Inspection on 18/09/06 for Cartlidge House

This inspection was carried out on 18th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Cartlidge House 06/12/05

Cartlidge House 25/04/05

Cartlidge House 21/12/04

Cartlidge House 06/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Cartlidge House Charlton Street Oakengates Telford Shropshire TF2 6BD Lead Inspector Janet Adams Key Announced Inspection 18th September 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 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. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cartlidge House Address Charlton Street Oakengates Telford Shropshire TF2 6BD 01952 618293 01952 616149 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) Accord Housing Association Limited Mrs. Jean Dickenson Care Home 54 Category(ies) of Dementia (36), Old age, not falling within any registration, with number other category (18) of places Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may accommodate a maximum of 54 service users. The home may accommodate up to 54 Elderly Persons of whom 36 may be suffering from Dementia. This includes 2 intermediate care beds Date of last inspection 6th December 2005 Brief Description of the Service: Cartlidge House is registered to provide personal care to a maximum of 54 older people of whom 18 may have dementia. Owned by Accord Housing Association Limited, the Registered Manager is Mrs Jean Dickenson. The home is located in Oakengates situated within walking distance to the main shopping parade, and it is also accessible to the local bus and railway station. It is set in its own grounds with its own private secure garden. Internal accommodation is arranged over three floors in single bedrooms. It has a roomy passenger lift which enables easy access to all parts of the home. Cartlidge House comprises of six individual units, each with its own lounge/dining room, bathroom, and small kitchen. Two of the six units have been especially designated to accommodate people with dementia related illness, and another unit accommodates people for shortterm stays in the home, for either respite or for intermediate rehabilitation type of care. Accord Housing makes Cartlidge House’s services known to prospective residents in their statement of purpose, and its brochure/service user guide. A copy of the most recent CSCI (The Commission for Social Care Inspection) Inspection report was also seen to be freely available for people to look at. The current fees charged vary between £348.88 and £390.28 per week depending on the care, support and accommodation required. Additional charges to service users are for hairdressing, toiletries, newspapers, and the charges incurred if a resident wishes to use a private chiropodist. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out the announced inspection visit to the home. This lasted seven hours. The inspection was carried out by observing activity within the home, inspecting the premises, having an ‘in depth look’ at records for residents and staff, observing, talking and listening to more than 30 of the people living there, as well as ten staff on duty throughout the time of the inspection. It was obvious a lot of preparation had been undertaken to make sure all information needed was available, and the details the home provided to CSCI (Commission for Social Care Inspection) before the inspection was most helpful. The deputy manager who was in charge at the time of the inspection was thanked for the management’s efforts for providing it. A variety of information confirmed what was seen at the inspection, including the results of a survey carried out by CSCI, when 30 of the 50 people living there, eight relatives and five visiting professionals all shared information about life at Cartildge House. Everyone, including residents and staff were very welcoming and helpful throughout. A total of 28 out of a possible 38 National Minimum Standards for Older People were assessed on this occasion. What the service does well: It was impressive to see that the home has continued to more than meet National Minimum Standards for many parts of the service and support it provides for its residents. On this occasion 13 out of the 28 assessed were exceeded. The home meets the individual personal and health care needs of the elderly people living at Cartlidge House on both a short and long-term basis in a most desirable manner. This home is very good at communicating with service users to find out what their needs are, how they would like their care to be provided and frequently reviewing the service provided to make sure it is still necessary, appropriate, and meeting their needs and aspirations in life. Towards the end of last year the home set up an intermediate care service, offering rehabilitation for people for up to a maximum of six weeks, which has also proved to be successful. All residents spoken to stated they were happy to be living at Cartlidge House, felt safe, and were well cared for. Others who were not able to confirm this as Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 6 a result of their medical conditions all expressed feelings of well being when observed during their daily pastimes. The home has an excellent activity programme, which is rolled out in different ways throughout the home. This shows it focuses on residents’ preferences and interests in a way to make them all feel involved. One relative confirmed findings and made written comments that: ‘The home is very good in every aspect. The care is wonderful and they keep you informed about the general care of the person. The staff are very good with everyone and are always happy and obliging.’ What has improved since the last inspection? Paperwork to inform prospective residents about the home has been compiled into an eye- catching information pack. As part of the home refurbishment programme last year, one unit was especially reorganised so that it provide support and accommodation for people staying at the home for a short period of time only. People spoken to felt this has been especially good to offer a stable ‘family community’ to individuals living at the home on a permanent basis, especially on the units where people with dementia related illness live. This also means that one unit has a team which specialises in getting to know people on a short term basis, and can offer appropriate support and care for the duration of their stay at the home. Different systems have been set up especially to meet the high turnover of residents on that unit. The internal and external surroundings at the home have continued to improve to enhance the home upgrade carried out last year. Homely finishing touches in all parts of the home make the part of Cartlidge where people live personal to the individuals living there. Communal areas on the units where people with dementia related illness live have eye-catching displays to offer stimulation appropriate to their condition. Many residents spoken to in all parts of the home commented how much they have enjoyed the new private garden area with its gazebo and greenhouse. The already good meals provided at the home were reported to have got even better. The range of topics covered by training for staff has continued to improve, and shows the team are well trained to meet the diverse needs of the people living in the home. Incentives carried out in the home have also demonstrated the staff team’s commitment to health education for both residents and staff. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 7 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. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 8 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 Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 6 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Cartlidge House’s admission procedures shows there is sufficient information to clearly demonstrate they can meet the long and short term needs of people thinking about moving in there. EVIDENCE: Since the last inspection in December, the management team have continued to improve the whole admission process for short and long-term residents. An eye catching information pack entitled ‘Care and Support’ is given to every person thinking about moving into the home, as part of the first ‘face to face’ meeting the management of Cartlidge House have with any prospective resident. This has been devised by Accord Housing, and contains all necessary details to inform people about the services it provides. However, the Cartlidge team are in the process of tailoring the information it currently contains to make the already good details provided about the home Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 10 even better, and following a comment made by one relative, they plan to record when such information is given to prospective residents. Examination of five sets of residents records show that people have a detailed assessment completed prior to, and upon admission to make sure the home knows how to look after that individual person from the time they move into Cartlidge House. Assessments have been carried out in enough detail to assure residents, their relatives and staff that the home can meet their needs. It is of note that the management team have devised a central register of all people assessed so the various senior team members know ‘at a glance’ what admission preparation has been carried out for any individual thinking about receiving care and support at the home. Upon entering the short term care unit, it was positive to see the senior carer working on care planning information in preparation for an individual being admitted later that day. Anyone who returns for another spell of ‘respite’ has their care needs reassessed and records updated. On the day of admission, consultation with the resident is carried out, so that any changes in their needs and support is noted and shared with the staff team on the short term stay unit. This means the staff know how to carry out the person’s needs in the way they prefer. In all sets of records seen, residents’ signatures showed they agreed with what was written about them. A group of residents who said they were on their third and fourth stay at the home all remarked that the staff go through their records with them to make sure any changes have been noted. Observations and discussions with many of the residents confirmed they were very happy living at Cartlidge House.One gentleman spoken to in private commented that when he came for a look round the home with his son, he ‘did not want to leave’. He commented that he knew right away that he could make Cartlidge House his new home. The gentleman said: ‘As soon as I got a lovely welcome from the staff, and saw my room with its smashing view I said ‘this is it boy’ - and I wasn’t wrong!’ Since the last inspection, the home has been receiving regular letters and cards of thanks from relatives of people who have been staying at the home. These were on display for all staff to read and appreciate. Social workers have also passed on several positive comments about Cartlidge House that people have shared with them. CSCI received a written comment by one such individual which also stated:‘The communication between the staff team and social services is excellent’ Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, &10 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Care planning systems are generally good, but not all essential information is provided for staff, meaning that people might not receive the care they need. Procedures and training relating to medication ensure the safety of service users. Excellent personal support in the home is offered in such a way that promotes and protects service users dignity and independence. EVIDENCE: All written and verbal comments received from residents and their relatives confirmed that on the whole, people are happy with the care and support this home provides. Many used one word to describe Cartlidge House in the comments received at CSCI: ‘Excellent.’ Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 12 Although some people who live at the home are not fully able to answer questions and write their opinions about Cartlidge House down, the inspector spent over four and a half hours observing residents in the home including half of that time on the units where people with dementia related conditions live. Observations of the care delivery and behaviours of these individuals during this time showed that the people living there appeared to be happy, were well groomed and had the support of plenty of knowledgeable staff on duty to give them the personal attention they needed. Two GP’s and one Community Nurse who replied to the CSCI survey also confirmed that they were satisfied with the overall care provided to residents within the home. An in depth look at eight sets of care records of people living in four different parts of the home showed that they were of a very high standard. Whether the resident was living at the home for two weeks or had been there two years, care records were seen to have been updated to contain most of the detailed information how people preferred and needed to be looked after. However, some of the records for newly admitted people did not quite have all of the information needed to confirm the home does as much as possible to keep them safe. The home uses forms called ‘risk reduction tools’ - and some of the information for three people lacked necessary details about all risks residents may encounter, particularly with regard to moving and handling them in an emergency or in the event of a fall. The records of an individual who was the subject of a letter of concern were also looked at and the content of the records showed that all aspects of care were written down in the care plan, and showed appropriate routine relative and social worker involvement in the person’s care. Neither the resident, relative, staff member or social worker raised issues for improvement when a ‘care review’ was carried out. It was observed, however, that some management actions concerning an emergency incident during this person’s stay at the home needs to be further explored as a separate issue. An adult protection meeting has been planned for this purpose and the outcome of this matter will be included in the next inspection report for the home. All staff on duty were observed working and supporting residents in a polite, caring and highly respectful manner. When the deputy manager was complimented about this she commented that a ‘terms of endearment’ project recently launched by Accord Housing in the home had raised staffs awareness of this matter. Meetings with residents had been arranged to get their opinions whether they liked being spoken to using terms such as ‘love’ or by any other way than their full name. Medication systems in the home were checked at random on one unit in the home. Staff were seen to be administering medication confidently and competently. Both carers demonstrated good hygiene practices whilst carrying Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 13 out this task. The observations showed the training they have had for this responsibility has been effective and appropriate. Written information seen also confirmed that all staff have had special training for this matter. On the short-term care unit the team have devised a ‘bag system’ to keep all the medications for one person together. This innovative system makes sure every residents’ medications are stored separately and helps the process for staff to administer medication as well as making sure all prescribed items which people bring into the home are safely returned to their owner when they leave. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 14 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 quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Staff have an excellent understanding of the service users support and leisure needs and use this to assist them to exercise choice and control in their lives. Service users have many opportunities for community/family contact which enables them to make a choice about who they see and when and where they see them. Dietary needs of service users are very well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: A wealth of positive information about the range of both communal and 1:1 activities from residents, families and staff confirmed standards continue to be exceeded. Residents continue to be as active as ever making the best use of the local amenities and clubs in Oakengates. Every unit has photo albums and displays showing a variety of ever changing activities and outings. Residents showed these to the inspector and confirmed they have had the choice of a very stimulating summer. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 15 Staff members were keen to inform the inspector of their personal development targets which focussed on exploring ways to encourage residents to stay healthy. One unit had a ‘healthy heart display’ in one corridor, which had a lot of useful eye-catching information. A children’s play area had been set up in part of the first floor lounge. The deputy manager commented acting upon this suggestion had been very successful in making sure that it all the family could be happily involved when visiting Cartlidge House. Two written comments sent to CSCI from staff shortly after the inspection confirmed they felt the activity programme has improved even more during the past six months. Since the last inspection the company have employed an activity coordinator to support the staff team in this important task. Although the person has only been in post for a month she was seen to be actively encouraging and befriending individuals on the short term care unit to accompany other residents to have a ride out on the home mini bus to a coffee afternoon. Discussion with this person confirmed she had set herself weekly targets to achieve to help get settled into her new role, and was pleased that she had managed to her first task on her list by setting up visits by the ‘Pets as Therapy’ service for the home. The social needs of people with dementia related conditions living at home were seen to be met by staff making the most of the specialist training they had received for this matter. The team are to be commended for the innovative displays set up in the corridors and communal areas of the two units where such individuals live.One knowledgeable staff member commented that they had used black and yellow colours to frame displays of ‘past times’ and photographs in line with the research findings from the Alzheimer’s Society in order to maximise the impact for people as they approached them. The service, presentation and meal quality at lunchtime was of a very good standard. The home’s menus were printed with an easy to follow ‘Green for Go’ stickers to enable residents to make a healthy eating choice when ordering their meals. During the actual mealtime, residents’ choice continues to be maximised by food being served in tureens so they can decide what portions they want on their plate. A 1:1 discussion with the cook on duty confirmed that she had received training in a ‘Safer Food, Better Business’ initiative by the local council, and the catering team were using the advice in a ‘Nutrition for Elderly People’ research folder to continue to improve the meals provided at the home. The above information shows how the home continues to excel in this part of the service it provides, to make sure people get the variety of food they prefer in a way to meet their dietary needs. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a good complaints system with evidence that service users feel that their views are listened to and acted upon. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. EVIDENCE: The information the home provided to CSCI showed that the home had received one complaint in the past 12 months. Examination of the records on site showed that this issue had been managed appropriately. At around the time of the inspection, CSCI also received a letter of concern about Cartlidge House. Details of how this was explored during the inspection are included in this report. It was evident that the home takes the matter of safeguarding individuals very seriously. In addition to the training that all staff receive, to support the robust policies they have on this sensitive matter, the home have recently held an ‘abuse awareness’ day at the home. A guest speaker from the county adult protection team was invited along to give a talk. Photographs show that an ‘abuse information’ display was set up as part of the day’s activities. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 17 Cartlidge House are to be commended for the professional actions they carried out when they made a referral to the adult protection team upon being concerned about a service user’s behaviour. The investigation was closed at its first meeting when it was seen the home had managed the situation extremely well. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,24, & 26 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The good standard of living accommodation provided within this home provides service users with an attractive, well-equipped homely and hygienic place to live. EVIDENCE: An extensive guided tour of the home confirmed that the home offers a good standard of personal and communal living facilities for all residents it is registered to have living there. The recent major refurbishment has maximised the potential of the home. This has been further enhanced by the efforts and involvement of the residents and staff to make Cartlidge House homely and welcoming for all the people living and visiting there. It is commendable the units where people live have been decorated and appointed with pictures and ornaments and soft furnishings Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 19 which have been ‘themed’ to take into account the hobbies and interests of the people living in that part of the home. The private, secure gardens provide a safe environment, and are easily accessible to residents at all times of the year. Although the home does not have en suite facilities to bedrooms there are enough bathrooms and toilets within easy reach for residents to access. Bedrooms are equipped with wooden commodes which look like ‘proper chairs’ for more private night time use. Although these are in satisfactory condition at present the management are advised to monitor them to make sure they can be effectively cleaned as they show signs of ‘wear and tear’.Other specialist equipment is available to help with care, as well as maximise independence wherever possible. Residents were observed to be encouraged to use grab rails and mobility aids such as walking frames. Hoists were also seen in use by competent staff. Several residents’ bedrooms were looked at. They all had been made to look individual and different with the addition of the person’s own belongings. The bedrooms on the short-term care unit were also personalised with some pictures, photos and smaller mementoes. The standard of cleanliness in the home is excellent. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29, & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of vetting and recruitment practices is excellent with appropriate checks being carried out. This ensures that suitable staff are employed to care for service users. The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: Clear, easy to understand rotas were seen in use and show the home is adequately staffed at all times. It is of note the home has a very low staff turnover –the majority of recent leavers has been due to staff retirement. The deputy manager confirmed that Cartlidge House currently has one part time vacancy for a carer, and a part time activity organiser as well as a part time domestic assistant. The files of two new recruits were seen and showed that robust recruitment practices are carried out.Four staff files were seen regarding induction and training. It was positive to see they were linked to the approved ‘Skills for Care’ training, and the records of the home’s latest recruit also had Alzheimer’s Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 21 Society information about how to carry out basic care needs for people with dementia related illness. This means that staff are provided with the right level of information to get off to a good start with their ‘Cartlidge’ care career and that they are prepared for looking after the specialist needs of some of the residents. One new starter was spoken to in private and made positive comments how he was supported upon starting work at the home. It was of note that in another part of the home another new starter was observed to be spending time with a senior team member. They were seen working through the induction paperwork in a positive professional manner. Staff confirmed that a wide range of training is provided and there are many equal opportunities to improve themselves for the benefit of resident care. A seasonal training newsletter is provided by Accord Housing, and the Spring 2006 version identified that several of the Cartlidge staff team have been nominated to undertake topics such as: Risk assessment, adult protection, stress, health and safety, medication, challenging behaviour, supervision skills, customer care and recording and reporting for care staff – as well as a range of necessary mandatory training. The home is also actively involved in Accord Housing’s ‘Dementia Care Best Practice Group’ - two staff members have attended these monthly meetings and cascaded relevant information to the rest of the Cartlidge care team. It was positive to see this information recorded in staff supervision notes. It is of note to report that all staff have received emergency aid and medication competency training. The files of two long-term staff members were looked at and showed that they were up to date with the entire mandatory training necessary to carry out their job. At present 72 of the care team at Cartlidge are NVQ qualified, which confirms that the majority of staff have had the professional training required to carry out their job properly. All comments received from residents and relatives were complimentary. Several individuals expressed similar comments that: ‘The staff are very friendly, caring and helpful’ ‘I always get a nice welcome when I visit’ ‘The carers are very helpful and are doing a good job’ ‘My Mum seems very settled and happy since she has been there.’ Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 22 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): 31,33,35 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Accord Housing have ensured Cartlidge House is managed by an experienced, suitably qualified individual who carries out her responsibilities fully. The manager has sound leadership skills and promotes a professional ethos within the home. The management team are developing and maintaining a well-supported staff group in the home’s quest to constantly improve the service to meet residents’ aspirations. The systems for resident consultation are excellent with evidence suggesting that their views are sought and acted upon. The majority of health, safety and welfare of service users and staff are promoted by the home’s established safe working systems. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 23 EVIDENCE: The professional manner in which Accord Housing, and the management team and the staff of Cartlidge House responded to this inspection confirmed that open, inclusive management systems continue to exist at the home. The home continues to have an effective quality assurance system in place. Satisfaction surveys continue to be held annually.Any other information about the ongoing changes in the home is shared with everyone at resident and staff meetings. The ‘Cartlidge News’ was given a ‘new look’ in August, and contains all details of changes and opportunities for residents, their relatives and staff as well as ‘diary dates’ for outings and news about projects the home is carrying out. In order to further improve on this, suggestion books have been provided on all of the individual units, and people are welcomed to make comments and suggestions this way. Discussion with seven staff members on a 1:1 basis confirmed the staff are committed to ongoing improvements, achieving best practice and to developing equal opportunities. All individuals relayed similar information about their personal targets to improve Cartlidge House during the coming year. This was also confirmed in the information seen in four sets of staff files. A noteworthy system to record this clearly shows how it has been managed. All necessary service and maintenance records requested were seen to be up to date and complied with necessary health and safety legislation showing the home’s commitment to providing a safe place for people to live. The current safe working systems in the home have resulted in good management of monies and valuables kept in safekeeping for residents, as well as satisfactory accident recordkeeping. When an incident, which was reported to CSCI, was explored, other records indicate that not all actions had been carried out as quickly as expected. As recorded earlier this issue is being looked into separately in an adult protection forum. The result of the investigation will be included in the next inspection report for the home. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 24 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 3 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 4 3 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 4 X 3 Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 13 (4)(a) Requirement All care plans must show that risk reduction tools have been compiled for all residents in the home, to keep them safe. These should include moving and handling issues, with details of all equipment including the type of hoists and slings, alongside any other risks people may be subject to. Timescale for action 09/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations It is recommended the home monitor the condition of the wooden commodes in the home in order to further enhance infection control arrangements. Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Cartlidge House DS0000020542.V313652.R01.S.doc Version 5.2 Page 27 - 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. 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