Inspection on 19/12/05 for Carnalea Residential Home

This inspection was carried out on 19th 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.

Other inspections for this house

Carnalea Residential Home 02/03/09

Carnalea Residential Home 05/03/07

Carnalea Residential Home 12/05/05

Carnalea Residential Home 12/01/05

Carnalea Residential Home 19/10/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Carnalea Residential Home 5-9 London Road Faversham Kent ME13 8TA Lead Inspector Mark Hemmings Unannounced Inspection 19th December 2005 9:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Carnalea Residential Home DS0000023368.V251812.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. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carnalea Residential Home Address 5-9 London Road Faversham Kent ME13 8TA 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) 01795 532629 Mrs Betty Florence Wake Miss Karina Pope Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Carnalea (the Home) comprises two older properties which have been combined to form one dwelling. The accommodation for the older people in residence (the service users) is provided on the ground and the first floors. There is a passenger lift and a stair lift which give step free access throughout those areas of the premises occupied by service users. There is provision for most of the service users to have their own bedroom. However when the Home is full, up to 10 people are accommodated in shared bedrooms. All of the bedrooms have private wash hand basin. There is call bell system in the premises with a call point located in each bedroom. This has been done to make it easier for service users to summon assistance when it is needed. The Home is located about one mile from the Faversham’s town centre and is set back a little from a busy main road. To the rear of the property there is a large and most attractive walled garden. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and it took about three hours to complete. During this time, the Inspector spoke with or spent time with four service users. He spoke with the Registered Provider and with the Registered Manager. Also, he spoke with two of the care workers and with one of the housekeepers. The Inspector looked at various parts of the accommodation. This included (by invitation) two of the service users’ bedrooms. The Home continues to provide the service users in residence with the support and assistance they need within a comfortable setting. There are no Required Developments at the end of this Inspection Report. The Inspector did not examine all of the Standards on this occasion. The reader is asked to read this Inspection Report in conjunction with the previous Inspection Report in order to obtain a comprehensive account of the Inspector’s current evaluation of the facilities and services available in Carnalea. What the service does well: What has improved since the last inspection? Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 6 Since the last inspection visit, the Registered Provider has begun a programme of work which eventually will see the accommodation extended. A part of this programme entails work which already is underway to reconfigure two of the existing bedrooms. This is being done to provide more usable floor space in these rooms. Also, the Registered Provider has completed a programme of work which has fitted guards to the heated surfaces of all of the radiators located in parts of the accommodation occupied by service users. The Registered Provider has introduced a new system which is designed to ensure that all of the care workers have the competencies they need in order to respond effectively to the service users’ needs for personal care. This is an important development which once completed will constitute an important example of good management practice. 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. Carnalea Residential Home DS0000023368.V251812.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 Carnalea Residential Home DS0000023368.V251812.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, 2, 3, 4, 5. Prospective service users are given the information they need to make an informed decision about living in the Home. Each service user receives a written statement of the terms and conditions of their residency. Service users’ needs for assistance are assessed before admission. Service users are confident that their needs for personal care will be met when they enter the Home. Prospective service users and their representatives are encouraged to visit the Home before a decision is made about moving in. EVIDENCE: There is a Service Users’ Guide. This is a brochure which prospective service users are given and which outlines the facilities and services provided in the Home. In addition to this, the Registered Manager speaks with prospective service users in order to answer any remaining questions they may have. Each service user receives a written statement of the terms and conditions in accordance with which the Registered Provider delivers accommodation and Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 9 personal care services in the Home. The document is suitably detailed and it is clearly laid out. Previously, the Registered Manager has said that all new service users and their representatives are given an opportunity to talk through the document with her. This is done so that any necessary clarification can be given. On this occasion the Inspector did not speak with any service users about this matter. However, when he last did so they said that they were confident at the point of admission to the Home, that their individual needs for support could be met reliably and consistently in Carnalea. The Registered Provider and the Registered Manager are aware of the responsibility placed upon them to ensure that only people whose needs for assistance can be met reliably, are admitted to the Home. Carnalea Residential Home DS0000023368.V251812.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 and 10. Service users are confident that their present and future needs for personal care will be met in a reliable and consistent manner. They are suitably consulted about the assistance they receive. Service users’ health care needs are met fully. Service users consider that members of staff are respectful and that they appreciate their needs for privacy. EVIDENCE: There is a service user plan for each service user. These documents should reflect a clear understanding between service users and care workers about the personal care support to be provided. The Inspector sample checked several of these plans and various related documents. He found them to be suitably detailed. Service users say or indicate that they are consulted about the contents of the plans. Service users consider that they receive all the assistance they need. The Inspector observed examples of care workers assisting service users in a manner consistent with that described in the individual service user plans. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 11 Service users say or indicate that care workers assist them to maintain their health. There is evidence which shows that service users’ doctors are called promptly when there is a concern about someone’s health. Service users say or indicate that care workers are cordial in their manner towards them, while at the same time being respectful of their individual preferences. The Inspector noted several occasions on which care workers varied their approach according to what they know to be service users’ different expectations of them. For example, some people wanted to spend quiet time in their bedrooms, while others wanted to be in the company of others in the lounge. Carnalea Residential Home DS0000023368.V251812.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 and 15. Service users have access to a suitably varied range of social activities. Service users are assisted to maintain normal contacts with family and friends. Service users are enabled to exercise suitable choice in their everyday lives. Service users are offered a suitably healthy diet. EVIDENCE: Various social activities are convened in the Home. Service users consider themselves to be occupied suitably. Service users say or indicate that the pace of daily life in the Home is relaxed and unhurried. There is evidence of service users exercising choice. For example, people observed that they decide for themselves when to get up and when to go to bed and how to spend their day. Service users say that they receive good quality meals and they always have enough to eat. On this occasion, the Inspector did not have the opportunity to join service users for a meal. However when he last did so, he noted the food to have been well prepared and that the portions were of an adequate size. Also noted previously, was the written menu which indicated that service users are offered a normally balanced diet. Care workers say that there are sufficient Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 13 provisions in the Home to enable all the meals listed on the menu to be prepared. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 14 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. Service users consider that their views are listened to and that as necessary they are acted upon. Arrangements are in place which are designed to protect service users from abuse, neglect and self harm. EVIDENCE: There is a complaints procedure which explains how service users and other stakeholders can make a complaint about any aspect of the facilities and services provided in the Home. Service users say or indicate, that they are confident that any matter they raise will receive serious attention and if possible will be addressed. The care workers have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances which might jeopardise the well-being of a service user. Also, they are aware of the various agencies external to the Home to which reference can be made should they become concerned about a service user’s wellbeing. Service users say or indicate that they feel safe living in Carnalea. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 15 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, 23, 24, 25 and 26. Service users are provided with a satisfactory environment. There is an adequate provision of shared use facilities. Suitable provision has been made to assist service users who experience a measure of reduced mobility. Service users’ bedrooms are suitably equipped and have been personalised by their occupants. Service users live in normally safe surroundings. Suitable arrangements are in place to achieve a normal domestic standard of cleanliness. EVIDENCE: Service users say or indicate, that they are comfortable living in Carnalea and that they consider the accommodation to be homely and welcoming. The Inspector has not identified any significant defects in the general presentation of the accommodation. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 16 There is an adequate number of shared use toilets and bathrooms to enable service users to access these facilities without having to wait or otherwise to be inconvenienced. The Inspector noted there to be a defect in an area of the enamelled finish on one of the baths. The Registered Manager said that this matter will be addressed before the Inspector next calls to the Home. There are various items of equipment in place to assist care workers when helping those service users who experience a measure of reduced mobility. These include things such as a hoists in the bathrooms and banister rails along hallways. Care workers say that enough provision has been made to enable them to safely undertake this aspect of their work. There is a call bell system installed in the Home. This means that there are call points in most areas of the Home from which service users can summon care workers should their assistance be required. Service users like their bedrooms. They say that they have enough facilities in them to use them as bed sitting areas in the manner envisaged by the Standards. The Inspector had the opportunity to see several bedrooms. He noted them to be pleasant spaces which reflected the preferences of their occupants. On the day of the inspection visit the weather was quite cool. However, the accommodation for service users was comfortably warm. Service users confirmed that this is always the case. Care workers said that there is an adequate supply of hot water. On this occasion, the Inspector did not examine the kitchen. However when he last did so, he noted the area to be clean and orderly. The Inspector understands that the local Department of Environmental Health has not required the completion of any improvements which remain outstanding. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 17 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 and 30. There is an adequate number of staff on duty to ensure service users’ needs for assistance are met. Appropriate steps are taken to ensure that only suitable people work in the Home. Care workers have the competencies they need in order to work effectively. EVIDENCE: There are four care workers on duty to respond to service users’ needs for assistance from early in the morning until the night time shift commences. These members of staff are supported in their work by other people who undertake catering and housekeeping tasks. At night, there are three waking care workers on duty. The Inspector considers that there are enough staff on duty to enable service users’ needs to be met in a timely and reliable manner. More than half of the care workers employed in the Home have acquired a National Vocational Qualification (NVQ) in health and social care. This level meets the specification required by the Standards. The Registered Provider intends to continue to increase the number of care workers who have acquired the Award. Naturally, this is an example of good management practice. The Registered Provider completes a number of security-related checks. These are designed to ensure that all members of staff employed in the Home are suitable to be entrusted with access to service users who may be vulnerable. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 18 The Registered Manager said that all new care workers receive introductory training. This is designed to ensure that they have the basic competencies necessary to enable them to work without direct supervision. In addition to the introductory training, existing care workers undertake a number of training courses which are designed to enhance their capacity to deliver care. The Registered Provider and the Registered Manager are aware of the responsibility placed upon them to ensure that all care workers are validated as having the competencies necessary to enable them to support effectively the service users currently in residence. In connection with this, they are completing a review of the competencies possessed by each of the care workers. This is being done in order to ensure that there are no omissions. The Inspector understands that this exercise will be completed by 1 April 2006. The Inspector observed care workers when they were assisting the service users. He noted this help to be delivered in an appropriate manner, in that the care workers demonstrated that they were competent to respond effectively and reliably to the requests for assistance in question. Also noted, was the fact that the care workers were kind and considerate in their approach. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 19 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, 32, 33, 36 and 38. There is a suitable management system in place to support the delivery of care and accommodation services in the Home. Service users’ preferences and wishes are reflected in the operation of the Home. The work completed by members of staff is supervised. The health and safety of the service users and of members of staff is promoted and protected. EVIDENCE: There are various arrangements in place to promote effective team-work in the Home. These include handover meetings at the end of each shift and the completion of diary records in relation to each service user. These and other measures are designed to help ensure that each service user receives a consistent response to their needs for assistance. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 20 Periodic staff meetings are convened in the Home. These are held to enable staff to meet and to discuss how their work is proceeding. The Registered Provider has a sound understanding of how the Home operates in practice. This enables her to support and to contribute to the work of the Registered Manager. In turn, the Registered Manager has completed both of the two National Vocational Qualifications which the Standards require incumbents of her role to have. The Registered Manager meets with each member of staff on a periodic basis to review their work and to resolve any difficulties. Service users say or indicate that the Home is run without there being any intrusive rules or routines. This means that they can continue to experience a normal home life of their choosing. The Registered Provider operates a system by means of which service users are invited to comment about their home. The Registered Provider is now going to develop this arrangement further. This will be done by making enquiries about some of the responses which indicate that some service users may wish to slightly reorganise selected aspects of the assistance they currently receive. The Registered Manager said that all items of equipment in use in the Home remain in good working order. The Registered Provider continues to maintain a suitable system which is designed both to prevent the occurrence of a fire safety emergency and to manage one effectively should the need arise. The Inspector understands that the Kent Fire and Rescue Service has not recommended the introduction of any fire safety equipment additional to that which already is in operation in the Home. The Registered Manager said that she has completed a review of the premises in order to identify any potential hazards which might compromise the health and safety of both the service users and members of staff. She reported that no such hazards were found. The Inspector examined various parts of the premises and he did not notice any obvious hazards which required attention. Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 21 Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 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 Sco3re 19 20 21 22 23 24 25 26 3 3 3 3 3 X 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 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 3 3 X X 3 X 3 Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 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. Refer to Standard Good Practice Recommendations Carnalea Residential Home DS0000023368.V251812.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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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