Inspection on 09/10/08 for Carrickfinn

This inspection was carried out on 9th October 2008.

CSCI found this care home to be providing an Good service.

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

Carrickfinn 27/11/07

Carrickfinn 06/12/06

Carrickfinn 02/02/06

Carrickfinn 25/08/05

Carrickfinn 26/01/05

Carrickfinn 10/05/04

Carrickfinn 30/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carrickfinn 29a St Werburghs Road Chorlton-cum-Hardy Manchester M21 0TL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Oliver     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Carrickfinn 29a St Werburghs Road Chorlton-cum-Hardy Manchester M21 0TL 01618605889 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mary Mills Type of registration: Number of places registered: Sheila Devanney care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Carrickfinn is a care home for older people providing personal care only for a maximum of 16 people. The home is situated in the Chorlton area of Manchester, within easy reach of Manchester City Centre and is well served by public transport to the neighbouring areas of Stretford, Stockport and Didsbury. The home is a two-storey building with a single storey extension to the rear of the property and a conservatory has been added to the front of the property. The home is situated in its own grounds that have an established and accessible enclosed garden for the use of the residents. There are eight single and four double bedrooms and as the home does not have a passenger lift. First floor accommodation is restricted to those residents who can access stairs safely. The dining room and lounge are open plan. The Kitchen is situated next to the dining room. There are bathrooms and toilets situated on the ground and first floor. The range of accommodation fees charged was between: 367.43 pounds and 382.88 pounds. Care Homes for Older People Page 4 of 26 0 Over 65 16 Brief description of the care home Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Commission for Social Care Inspection) in relation to the home prior to the site visit. This visit, which the home did not know was going to happen, took place over the course of 6 hours on Thursday 9 October 2008. During the course of the site visit we spent time talking to the residents, the registered manager, the deputy manager, and a number of staff on duty to find out their view of the home. Before the site visit we sent the manager of the home an Annual Quality Assurance Assessment (AQAA) document for them to complete and return to us with information Care Homes for Older People Page 6 of 26 about the service they provide. This was returned before the visit took place and contained some information that helped us to assess the service being offered by the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before admission into the home takes place to ensure identified needs can be met. Evidence: The manager told us that all prospective residents receive a pre admission needs assessment before moving into Carrickfinn. This assessment is carried out by the manager or deputy manager of the home and during this visit the information gathered is used to give an indication if the home would be a suitable placement for the person. We looked at the file of the most recently admitted resident and this contained an assessment of need carried out by the deputy manager. Not all questions had been answered within the written documentation and this could place the prospective resident at risk of certain needs not being identified or addressed. Along with the Care Homes for Older People Page 10 of 26 Evidence: assessment carried out by the deputy manager we saw assessments that had been carried out by other health care professionals. Wherever possible, prospective residents and their family/representative were encouraged to visit Carrickfinn before making any decisions about moving in. One resident told us The staff here know what you need and how to help you. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of individual residents were assessed and met by staff in the home. Evidence: We saw that each person living in Carrickfinn had an individual care plan on file that had been generated from all the information gathered during the pre admission stage. Of those care plans examined, details appeared to be comprehensive and evidence that monthly reviews had been carried out was seen. Risk assessments had been completed that linked to care plans and each had a management strategy in place that guided staff on the best way the identified risk was to be managed. The manager told us that she reviews care plans and risk assessments and updated them if needed and although the manager said that she has encouraged residents to participate in reviewing their own care plans with the staff, most had declined to do this. Wherever possible, care plans should be signed by the resident and or their representative to show their involvement in the process. The manager told us that where this had been declined a note had been made in the individuals file. Care Homes for Older People Page 12 of 26 Evidence: We saw from the information on residents files that other health care professionals such as district nurses and doctors regularly visit people living in the home. One resident told us If I am not well the doctor comes to see me. We spent some time watching staff interacting with residents and in most instances staff response was good and showed that positive relationships had been developed. Staff were respectful in the way they supported the residents and also ensured that the residents privacy was respected by way of knocking on doors before entering and allowing people time in their own rooms should they wish. Before this visit took place we received six completed survey questionnaires returned to us by residents living in Carrickfinn and all of them indicated that care and support was always available when it was needed. Medication is administered via a Monitored Dosage System (MDS) and the deputy manager has responsibility for monitoring the way in which medication is dealt with in the home. Since the last inspection visit in November 2007 she has maintained a regular check of medication used in the home and carries out regular spot checks to make sure staff with the responsibility for administering medication are doing so in accordance with the policies and procedures for the home. We randomly selected some Medication Administration Records (MAR) to check and most were found to be appropriately completed. We also checked some medication that had been prescribed to be given as and when required which was not in the MDS. The balance of this medication was found to be correct except in one instance where it appeared tablets had been signed for on one occasion and had not been given. It is important that staff with the responsibility for administering medication are not distracted when carrying out this task in order to minimise the risk of such errors occurring. It was confirmed by the manager that all staff who administer medication had been appropriately trained. As well as staff receiving training it would be good practice if regular checks are made on their individual competency in administering medication in order to maintain good and appropriate practice at all times and to ensure staff are adhering to policies and procedures. It was confirmed that no resident was prescribed controlled drugs at the time of this visit. We advised the manager to contact the pharmacy to check that the cabinet currently used for the storage of such medication complies with the requirements of recently updated legislation. Care Homes for Older People Page 13 of 26 Evidence: We saw evidence that all prescriptions are received by the home before being sent to the pharmacy for dispensing and are checked to ensure the right medication has been prescribed. One resident spoken to about medication told us, I get my tablets when I should, morning, afternoon and before I go to bed. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents had choice and support to meet their expectations and preferences regarding their daily lifestyle. Evidence: The manager told us that she had recently interviewed a person for the role of activity organiser in the home and was just awaiting clearance of the relevant pre employment checks before giving this person a start date. Residents spoken to during this visit confirmed that activities do take place on a regular basis and comments included, We have a sing a long every Tuesday, everybody enjoys it and A man comes in and sings. Three of the six survey questionnaires returned to the Commission by residents indicated that activities are always arranged for people to participate in and three stated usually. Menus are planned in consultation with residents using a four weekly menu cycle. Two main choices are available each day and the cook asked residents individually what their preferred choice was. Questionnaires returned to us confirmed that residents were happy with the meals provided and residents we spoke to said Food is number Care Homes for Older People Page 15 of 26 Evidence: one and We have a really good cook, she asks you what you want for dinner. We saw that menus included healthy option meals that any resident could choose if they preferred. The manager told us that nutritional assessments are carried out as part of the admission process and then reviewed and monitored on a regular basis. We spoke with the cook who told us that she was currently working towards obtaining a National Vocational Qualification (NVQ) Level 2 in kitchen management. Residents told us that visitors are made very welcome when they come to the home and during our visit a man came to visit his mother. He told us that he was happy with the service provided and that as long as my mum is happy, Im happy. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had relevant policies, procedures and systems in place to enable concerns to be raised and to protect residents from neglect and/or abuse. Evidence: Information about how to make a complaint is included in the Service User Guide and residents have a copy of this in their room. We spoke to one resident who told us I have no worries or complaints but if I did I would speak to Mary (manager), Mary knows what she is doing. Of the six questionnaires returned to us, 5 stated yes they knew how to make a complaint and 1 stated no. We looked at the complaints record and saw that no complaints had been received since our last visit to the home. There was a detailed policy and procedure relating to the protection of vulnerable adults, including the latest version (September 2008) of the Local Authoritys multi agency procedure No Secrets. The manager told us that no allegations of abuse had been made or referred since our last inspection visit. When we spoke with the managers and staff they were able to demonstrate that they were clear about the procedure to follow in the event of an allegation of abuse being made etc. Staff also confirmed that they had received training in the Protection of Vulnerable Adults. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment was clean, tidy and comfortable and provided residents with a pleasant place in which to live. Evidence: We had a look around some parts of the building and found the home was clean, tidy and well kept. Rooms have been personalised to reflect the character of the person whose room is is and, since the last inspection visit, a number of rooms have had new floor covering fitted. A general assistant is employed and day to day maintenance of the home had been carried out. At the time of our visit repairs were taking place to the ceiling of an upstairs bathroom where water had penetrated through. The manager told us that these repairs were being carried out by a professional roofing company. We also noticed that the new UPVC windows fitted to the bedrooms upstairs could be opened quite widely and could pose a risk to the health and safety of the people using those rooms. It is acknowledged that the general assistant went and purchased suitable restrictors and fitted them immediately. Some areas of the home, especially parts of the upstairs corridors and landings would Care Homes for Older People Page 18 of 26 Evidence: benefit from redecoration and should be prioritised as part of the rolling programme of maintenance. The manager told us that the lounge and dining area would be redecorated next month and that the flooring in the toilet areas would also be replaced. We saw that bacterial hand wash and paper towels had been provided in toilets, the kitchen and laundry area. Discussion with the manager confirmed that staff would benefit from having training in the control of infection and this, she said, would be arranged. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient numbers of staff were employed in the home, with staff training and development helping to ensure staff are competent to carry out their jobs. Improvements had been made to the recruitment and selection process that helps to protect residents from unsuitable people working in the home. Evidence: The manager confirmed that no new staff had been employed in Carrickfinn since the last key inspection was carried out in November 2007. At that inspection we saw evidence that one member of staff have started working in the home before any Criminal Record Bureau (CRB) checks or POVA First checks had been applied for and no written references had been received. The manager told us that since that visit, she and the deputy manager had checked all employee files to ensure that all pre employment paperwork was in place. Where any shortfalls were found, these had been appropriately dealt with. We looked at staffing rotas and they demonstrated that enough staff appeared to be on duty at any one time to meet the needs of those residents living in the home and the manager confirmed this. We spoke to one particular resident about staffing who told us There is always enough staff here, a couple come on at nine oclock and are her all night, we are never alone. One member of staff spoken to also told us Care Homes for Older People Page 20 of 26 Evidence: Residents get good care and we usually have enough staff on duty. The manager told us that she keeps an individual record of all the training staff undertakes and we saw evidence of this on the computer. We saw that individual records contained the date training took place, the type of training attended, whether the training had been successful and the date of review. Recent staff training included Basic Food Hygiene, First Aid and Moving and Handling and staff spoken to confirmed this. Staff confirmed that this training had taken place and one member of staff told us I completed my NVQ Level 2 and this included learning about abuse and how to deal with this. The manager confirmed that a total of 11 staff have successfully completed NVQ Level 2 and funding has been secured for four staff to commence NVQ Level 3. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living in the home benefit from having the support of a manager with skills to provide a good quality service and procedures in place to promote their interests and well being. Evidence: The registered manager has the necessary experience to manage the home and, as she has been in post for a number of years, knows the residents very well. The manager has participated in the same training that the care staff have completed and, at the time of this visit, was in the process of completing the Registered Managers Award. Since the last inspection visit in November 2007 a new deputy manager has been appointed and this has enabled the registered manager to delegate a number of responsibilities and allows her more time to concentrate on staff development and record keeping. This was demonstrated in the way in which the manager had been Care Homes for Older People Page 22 of 26 Evidence: enabled to carry out a full audit of all employee files. We saw evidence that the owner carries out regular visits to the home and completes a monthly report of those visits. Both residents and staff were very complimentary about the manager and management team and comments included, Mary is a good manager, she always talks to you to see if you are alright, I enjoy working here, we have a good manager.. and We have a very fair manager, also has an open door office policy. Residents, relatives and visitors are given the opportunity to complete a questionnaire provided by the home that asks relevant questions about the service offered by Carrickfinn. Those questionnaires we examined were all very positive in their responses about the home, the care received and the management. Where the management team supported residents to maintain their personal allowance, records were kept of monies spent with receipts obtained. Each resident has a small safe in their bedroom in which they could put small personal items of value etc. Staff spoken to confirmed that they received regular one to one supervision from one of the managers and that written notes of this supervision are kept. We also saw evidence that the manager carries out regular spot checks when she is off duty which involves her calling into the home unannounced. Records from one of these visits carried out at 10:30 pm included C was helping one of the service users into bed, all fire doors were closed and outer doors and windows locked. Medication had been given and signed for, drug trolley and cupboard locked. The manager told us that all required maintenance of equipment had taken place and we looked at a random selection of maintenance records to confirm this. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 An audit of all upstairs windows should be undertaken to ensure that they do not open too wide and any necessary action should be taken to minimise any potential risk to people using the service. Staff should receive training relating to Infection Control. 2 26 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!