CARE HOMES FOR OLDER PEOPLE
Cartmel Old Grammar Cartmel Grange Over Sands Cumbria LA11 7SG Lead Inspector
Margaret Drury Unannounced 15 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Cartmel Old Grammar Address Cartmel Grange Over Sands Cumbria LA11 7SG 015395 36868 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ms Beverley Anne Clarke Care Home 19 Category(ies) of OP - Old Age registration, with number of places Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for amaximum of 19 service users to include: up to 19 service users in the category of OP (Older People) 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 25 January 2005 Brief Description of the Service: Cartmel Old Grammar offers accomodation for up to 19 older people needing social and personal care. The home is owned and managed on a day-to-day basis by Ms Beverley Clarke. Cartmel Old Grammar is situated just outside the village of Cartmel, overlooking the racecourse and within walking distance of the Priory and the shops. It is a large two-storey building which has been refurbished and extended for its present use as a care home. There are larga well kept gardens providing outside sitting areas, with car parking facilities at the front of the building. Accomodation is on two floors, with the upper being accessed by a passenger lift. There is a bright airy entrance hall, a lounge and dining room, all of which provide plenty of communal space for the residents to enjoy. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, and took place over one morning. During the inspection time was spent talking with the manager and care staff on duty, looking at records to do with the day-to-day running of the home and the care of residents. Time was spent with of the residents individually and in groups, and all parts of the home were looked at. What the service does well: What has improved since the last inspection?
There have been no major changes since the last inspection and the manager continues to give the required support to the staff and residents. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 6 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. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 3 The Statement of Purpose and resident’s guide provide residents and their families with details of the services and facilities on offer at the home. Residents benefit from an admission process during which a full assessment of needs is completed. EVIDENCE: An information brochure is given to all prospective residents and/or their families when they first visit the home. After the trial period of one month all residents are given a copy of the Statement of Purpose, together with a contract and terms and conditions. This documentation provides all the information that is needed for the residents and/or their families to decide about moving into the home.. No resident is admitted to the home until an assessment of needs and capabilities is completed. There is then an on-going assessment during the month’s trial period. The information gathered during this period ensures the home is able to meet the assessed needs. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 10 The home has a care planning system in place, which ensures residents health, and social care needs are met in a way that promotes their privacy and dignity EVIDENCE: The care plans contain information about residents current needs assessments and daily care records. They are reviewed and updated every 3 months unless there are changes in the care needs of the residents to record. The plans provide the care staff with the information they need to deliver the level of care required. Records are kept about GP appointments and when district nurses visit, and people said that an appointment is made for them if they ask to see the doctor or nurse. The care staff speak to residents in a courteous and polite way, knock before entering bedrooms, and close doors when assisting people with personal care tasks. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Social activities, although limited, and meals are varied, providing residents with a range of choices. EVIDENCE: Activities are organised on two days a week and the residents said they enjoyed taking part but would like more if possible. Ministers visit the home from time to time and give communion to those wishing to partake. There is no restriction on visiting times as long as the visitors are considerate of those living in the home. There is a three-week menu with an alternative choice at the main meal. Residents can pretty well pick what they want for their evening meal. Those who spoke with the inspector said they enjoyed their food. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 &18 Residents benefit from a complaints policy and staff have a good knowledge of adult protection issues which safeguards residents from abuse. EVIDENCE: The home has a complaints policy in place, although there is no means of recording any that may be made. The manager confirmed that there has been none to record. There is an abuse policy in place that includes whistle blowing and staff completed training in abuse awareness last year. There has been one recorded case of abuse, which was dealt with satisfactorily. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 25 & 26 Residents benefit from safe, warm and pleasant surroundings in which to live. EVIDENCE: The home is very well maintained with decorations, furniture and fittings of a very high standard. There is ample communal space, comprising of a large airy reception area, a lounge and separate dining room. There are well kept gardens, with a patio and sitting areas, around the building, providing extra communal space. All the bedrooms have full en-suite facilities and there is a communal bathroom that is suitable for older people and those with a disability. Domestic arrangements in the home mean it is clean, pleasant and hygienic. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 30 Residents benefit from an experienced staff team although none have formal qualifications They have a good understanding of the residents’ support needs. This is evident from the interaction between them and the residents. EVIDENCE: There is a low turn over of staff, with some working at the home for a number of years. Although none are qualified to NVQ level they all have a great deal of experience in the care of older people. Their interaction with the residents was easygoing and relaxed and the residents said that the staff are very kind and caring. Internal training and limited external training plus comments from the residents evidenced that the staff are competent to do their jobs. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36 &38 There is clear leadership, guidance and direction to staff to ensure residents receive good quality care. Residents benefit from health and safety policies that ensure the home is a safe place in which to live. EVIDENCE: The registered manager has a great deal of experience in the care of older people although she does not see the need for formal qualifications. The management style is very relaxed, with residents, on the whole, feeling they are able to voice their opinions about the running of the home. There is no resident’s money held in the home and the manager works with her accountant to ensure the home remains financially viable. Although the manager said she supervises staff on a daily basis there is no formal, documented supervision of staff. She feels this is added paperwork that is not entirely necessary. However this is recommended, for the personal and professional development of all the staff working in the home. Health and safety, food hygiene and
Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 15 manual handling training have all been completed and this, together with the health and safety policies, ensures that the home is a safe place to live and work in. Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 3 x x x 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x 2 2 x 3 Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 17 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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. 2. Refer to Standard 36 Good Practice Recommendations It is recommended that staff are supervised every 2 minths Cartmel Old Grammar F58 F10 s22582 cartmel old grammar v233063 150705 ui stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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