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Inspection on 14/12/05 for Carlton Care Home

Also see our care home review for Carlton Care Home for more information

This inspection was carried out on 14th December 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a safe, homely environment in which residents are supported to maintain their levels of physical and psychological ability. There is a stable and skilled staff team. Staffs spoken with were aware of the needs of the residents and qualified nurses and senior staffs ensure appropriate management of the personal, health and social care needs. The staff have links with external professional agencies in infection control, continence care and tissue viability, which ensures that up to date practice in the management of health related conditions, is provided. Care staffs receive training to NVQ level 2-3 ensuring that residents receive support from staff that are trained or on a programme of learning that leads to a qualification that matches their job role.

What has improved since the last inspection?

Hand written medication records are maintained as appropriate. Staff spoken with reported training is ongoing. Training records are well maintained.

What the care home could do better:

Records of food provided and cleaning undertaken and weekly fire tests need to be consistently maintained. It is recommended that a checklist for the recruitment and selection of staff is developed to `track ` information and documentation requested and received.

CARE HOMES FOR OLDER PEOPLE Carlton Hill Care Home 398 Carlton Hill Carlton Nottingham NG4 1JA Lead Inspector Judith Avill Unannounced Inspection 14th December 2005 09.40 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 Carlton Hill Care Home DS0000026424.V271794.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. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carlton Hill Care Home Address 398 Carlton Hill Carlton Nottingham NG4 1JA 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) 01159619959 01159873889 Mrs Josephine E Flavill Mrs Catherine Flavill Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (28), Terminally ill (1) of places Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. For one Service user aged 59 requiring Nursing To admit one named Service user under 65 years Date of last inspection 13th September 2005 Brief Description of the Service: Carlton Hill Care Home provides 28 places for Older people requiring Nursing or residential care and for one person with a Terminal Illness. The home was opened in 1988 and consists of a two -storey building with a newer purpose built extension. There are 16 single rooms and 8 double rooms; one single and one double room provide en-suite facilities. There are suitable adaptations and equipment including a passenger lift which ensures that the home is suitable for the client group accommodated. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted unannounced. The main method of inspection used was to case track, this means that the care plans of 4 residents were examined to ensure that the home are able to meet their assessed needs and that documentation meets the National Minimum Standards. Residents, one relative and one member of staff were spoken with to obtain their views on what life was like in the home. All those spoken with confirmed that they were very happy with the care they receive and felt that the staff were very caring. During the inspection the manager and Proprietor were present and provided all the required information to the inspector. The premises were not inspected in detail but various parts of the building were visited as part of the inspection. The home was clean, warm and well maintained. What the service does well: The home provides a safe, homely environment in which residents are supported to maintain their levels of physical and psychological ability. There is a stable and skilled staff team. Staffs spoken with were aware of the needs of the residents and qualified nurses and senior staffs ensure appropriate management of the personal, health and social care needs. The staff have links with external professional agencies in infection control, continence care and tissue viability, which ensures that up to date practice in the management of health related conditions, is provided. Care staffs receive training to NVQ level 2-3 ensuring that residents receive support from staff that are trained or on a programme of learning that leads to a qualification that matches their job role. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 6 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. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 &3 No resident moves into the home without having had their needs assessed and been assured that these will be met. EVIDENCE: The records of 4 residents seen demonstrated that the manager assesses residents prior to admission to the home and prospective residents and their families have the opportunity to visit the home prior to admission. If the prospective resident wishes to stay at the home the manager then obtains an appropriate Nurse or social worker assessment as required. No record of the homes involvement /arrangements for the management of residents personal finances were seen in the Statement of Purpose or service user guide. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 9 Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 10 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, 10 EVIDENCE: During the inspection staff observed were respectful to the wishes of individual residents and demonstrated a good knowledge of the person’s preferences in regard to their privacy. Staff reported that residents are able to have a key to their door if they are assessed as safe to operate these. 4 care plans were viewed during the inspection. Details of assessed needs, care provided, access to regular chiropody, dentistry, and ophthalmology environmental assessment, risk assessment and details of action to be taken by staff to provide support and care to encourage enable residents to fulfil their physical and emotional capabilities. Staff spoken with was well aware of individual residents needs and support to be provided. The medicine record sheets are signed and witnessed each month. One record of a new prescription commencement date was not recorded. The receipt, storage, administration and waste disposal are all compliant with the Medicines Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 11 and Environmental laws. No residents self medicate at the time of inspection. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 12 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 Records of resident’s religious, cultural social preferences and contacts with relatives, friends and community personal choices are well maintained. EVIDENCE: The home employs an activities co-coordinator. Records of resident’s recreational, cultural, religious interests and preferences are included in care plans. Residents are able to have visitors at any reasonable time and are able to choose whom they see and do not see. Visitors spoken with on the day of inspection commented that they were always made welcome. Records seen evidenced resident’s choice of financial arrangements. Individual and shared bedrooms viewed were well personalised. Residents spoken with commented on the quality of food provided. At the time of inspection lunch was being prepared and appeared nutritious and well cooked. Records of food provided and details of temperature recordings and cleaning tasks undertaken were not consistently maintained. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Residents are safeguarded from abuse in accordance with local adult protection guidelines. Residents can be confident that their concerns will be listened to and addressed in an appropriate timescale. EVIDENCE: The home has a complaints procedure in place. Relatives commented they would raise concerns with the proprietor and manager and senior staff. Staffs spoken with were aware of the procedure to follow in the event of a suspicion/allegation of abuse. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22 &26 The home provides comfortable and safe standard of accommodation for the residents. Residents have access to appropriate equipment to maximise their independence. EVIDENCE: The home is suitable for its stated purpose, having a range of adaptations and equipment necessary to support older people. The Fire and Environmental offices inspect the premises and routine maintenance records are maintained. Records of fire tests were not maintained up to date. On the day of the visit a loose tile in bathroom was identified and repaired during the visit. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 15 All areas of the home viewed during the inspection were clean and had no malodour. Staff had access to protective equipment and areas of infection risks were supplied with clinical waste disposal units. One qualified nurse and one carer attend Infection control link nurse meetings, which provide them with all up to date information on infection control practice. This information is then cascaded to staff at the home and informs practice accordingly. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 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): 27,29 &30 Residents are protected by the homes’ recruitment practice and the rota indicates there are appropriate numbers of staff on duty to meet their needs. EVIDENCE: Staff duty records seen evidenced that sufficient and appropriately skilled staff were employed over the 24hr period to meet the needs of the residents at this time. Two staff files viewed show that the homes’ recruitment practice safeguards the residents from people who may be unsuitable to work with vulnerable adults. Staff spoken confirmed and training records seen demonstrated that staff training is planned ensures the staff are rained to meet the needs of the residents accommodated at the home. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35, 37 & 38 EVIDENCE: The registered provider and registered manager have managed the home for several years. Staff spoken with commented that they are able to put their views forward and that they are listened to. Feedback is sought from personal contact with residents and relatives and friends. The staff shared information about the home’s practices regarding residents’ money and financial affairs to ensure that residents’ have access to their personal financial records and there is safe storage of money and valuables. However no policy and procedure for resident’s finances and safe storage of valuable and money was seen. It is recommended that details of the homes policy and procedures for the management of residents personal finances is developed and are included in the service user guide. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 18 Staff records seen evidenced detail of yearly staff appraisals of all levels of staff completed by the registered manager. No planned regular formal supervision record was seen. The registered manager reported that a review of the management structure is being considered. It is recommended that consideration be given to roles and responsibilities of senior staff for the supervision of all levels of staff. The Commission has been notified about an allegation, and records are maintained of action taken. Health and safety records are maintained. Records of weekly fire tests were not maintained up to date. Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 3 X 3 X 2 2 2 3 Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP15 Regulation 17 Requirement The registered person must ensure that records of food provided, environmental checks required and kitchen tasks undertaken are consistently maintained The registered person must ensure that records of fire tests are consistently maintained The registered person must ensure that all persons working at the home are appropriately supervised Timescale for action 06/02/06 2 3 OP37 OP36 17 18 06/02/06 06/02/06 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 Refer to Standard OP29 OP35 Good Practice Recommendations Develop a checklist for documentation requested and received Develop a policy and procedure for the management of residents finances Carlton Hill Care Home DS0000026424.V271794.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. Extracts may not be used or reproduced without the express permission of CSCI Carlton Hill Care Home DS0000026424.V271794.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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