Inspection on 04/11/08 for Carrington House

This inspection was carried out on 4th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Carrington House 19/05/09

Carrington House 25/11/08

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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: Carrington House Carrington House Vandyke Rd Leighton Buzzard LU7 3HQ     The quality rating for this care home is:   one star adequate 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: Angela Dalton     Date: 0 4 1 1 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 24 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 24 Information about the care home Name of care home: Address: Carrington House Vandyke Rd Carrington House Leighton Buzzard LU7 3HQ 01525853211 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Georgina Thandi Type of registration: Number of places registered: Resicare Homes Limited care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 60 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Physical Disability - Code PD Dementia Code DE Date of last inspection Brief description of the care home The service was newly registered in May 2008. It can accommodate 60 people over 3 floors. There are lounge areas throughout to ensure people who use the service can meet relatives in private. The service offers a choice of bath and shower facilities. There is a garden area which has garden furniture and is used for barbeques in better Care Homes for Older People Page 4 of 24 Over 65 0 60 0 60 0 60 Brief description of the care home weather and a conservatory. The hairdresser has use of a designated hairdressing room which caters for people who use a wheelchair. There is also a craft room to be used as people who use the service wish. Care Homes for Older People Page 5 of 24 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: one star adequate 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: One inspector conducted this unannounced site visit on 4th November 2008 between 10am and 5.30pm. Three people were case tracked. We followed the care of people who use the service to ensure the care they receive is reflected in the care plan and meets their individual requirements. The case tracking process cross references all the information gathered to confirm that what we are told is happening is actually occurring, and, reflects the Statement of Purpose, which contains the aims and objectives for the service. We spoke to the people who use the service, their relatives, members of the staff team and the manager. We received some surveys from people who use the service and their comments have been included in the report. We were present for lunch and observed several aspects of care delivery. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 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 24 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 24 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. People who use the service are offered the necessary information to enable them to make an informed choice Evidence: The statement of purpose and service user guide is given to every person who uses the service on moving into Carrington House. Both documents are in large print for easy reading purposes. The service user guide details what specialist services are provided and what facilities are available and includes the services terms and conditions. A colour brochure provides photographs of the interior and exterior to provide information to people who cannot make an initial visit to the service. As the service is not yet full people who use the service are able to choose which room they will move into. A contract is issued immediately when the person moves into the service and is reviewed after a six week stay. This ensures that the individual is happy with their room, the service that they are receiving and enables any changes to be Care Homes for Older People Page 10 of 24 Evidence: made. A copy of the issued contract is kept in the care plan for future reference if desired. People who use the service confirmed that they had received a copy of the complaints procedure and were aware of who to raise any issues of concern to. We were told that complaints did not escalate as the manager took proactive action to ensure that a positive outcome was achieved. A comprehensive needs assessment had been completed for each person who uses the service. It provides the foundation for the care plan and was also completed for people who use the service who were receiving respite care. The service offers a respite stay option for two weeks or longer. This option will be reviewed once the majority of rooms are occupied. The assessment fully explores health and social care needs. It also ensures personal information such as preferred time of retiring to bed and rising, preferred beverage and care preferences e.g. noting any opposition to receiving care from a member of staff from the opposite sex. People we spoke to confirmed that the information received from assessments formed part of their daily care routine and we also observed this. Staff receive training and are able to meet specific needs such as dementia care and mobility requirements. The service does not offer intermediate care. Care Homes for Older People Page 11 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Despite a high level of care delivery the current medication system does not ensure the safety people who use the service. Evidence: Each person who uses the service has an individual care plan which is comprehensive. Care plans were also completed for people who were using the service for a short period of time. They were informative and were effective as the assessment had been thoroughly completed. The manager is looking at ways to store all relevant information together as it is currently in several different places but staff know where to look. People who use the service or their relative had signed the care plan to evidence that they had read and agreed with the content. District nurses visit to support people who use the service with health needs such as diabetes and continence requirements. The manager plans to ensure that district nursing records form part of the care plan to ensure staff are aware of health needs. Falls are recorded and the manager is developing an analysis tool to identify causes that can be reduced or address potential risks. We observed staff being kind , patient and gentle with people who use the Care Homes for Older People Page 12 of 24 Evidence: service. They worked appropriately with people with dementia and reassured them. One lady stated she was frightened and a member of staff comforted her and ensured she was calm before engaging in another task. We spoke to many people who use the service who were positive about the care they receive and the staff. I think its mighty fine. The people are fantastic, I cant fault it. We get good care. I like it here. People who use the service are encouraged to maintain their independence and care plans reflected which tasks could be done with little or no help. The care plans also included specific important details identified in the assessment. The manager plans to develop individual pen pictures to provide staff with information about personal histories and to be used as a reminiscence aid. End of life wishes are recorded and thank you cards reflected relatives were appreciative of the care delivered and funeral arrangements made. We observed staff maintain peoples dignity: a lady had removed the buttons on her dress and it was exposing her underwear: she was gently encouraged to change and the dress was placed in the laundry for repair.The stay put system is used in the laundry to identify clothes: a personalised button is sewn into clothes which can be scanned rather than using name tapes. People who use the service confirmed that they could lock their bedroom door and staff knocked before entering. Each bedroom has a front door to replicate the front door of a house with a door knocker which enhanced the homely atmosphere. There is plenty of space for people who use the service to meet their relatives: furniture is on order for the spaces on each floor and provide cosy seating areas for friends and relatives to meet. The medication system needs some attention. Amounts of medication had been recorded on the Medication Administration Record Sheet (MAR) but, when checked the totals did not reflect the records accurately. This occurred on four occasions. Lactulose had not been given on one occasion and unable to find lactulose had been recorded. A person who uses the services family are overseeing medication, collecting the prescription and dispensing medication into separate containers. This practise compromises the services ability to comply with the National Minimum Standards and Care Home Regulations or adhere to the guidance issued by the Royal Pharmaceutical Society. The manager must ensure safe medication procedures are in place. There are plans for a part time pharmacist to commence employment in the coming weeks. Care Homes for Older People Page 13 of 24 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. People who use the service find that the service meets their social expectations. Evidence: An activity coordinator has been recently employed and will begin work in the coming weeks. Care staff are currently providing activities and a record is kept to ensure individual likes and dislikes are catered for. We observed dominoes being played and bonfire night celebrations had been planned. We were told that bingo and armchair exercises also took place. A tea dance was organised a few weeks ago which people participated in: I really enjoyed it, we sang old songs. Preparations are being made for Christmas activities and activities are publicised on a notice board in the corridor and by word of mouth.The weather for each day is also displayed. The local girl guides will be visiting in the coming weeks to forge community links with the service and there are plans to develop links with local churches to enable people who use the service to practise their religion. An organ is available and was used during our visit for a sing a long. There is a designated craft room for those wishing to participate in quieter (or messier) activities. A separate hairdressing room used by the visiting hairdresser provides two back wash sinks: one sink is accessible to wheelchair users. Care Homes for Older People Page 14 of 24 Evidence: We observed lunch and sat with three people who use the service. There was a choice of liver, cottage pie and ham salad with ginger sponge and custard for pudding. One person who uses the service had requested smoked haddock for breakfast and this was prepared for them. We observed the cook asking people what they would like for tea and a wide variety of food was served. We were told that food was lovely and good on several occasions. Some people who use the service reported that food sometimes arrived cold. The manager plans to address this by purchasing a heated trolley. Care Homes for Older People Page 15 of 24 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. People who use the service are confident that their concerns and complaints are listened to and acted upon. Evidence: There is a designated complaints and compliments folder to record any concerns and evidence how they were dealt with and record the outcome. A relative stated that any issues raised were dealt with which prevented them from escalating. People who use the service told us that they knew who to raise any concerns to and seven surveys we received from people who use the service confirmed this.The manager told us she was aware of local advocacy agencies should they be needed. As stated earlier many compliments have been received in the form of thank you cards from relatives. The service does not currently keep any money on behalf of people who use the service. All staff have received safeguarding training to ensure that they are equipped to deal with a disclosure of abuse.Staff will be attending training about the Mental Capacity Act in the near future as this may impact upon caring for people with dementia. A record is kept of any incidents and accidents to ensure any patterns are identified and appropriate treatment is given. Care Homes for Older People Page 16 of 24 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. People who use the service live in an environment designed to meet their needs. Evidence: The service is purpose built and was registered by the Commission for Social Care Inspection in May 2008.There are two married couples who have access to two rooms: one being used as a lounge, the other as a bedroom. individuals are encouraged to personalise their bedrooms. Some parts of the home require snagging issues to be completed such as toilet roll holders and magnetic door closers but this work is planned for completion in the next six weeks. The fire service have made two visits to the ensure that the initial issues identified have been resolved. Magnetic door closers have been fitted. Laminated signs will be displayed to inform people who use the service and their visitors that staff assistance may be required to access parts of the building. The home is in good condition and odour free. We observed a bedroom carpet being cleaned during our visit. Each bedroom has an en suite toilet and small hand basin and a choice of bath and shower facilities are available in recognition that some people prefer to have a bath. Shower heads are regularly descaled to ensure the risk of Legionella is minimal. Regular fire checks and drills are conducted. The manager plans to incorporate the local fire services risk assessment into the fire plan to assist in the development of the Care Homes for Older People Page 17 of 24 Evidence: fire procedure. The laundry is spacious with industrial style machines. People who use the service confirmed that they received their own clothes and they were kept in good condition. Gloves and aprons were readily available to assist with infection control and staff were observed to change these each time they cared for an individual person who uses the service. Care Homes for Older People Page 18 of 24 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. Staffing numbers and skill mix meet the needs of people who use the service Evidence: The staff complement is generous as the manager is recruiting on a continuous basis to ensure that the staffing levels are adequate as more people move in. All staff complete the Skills for Care induction which is comprehensive. Staff clearly enjoy their work and we observed kind and friendly interaction. People who use the service stated that this was always the case. Staff seemed to have a rapport with people and this contributed to the calm and relaxed atmosphere. All care staff are enrolled to commence an NVQ qualification:14 staff are enrolled for level 2 and 15 for level 3. 14 staff already hold an NVQ qualification which meets the 50 recommendation. We looked at 5 staff recruitment files and all necessary checks had been conducted to ensure that people who use the services safety is observed. The manager is currently developing the application form to enable more information to be provided about previous employment experience. Staff have received moving and handling training, fire training, first aid and safeguarding adults training. Care Homes for Older People Page 19 of 24 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. The manager ensures that the home is run in the best interests of people who use the service. Evidence: The manager is registered with the Commission for Social Care Inspection and owns Carrington House and another local service. She is exploring the possibility of delegating the monthly visits the Commission requires to provide a more objective insight and assist in developing her management teams skills. Although there are structured activities and routines the manager makes it clear that individual needs are catered for if they occur at other times. Relatives we spoke to were complimentary about the care: I cant fault the care my mother receives. The girls are excellent. Staff have empathy. Families deal with finances - the service does not oversee any people who use the services money. A quality assurance review will be conducted in January. The Annual Quality Assurance Assessment has been completed which is sent to the service by the Care Homes for Older People Page 20 of 24 Evidence: Commission for Social Care Inspection. Informal reviews demonstrate that people are satisfied with the service they receive. The manager plans to introduce meetings for people who use the service when the activities organiser settles in. Staff receive supervision every 2 months which enables them to identify any areas which require development or areas of special interest. We spoke to 3 members of staff who confirmed that they felt adequately supported by the manager and equipped to carry out their duties. Care Homes for Older People Page 21 of 24 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 22 of 24 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 1 9 13 Medication must be safely stored, dispensed administered and recorded appropriately. The current medication system does not assure the safety of people who use the service. 30/11/2008 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 Care Homes for Older People Page 23 of 24 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 24 of 24 - 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!