.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. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 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.V325838.R01.S.doc Version 5.2 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 23rd February 2006 Date of last inspection Brief Description of the Service: Carisbrooke Care Home is an older converted house set in the residential area of Mapperley Park about two miles from the city centre. The care home provides care for older people with nursing needs and is registered for up to 20 service users. The care home has a pleasant outlook, with safe attractive wellmaintained gardens to the front of the property, where car parking facilities are available. 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. This environment is accessible and safe for the servicers’ needs. The range of fees are: £272.58 to £309.00 Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted unannounced. Prior to completing this visit the inspector assessed the homes previous inspection reports, the service history including complaints and adult protection referrals, and a Pre-inspection questionnaire completed by the registered manager. Four completed residents satisfaction questionnaires were also received prior to this inspection. The main method of inspection used was case tracking, this is to randomly select three residents and read their care files, examine their private and communal accommodation along with any specialist equipment they require. Their care is tracked to ensure that their needs are being met and that staff have the skills to deliver the care they need. Various records were looked at including the medication policies, duty records, employment files and training files. Six residents, 1 relative and 4 staff were spoken with. The people selected for case tracking had limited ability to understand and communicate. Therefore many judgements in this report are from observation, discussion with staff and reading residents’ records and documents. Residents who were not part of the case tracking provided other information during the inspection. What the service does well: This small home provides a good quality level of care for the residents within a well-maintained and safe environment. The home benefits from consistent and strong management with a sustained track record in meeting the National Minimum Standards. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 6 The manager considers carefully the needs assessment for each prospective resident before agreeing admission to the home. Prospective residents and their family, always have the opportunity to visit and spend time in the home prior to agreeing admission. The care plan is used as a working tool and is understood by all staff. It is written in clear language and can be used in an emergency by people who are not familiar with its content. Each care plan includes a comprehensive risk assessment. Management of risk takes into account the needs of residents balanced with their aspirations for independence and choice. The manager routinely observes staff attitude and approach to privacy and respect and constantly seeks and values residents’ views and experiences. The staff team are qualified and experienced to work with the needs of the resident. Where the home admits people from different cultural or ethnic backgrounds it either employs staff that understand the cultural expectations of those residents or provides training and guidance to staff to enable them to be responsive to the residents individual needs. What has improved since the last inspection? What they could do better: The manager should ensure that any hand written medicines are checked by a second person that also signs the medicine record sheet, this reduces the chance of any error. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 7 Where residents require regular positional changes the manager should ensure that this is recorded to ensure that staff undertake this as required to safeguard the residents from harm. 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. The summary of this inspection report can be made available in other formats on request. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 8 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.V325838.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home consistently ensures that before any resident is admitted they receive a thorough assessment of their needs. EVIDENCE: The records of three residents were looked at and demonstrated that the manager had taken significant time to visit prospective residents prior to admission to undertake a thorough assessment of the person’s needs. The manager also invited the relatives and advocates of the prospective residents as well as a member of the home’s care staff. Following the assessment the manager said that he discusses the proposed admission with staff at the home and prepares any equipment to ensure the Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 10 home are able to meet the person’s needs and that staff are fully informed of how to deliver the care. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7-8-9-10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The records of three residents were examined. Each resident had a suitable care plan in place, which was drawn up in consultation with the resident or their relative and wherever possible signed by them. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 12 Each person has any risks to their health and wellbeing assessed on a monthly basis using recognised risk assessment tools. Any changes in the needs of the residents are recognised and recorded appropriately. Staff said they receive a thorough handover at the start of each shift where the qualified nurse informs them of their duties along with any changes in the conditions in the residents which ensures they deliver appropriate support and care. There was good evidence seen of the arrangements in place to ensure residents nutritional needs are assessed and met. Each person is weighed monthly and this is used to inform the risk assessment. The manager has suitable links with community specialists and refers any resident requiring specialist nutritional support. Daily records and meal records show that staff spend time ensuring that residents receive a suitable nutritional intake. Case tracking demonstrated excellent support for residents at risk of developing pressure sores. The staff ensure that each person is regularly assessed and provided with suitable equipment to maintain healthy skin. Residents were seen to be sitting on pressure relieving cushions and were provided with pressure relieving mattresses as their care plans indicated. The medicine records of three residents showed that staff administer the medicines as prescribed. The management of the medicines ensures the safety of the residents; there are appropriate audit trails for all medicines received into the home. Hand written medicine prescriptions were signed by the person writing the drug, this could be improved by ensuring a second person witnesses this to avoid any error. The dispensing pharmacist regularly inspects the service and provides updates in training for the staff undertaking medicine administration. One relative spoken with said he felt confident that the staff delivered a good standard of care. Four resident responses indicated that they were happy with the care they received. The staff were observed in their duties delivering care to the residents, they were sensitive and aware of how to maintain the dignity of the residents. Staff spoken with demonstrated a clear understanding of how they should maintain the privacy and dignity of the residents. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-14-15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: The capacities of the residents that were case tracked to be involved in social activities varied. Each person had a social care plan in place and a record of what activities they took part in. The home provides mainly in house activities such as visiting Music Therapist’s and others providing reality orientation and craftwork. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 14 On a daily basis the residents watch television, read or play bingo and dominoes. Those spoken with said they were happy with the activities provided. One relative spoke of being able to visit at any time of the day and was able to continue to support his relative both within the care home and was able to regularly take his relative for visits home. The cultural needs of each resident is considered and in one example the manager has employed a member of staff who is able to communicate in the same language as a resident who is not English speaking. The manager has also ensured that they have access to the interpreter service to enable better communication for residents of ethnic minorities. Lunchtime was observed to be organised and taken in a congenial setting. Staff were seen to be very supportive and ensured that residents received a good level of support whilst encouraging their independence. There are a variety of meals offered and some residents had chosen alternatives to the main meal. All those spoken with said they enjoyed the meals and had plenty of choice. Soft diets were served in an appetising way; kitchen staff had taken time with the meal presentation, which included fresh vegetables. All meals are recorded appropriately. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16-19 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure, and are protected from abuse. EVIDENCE: The home displays a large print complaints procedure and ensures that all prospective residents are issued with a copy. The Commission for Social Care Inspection have not received any complaints or referrals via the Protection of Vulnerable Adults Procedures during the last year. Relatives spoken with said they could communicate with staff daily and any concerns they have are taken seriously and acted upon. Staff training records indicated that they have recently received training in Protecting Vulnerable Adults from abuse, staff spoken with confirmed this. The home has suitable policies in place to protect residents from abuse. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The home is suitable and accessible for the resident group. It is well maintained throughout with suitable adaptations to meet the individual needs of the residents. Individual rooms are well equipped, warm and very clean. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 17 Each resident has access to emergency call bells. The home has received both Fire and Environmental inspections over the last six months and found to comply with the requirements of these services. The homes policies regarding infection control are up to date and evidence based ensuring that residents are protected from acquiring infection. Significant effort has been made to ensure that staff are provided with protective equipment and safe hand cleansing dispensers. There is good management of clinical and sharps waste. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27-28-29-30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. EVIDENCE: The recruitment files of the three staff on duty identified that an appropriate procedure had been undertaken before they were employed. Thorough checks had been made to ensure the residents were protected from anyone unsuitable to work with vulnerable adults. The staff files were in very good order and identified training and supervision records. Staff confirmed that they have received training in areas such as moving and handling and food hygiene as part of their ongoing training. The manager has currently fell just below the required 50 of staff achieving NVQ, however he has accessed further NVQ provider’s and continues to Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 19 provide foundation training to ensure staff are trained in all the areas of their practice. Records of staff induction show that new staff are provided with training about the work they are to perform. The manager is currently implementing the revised National Induction Standards, which is good practice. Records of staff on duty are held. The case tracking process and discussion with relatives and residents determined that there are sufficient numbers of staff on duty to meet the needs of the residents. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33-35-38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. The health and safety of the residents is suitably protected. EVIDENCE: The manager is a registered nurse with 20 years experience both in private practice and the National Health Service. In addition he is a registered mental nurse, which is of benefit to residents with dementia or other mental health Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 21 problems. The City Hospital runs seminars for nurses wishing to keep their practice up to date and the manager makes full use of these. The staff expressed that they felt the manager was very supportive and approachable. 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 at the last inspection that the local authority acts as appointee for a number of residents where relatives are unable to and protecting residents financial interests. The manager has introduced quality-monitoring questionnaires, which he uses to survey residents and relatives opinions of the home. Feedback on the results from surveys is done verbally and changes are made where improvement is suggested. Residents and relatives benefit from being able to attend meetings at the home, records of these were seen and demonstrate that people are listened to and suggestions acted upon. The manager takes seriously his responsibilities to maintain the health and safety of the residents. Suitable arrangements for the training of staff in health and safety issues were identified through the pre-inspection information provided. The records of the management of fire risks were seen and compliant with recognised weekly checks and drills. The report of 21/12/06 from the environmental health states “it is pleasing to note the high standard of cleanliness and management of food safety” Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP8 OP9 Good Practice Recommendations The positional changes of residents should be recorded. Hand written prescriptions should be checked by a second person and signed accordingly. Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Carisbrooke Care Home DS0000026423.V325838.R01.S.doc Version 5.2 Page 25 - 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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