CARE HOMES FOR OLDER PEOPLE
Carntyne Residential Care Home Hencotes Hexham Northumberland NE46 2EE
Lead Inspector Alan Baxter Unannounced 10 May 2005 09:30 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 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. Carntyne Residential Care Hoem Version 1.10 Page 3 SERVICE INFORMATION
Name of service Carntyne Residential Care Home Address Hencotes Hexham Northumberland NE46 2EE 01434 600195 01434 600195 N/A Sister of Mercy, Convent of Mercy Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Jennifer May Cain CRH 18 Category(ies) of OP Old age (18) registration, with number of places Carntyne Residential Care Hoem Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th October 2004 Brief Description of the Service: Carntyne is an old building providing personal care for older people. It is situated close to the centre of Hexham and convenient for public transport. The home is registered to provide care for up to 18 older people. Accommodation is provided over 3 floors. All bedrooms are single, some with ensuite. There are several lounges and a pleasant dining room. The garden is large and enclosed at the rear of the home and can be used by residents and their visitors. All areas are accessible by disabled people. There is a lift to all 3 floors. Carntyne Residential Care Hoem Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced during the day. The manager of the home was present during the inspection. A number of residents and staff were spoken with during the course of the inspection, which was 4.5 hours. The purpose of the inspection was to check the requirements made at the last inspection and to look at a range of standards. What the service does well: What has improved since the last inspection?
Staff responsibilities are clearer now. Senior staff are doing risk assessment training. A formal quality assurance system is being introduced. A resident survey has been completed. A range of new policies and procedures are being introduced. Some supervision is being given to staff. The manager has achieved her professional qualifications. Carntyne Residential Care Hoem Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Carntyne Residential Care Hoem Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Carntyne Residential Care Hoem Version 1.10 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 standard(s) 1, 2 and 3 New residents are given sufficient information about the home and a written contract. No resident moves into the home before their need is assessed. EVIDENCE: The care records of 3 residents showed that new residents are given a full information pack before admission and a contract/statement of terms and conditions on admission. There was evidence that the home carries our assessments before admission (however, these should always be dated). The manager is looking at the assessment document to make sure that it covers the needs of self funding persons, who do not have an assessment from a social worker or care manager. Other assessments carried out include the Norton, risk assessments, social and manual handling assessments. Carntyne Residential Care Hoem Version 1.10 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 standard(s) 7, 8 and 10 Residents needs are set out in individual care plans, but these should be more detailed and regularly reviewed. Residents health care needs are fully met. Residents are treated with respect and privacy. EVIDENCE: It was a requirement at the last inspection that a detailed and holistic care plan is drawn up for each area of assessed need. This has been partly implemented. Care plans are reasonably holistic but still need to be more detailed, especially in the description of problems/needs and staff actions. Care plans are signed by each resident, but are not always regularly reviewed. Regular site and dental check ups take place and a private physiotherapist visits the home twice a week. Chiropody is provided. Records are kept of all appointments or visits with health care professionals. Results of an inhouse resident survey showed the residents rated the personal care in the home as ‘fine’ and ‘very good’.
Carntyne Residential Care Hoem Version 1.10 Page 10 Residents said that they are treated very well and with great respect by the staff and they confirmed that their privacy is also respected. They spoke highly of the manager and all her staff, who they said were very approachable. Carntyne Residential Care Hoem Version 1.10 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 standard(s) 12 and 15 The majority of residents find that the home matches their expectations in terms of social and religious needs. However, a small number of residents would benefit from a more frequent and varied social activities programme. Residents enjoy a varied, well-balanced and attractive diet. EVIDENCE: It was a requirement from the last inspection that a more varied and interesting social activities programme should be introduced and that this should include activities outside the home. There has been little progress to date, but the manager is working on the issue of involving those few residents who wish to take part in activities. There has been a recent trip out with 4 residents to Brooks Bushes farm shop and restaurant. The home has it’s own chapel and provides weekly services. In a recent resident survey the home’s recreational facilities were rated as being very good. The food was not sampled on this inspection. However the results of a recent resident survey were that the food was very good, varied, with choice. One resident said ‘some very tasteful and delicious meals are served’. Carntyne Residential Care Hoem Version 1.10 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected. EVIDENCE: Carntyne Residential Care Hoem Version 1.10 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected. EVIDENCE: Carntyne Residential Care Hoem Version 1.10 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The numbers of staff are sufficient to meet the needs of residents. EVIDENCE: The staff rota indicated that the home is meeting the previously agreed staffing levels. Carntyne Residential Care Hoem Version 1.10 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36 EVIDENCE: There were a number of requirements made at the last inspection. One was to clarify the lines of accountability in the home by making clear the status of senior staff. This has been achieved. It is now clear who the senior on duty is between 4 and 10pm. All seniors are up to date with statutory training and are doing risk assessment training. A further requirement was for formal quality assurance systems to be developed. A resident survey has recently been completed and the outcomes were very positive in all areas. Surveys of friends and relatives and visiting professionals are being considered. The home’s administrator is working with the manager in drawing up a formal quality assurance system.
Carntyne Residential Care Hoem Version 1.10 Page 16 A further requirement was for a range of new policies and procedures to be drawn up. These have now all been completed, or are in the process of being completed. Formal supervision is being given to all staff, but still not at the required regularity. Mrs Cain is looking to involve some senior staff in giving supervision and is exploring training in this area. It was a recommendation of the last inspection that the manager achieves NVQ level 4 and the registered manager award. Mrs Cain now holds these qualifications. Residents said that they are very happy with the new manager, Mrs Cain, who they find very approachable. Carntyne Residential Care Hoem Version 1.10 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x 2 x x Carntyne Residential Care Hoem Version 1.10 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 15 Requirement A detailed and holistic care plan is needed to address all care provided to residents giving particular attention to the description of problems/needs and staff actions. (Outstanding requirement) The home must provide a more varied and interesting activities programme, including trips outside the home, for those who wish this. (Outstanding requirement) Staff must receive 2 monthly supervision. (Outstanding requirement) Timescale for action 10.8.05 2. 12 16(2) 10.6.05 3. 36 18(2) 10.8.05 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. Refer to Standard Good Practice Recommendations Carntyne Residential Care Hoem Version 1.10 Page 19 Commission for Social Care Inspection Northumbria House Manor Walks, Cramlingotn Northumberland NE46 2EE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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