Inspection on 14/02/06 for Carrington House

This inspection was carried out on 14th February 2006.

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

Carrington House 20/09/07

Carrington House 08/11/06

Carrington House 26/07/05

Carrington House 02/03/05

Carrington House 09/08/04

Carrington House 01/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Carrington House Carrington Way Wincanton Somerset BA9 9BE Lead Inspector John Hurley Unannounced Inspection 14th February 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 Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Carrington House Address Carrington Way Wincanton Somerset BA9 9BE 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) 01963 32150 01963 33590 Somerset Care Limited Miss Karen Smith Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user, under 65, to reside at the home, this condition will lapse when they are 65 or leave the home. 2nd August 2005 Date of last inspection Brief Description of the Service: Carrington House provides residential care to 44 adults within the Old Persons category of registration. The home is part of Somerset Care Limited. The home was built in the 1960s on a hillside in the centre of Wincanton, close to shops a medical centre and other amenities. All areas of the home are accessible by passenger lift. Access to and from the home is difficult for frail service users due to the gradient and length of the path. There is level access at the back of the building from a small car park to the middle floor of the home. There are bedrooms and communal rooms on all three floors.There are small patio areas by the front door and at the back of the building that service users can access. The home’s kitchen provides for all catering needs of service users Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours. As the previous inspection had been comprehensive, covering most of the core standards, the main focus of the inspection was to ensure that previous requirements had been attended to and spend time talking with service users regarding their experience of the home. Therefore the report may appear brief but should be read in conjunction with the previous inspection report. The inspector viewed all areas of the home and met with eight service users, one visiting relative and a individuals solicitor who holds their power of attorney during the inspection. The inspector spoke with several staff on duty and the registered manager. A number of records were examined including service users care plans, risk assessments, health and safety records and staff recruitment files. What the service does well: What has improved since the last inspection? The registered manager has introduced new rotas and continues to update them based on the needs of the service user. Extra staff hours are made available on an as and when basis demonstrating a flexible approach to service delivery. The statement of purpose has been amended to reflect the services on offer at the home. Following the last inspection all the requirements set relating to recruitment practices and risk assessments have been dealt with in a timely fashion. The inspector noted that the laundry area has been refitted and a new impermeable floor has also been provided in this area. The registered manager was able to demonstrate that they have developed a proactive approach with regards to the use of respite and interim care beds Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 6 and now set the agenda for the rationale of the placement and review of the service user placed under these situations. 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. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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 Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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): 1,6 The information provided prior to placement is clear and concise. There needs to be target dates set in relation to when service user placed on a intermediate care status will return home so that all involved in the care package are clear as to the time scales they are working too. EVIDENCE: The inspector noted that the statement of purpose had been updated as required following the last inspection. It now states the different types of service on offer ranging from full residential care through to respite and intermediate care. A number of emergency admissions had been made on the previous day following a fire at a nearby home. These service users were settling in well and were complementary with regards to the arrangements that had been made on their behalf. At the time of the inspection the inspector noted that staff were continuing to provide key information to those placed, being sensitive to the unique way in which they had come to be staying at the home, for example Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 9 informing them of forthcoming weekly fire alarm testing and information relating to meal times. The inspector looked at several files relating to those individuals who had been in attendance for respite and intermediate care. Some of the older files demonstrated that important information was missing; more recent files evidenced a proactive approach to the management of the individuals stay at the home. The documents seen in these later files demonstrated that reviews were planned and rationale for the placement was now being considered as part of the homes evaluation when considering if they could meet the stated aims and objectives of the service user care plan. During discussions with regards to intermediate care it was established that an individual has made sufficient progress to be able to have their needs met in the community, however no date had yet been set with the other professionals involved to facilitate this move, which is also the wish of the service user. Through discussion with the registered manager the inspector established that the process was not quite robust enough at the time of the inspection. However considering the good progress that has been made since the last inspection they are confident that given time and further placements the issues discussed will be ironed out as the service continues to learn and develop in this area. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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): 9,10 The staff treat the service users with respect and dignity. More needs to be taken into consideration when risk assessing those service users who self medicate. EVIDENCE: The service users the inspector spoke with informed them that they were happy with the lifestyle offered at the home. They told them that staff were approachable and that they respected for who they are. One individual informed the inspector that they (staff) talk to me about what the old days were like and take an interest in my photos. Staff were observed knocking on service users doors before entering, toilet doors were closed when in use, service users were seen going about the home unrestricted in the communal areas. The inspector looked at the records relating to those who take control of their medication. The home provides safe storage arrangements for these individuals and has some overview of what medication is held as they collect the medication on behalf of the individual. A signed declaration is made by the Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 11 service user regarding their wish’s with regards to them self-medication. A risk assessment is made by the home that is signed and dated. The records the inspector looked at did not review risk on a monthly basis, the risk assessments did not show what medication was being taken. The registered manager acknowledged these omissions and agreed to make amendments to the process and reviewing procedures. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 The daily rhythm of life at the home appears to meet most of the service users expectations and requirements. The menus are not available to the service user in advance; likes, dislikes and dietary consideration are not consistently recorded in the information held by kitchen staff The fridge and freezer temperatures are not always recorded. EVIDENCE: Service users told the inspector of the activities on offer. They said that they appreciated the activities carried out by the staff. One service user told the inspector that they enjoyed being able to go out and visit the local library to collect books. The service user informed the inspector that a staff member accompanies them. The inspector considers that this demonstrates a degree of flexibility in the staffing arrangements to ensure individual’s needs are met. The individual service user was extremely complementary and grateful that the home had been able to accommodate this life long activity. A group of service users informed the inspector that friends and family can visit at any reasonable time, a visiting relative confirmed this. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 13 The service users commented that the food was good and in sufficient quantities. A service user explained that if they did not like what was on offer an alternative would be provided. They further commented that food was on offer at varying times of the day. They felt that they had a degree of choice of what to have and when to have it. When the inspector asked what was for dinner no one knew for certain. The inspector looked around the kitchens and found them to be clean with adequate storage for foodstuffs. The stocks of food were found to be ample with a good balance between frozen, tinned stuffs and fresh food. The inspector was shown the menus, which appeared to be drawn up on a daily basis. These menus did not always state what the choice was. There was some information relating to personal preferences and dietary considerations but this did not appear to be either comprehensive. Through further discussions with staff it appeared that most of the information regarding these issues was not recorded just known. The inspector looked at the fridge and freezer temperature-monitoring log that was found not to have been kept up to date. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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): This group of standards were not assessed on this occasion. EVIDENCE: Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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): 19,20,22,23,24,26 The home continues to provide a good standard of accommodation. There continues to be evidence of ongoing internal investment. The outside patio requires maintenance EVIDENCE: The risk assessment documentation relating to the home has been updated in line with the comments made during the previous inspection. All communal areas are well lit and ventilated. All furnishing have a domestic look to them and strip lighting is avoided where possible. The service users rooms are comfortable and well maintained. The inspector noted that a number of the bed bases were showing signs of wear and required replacing. The registered manager confirmed that this was acknowledged and a programme of replacement was underway. The inspector noted that a high Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 16 percentage of the service users rooms only have one plug socket, it would be helpful if a plan was in place to rectify this shortfall. A service told the inspector that they had brought in some of their own photos and keepsakes. They said that they liked their room and felt it was furnished to their liking. The home has a number of aids including hoists and associated slings, wheelchairs, pressure relieving mattresses and other aids relating to personal care. These aids were observed as being in good clean, serviceable condition. The laundry area has been refitted. It has a new impermeable floor covering and better storage and sorting arrangements as well as new equipment. The large patio area outside of the dinning room was noted as having a degree of moss and algae growing on it. This will poise a slipping hazard and needs to be addressed before the warming weather comes. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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): 27,30 The staff team are well trained and knowledgeable with regards to the service users needs and aspirations. The deployment of the staff is flexible to fit the service users needs. Training and induction at the home is good. EVIDENCE: The staff are knowledgeable with regards to the service users needs and the part they play in ensuring these needs are met. The rotas seen evidence that there have been subtle changes to the staffing hours to ensure that at key times of the day there is sufficient staff on duty. For example care staff may now start earlier to assist the service users to get up and dressed, shifts may start earlier in the afternoon to ensure enough staff are available at dinner times. Similarly domestic staff hours are being considered in line with the lifestyle of the service user that currently resides at the home. The registered manager informed the inspector that the feed back from the staff at supervision suggests that they support the changes. A number of new training initiatives have been made available to staff via Yeovil College. These complement the organisations own training programme. These include courses in infection control, dementia awareness, good food and nutrition, bereavement issues and fire training. Individual staffs training files are well kept and demonstrate the continuing commitment to ensuring that the staff of the service has good opportunities for further development. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 18 The inspector viewed the new induction material that is being introduced for new members of staff. The inspector considered that the material was both informative and relevant allowing the management to evaluate progress. The inspector considered that it would be helpful if the organisation included an introduction to its vulnerable adults and whistle blowing policy within this documentation. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 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): 31,32,33,35,38 The home continues to be well managed. Previous requirements and recommendations have been acted upon in a timely fashion. EVIDENCE: The manager has been in post for over two years and informed the inspector that they have now completed the registered managers award. They have continued to update their own training on an as and when basis. Service users are able to identify the manager and have a good understanding of the manager’s role. The staff the inspector spoke with said that the manager was approachable and fair, often working with them and the service users. The records observed evidence that staff are being supervised on a formal basis. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 20 The Health and Safety of service users and staff is generally addressed through risk assessment process. During a tour of the building the inspector noted that a fire door was held open by a hook. The registered manager acknowledged this and agreed to have it removed immediately. As this was acknowledged the inspector considers this should not warrant a requirement. The inspector looked at the financial records relating to the money held on behalf of the service users. Although the recording appeared to be maintained in good order all of the money was held as one sum and so the inspector was unable to establish if the amount on the individuals sheets accurately reflected was held. Although it would have been possible to tally up all of the records to see if the money held balanced with the total this is not considered to be best practice. The registered manager informed the inspector of plans to introduce storage arrangements that allow for money to be held individual rather than collectively. As the registered manager had already made plans to address this prior to the unannounced inspection, and considering the administrator also recognised the need to change the system again the inspector does not consider it necessary to make a requirement relating to this issue. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 21 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 3 x x x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 2 3 X 3 3 3 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 x x 3 Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 22 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 OP38 Regulation 13 Requirement The registered manager must ensure that he patio area is fit for use and does not poise any significant slipping hazards The registered manager must ensure that monthly risk assessments are carried out with regards to those who self medicate at the home. The registered manager must ensure that a planed menu is available which clearly demonstrates choice. The registered manager must ensure that the fridge and freezer temperatures are recorded on a daily basis. Timescale for action 28/03/06 2 OP9 13 07/03/06 3 OP15 16(2)(h) (i) 14/02/06 4 OP38 13 14/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 23 No. 1 2 Refer to Standard OP24 OP18 Good Practice Recommendations The registered manager should consider ensuring that more electrical sockets are made available in service users rooms The responsible individual should consider including the organisations vulnerable adults and whistle blowing policy in the staffs induction material. Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Carrington House DS0000016102.V281333.R01.S.doc Version 5.1 Page 25 - 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. 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