Inspection on 24/07/06 for Carlton Care Home

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Carlton Care Home 14/12/05

Carlton Care Home 13/09/05

Carlton Care Home 20/10/04

Carlton Care Home 23/06/04

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

Annesley Lodge Care Home

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

CARE HOMES FOR OLDER PEOPLE Carlton Hill Care Home 398 Carlton Hill Carlton Nottingham NG4 1JA Lead Inspector Mary O`Loughlin Key Unannounced Inspection 24th July 2006 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 Carlton Hill Care Home DS0000026424.V298827.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. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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.V298827.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To admit one named Service user under 65 years One named service user aged under 65 years or over may be admitted in category PD Date of last inspection 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. The range of fees are: £319.00 TO £532.00 Carlton Hill Care Home DS0000026424.V298827.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. The registered manager and registered provider were present during the inspection. A range of information was used to inform this report, The history of the home’s compliance with the National Minimum Standards, Pre-Inspection Questionnaires and the service history. The inspection reviewed the arrangements around the care that 3 people were receiving based on their individual care plan, this method is called case tracking. Those case tracked were spoken with and their rooms viewed. 5 members of staff were spoken with including one new member of staff. 2 visiting relatives were also spoken with. 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. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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 Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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): 3-6 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The home has a sustained track record of delivering appropriate pre admission assessment and ensuring that the needs of the resident are assessed and planned for. Intermediate care is not provided. EVIDENCE: The home has a sustained track record of compliance with these standards. The most recent admission to the home was case tracked and records reflect continued compliance with the standards required. Significant time and effort is spent making each persons admission personal and well managed. Each prospective resident receives a comprehensive assessment from a suitably qualified person prior to admission. Any external professional assessment is also obtained. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 Page 8 The service does not offer accommodation to anyone whose needs they have not assessed and planned for. Prospective residents have information they need to inform them about the services the home provides. Wherever possible the home manager and senior staff are allocated to work on the day of the planned admission which enables a clear up to date assessment is undertaken at that time and that information can be effectively cascaded to staff. Residents from different ethnic groups are assessed for their cultural and religious needs along with methods of communication and advocacy. Carlton Hill Care Home DS0000026424.V298827.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 excellent. This Judgement is made using available evidence including a visit to this service. The health and personal care which residents receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. The management of medicines safeguards the residents. EVIDENCE: The records of three residents were examined. Each resident has a robust care plan in place that reflects the persons individual needs based on a thorough assessment of their activities of daily living. The home ensures that the resident and their representative are involved in care planning and reviews of the care plan. Plans are updated monthly or as conditions change. The plans are a working tool and are used and understood by staff. They are written in clear language and could be used by people not familiar with there content. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 Page 10 There is active promotion of the residents right to access health and remedial services both within the home and the community. Residents are assessed for their need for specialist equipment and staff keep a check on aids, making sure they are in good working order and improve the quality of life for the resident. There was good evidence that the home promotes the independence of residents, undertstanding their individual goals and expectations. Residents and relatives discussed how the staff promote their privacy and dignity, how they felt safe and well cared for. Relatives said they found the staff were skilled and in one case said they felt more confident about the delivery of good health care at the home than they had experienced within the NHS. Care plans are developed using the outcomes of any assessed risks to inform the care delivery for that person, which is good practice. Relatives said they had been able to spend as long as they wished at the home and were also able to have their meals there. Medicines are well managed within the appropriate legislative framework, which safeguards residents. The supplying pharmacist inspects the service in line with its contractual arrangements with the Primary Care Trust. The last audit of the homes medicine management was satisfactory with no recommendations made. Carlton Hill Care Home DS0000026424.V298827.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 excellent. This Judgement is made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with their family and friends. Social, cultural and recreational activities meet the expectations of the residents. Residents receive a healthy and varied diet following continuous assessment of their dietary preferences and nutritional needs. EVIDENCE: Policies and procedures in place ensure that each resident has a social history completed within their care file. Each resident has a member of staff allocated to them as their social mentor, Staff spend individual time with them, this ensures that the resident receives a full and varied lifestyle that meets their individual tastes and preferences. Residents have recently been on a boat trip organised by the home. The staff encourage independence, residents are supported to visit local shops either escorted or if able, alone. There was some excellent work undertaken to establish a rehabilitation programme for one younger adult that is accommodated at the home. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 Page 12 Relatives are encouraged to maintain contact with residents and support their interests and hobbies. One full time staff member is a social care co-ordinator. The home has also joined the National Association for Providers of activities for Older People, which ensures good practice guidance and access to training for staff. The home provides a healthy diet, written menus and choices of food. Residents said they loved the food provided. The manager monitors the satisfaction with the diet provided through quality assurance systems such as questionnaires, meetings and obtaining the likes and dislikes of the resident during care planning. Carlton Hill Care Home DS0000026424.V298827.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): 16-18 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Residents have access to a robust and effective complaints procedure and are protected from abuse. EVIDENCE: The home has a sustained track record in meeting these standards. The service has a complaints procedure in place which is available to all those that use the service. Concerns are recorded and show they are dealt with effectively and sensitively. Residents said they were very satisfied with service provided. The home ensures that through training, supervision, review and quality monitoring that care staff fully comply with the policies and procedures relating to safeguarding the rights of residents. Carlton Hill Care Home DS0000026424.V298827.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): 19-26 Quality in this outcome area is excellent. This Judgement is 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 environment which encourages independence. EVIDENCE: The home provides a safe and clean environment for residents. Residents case tracked had a range of equipment to support their independence. There is evidence that different cultural needs can be supported within the environment. An enclosed rear garden is accessible to people with mobility problems and provides a safe outside space. There is a selection of communal areas, which allows residents a choice of sitting quietly, meet with family and friends or engage with other residents. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 Page 15 The home was clean and hygienic with suitable arrangements for the disposal of clinical waste. The manager is an infection control link nurse who attends the community link nurse meetings and ensures that the practice of infection control meets the National guidance. Carlton Hill Care Home DS0000026424.V298827.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 excellent. This Judgement is made using available evidence including a visit to this service. The staff at the home are trained, skilled and sufficient in numbers to meet the changing needs of the residents. EVIDENCE: The service has a well developed recruitment procedure that has the needs of the residents at its core. Management prioritise training and facilitate staff to continually update their knowledge and skills through external qualifications and internal updates on practice issues. The staff team have a period of induction at the start of their employment and ongoing training throughout their employment. Training reflects the needs of the residents. Staff have also undertaken training in Dementia care. Residents and relatives reported that staff were skilled in their role and able to meet the needs of the residents. Staff felt they worked in sufficient numbers to deliver care for residents. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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): 31-33-35-38 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The management and administration of the home is based on openess and respect, has a quality assurance system in place and a qualified competent manager. EVIDENCE: The registered manager has the required qualification and experience, is highly competent to run the home and met its stated objectives. A registered nurse with many years of experience in the care of older people, she is a qualified NVQ assessor and continues to update her knowledge and skills. The home is owned and managed by members of the same family. There are excellent arrangements in place that ensure both the manager and the provider have clear roles and lines of accountability within the service. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 Page 18 Resident’s monies are not managed by the home but the manager with appropriate records of all transactions made can hold small cash floats safely. There are good quality monitoring systems in place and significant time is spent ensuring the views of all those involved in the service are obtained and their comments acted upon to inform the service provided. Innovative ways of providing feedback to residents and relatives such as newsletters and cheese and wine evenings have been implemented. All records are clearly written and dated; any findings from risk assessments have been actioned. There is strong evidence that the ethos of the home is open and transparent with the views of the staff and residents listened to and acted upon. The registered persons are committed to ensuring the health and welfare of the residents and staff. Arrangements for the fire prevention in the home were reviewed and found to be fully compliant with the local Fire department following a recent inspection by them. During the inspection it was noted that the visiting hairdresser was using a hairdryer from an extension lead in the ground floor bathroom, the manager dealt with the risk this imposed at the time ensuring the practice did not continue. Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 X X X X X X 4 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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. 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. Refer to Standard Good Practice Recommendations Carlton Hill Care Home DS0000026424.V298827.R01.S.doc Version 5.2 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.V298827.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!