Inspection on 18/03/08 for Cassandra House

This inspection was carried out on 18th March 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cassandra House 13/07/06

Cassandra House 26/10/05

Cassandra House 13/06/05

Cassandra House 31/01/05

Cassandra House 23/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Cassandra House 19 Dunswell Lane Cottingham Hull East Riding Of Yorks HU16 4JA Lead Inspector George Skinn Key Unannounced Inspection 18th March 2008 09:00 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 Cassandra House DS0000019656.V359441.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. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cassandra House Address 19 Dunswell Lane Cottingham Hull East Riding Of Yorks HU16 4JA 01482 876150 01482 876111 carol@mellandene.karoo.co.uk 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) Carol Lesley Olive Murrey Carol Lesley Olive Murrey Care Home 42 Category(ies) of Dementia - over 65 years of age (42), Old age, registration, with number not falling within any other category (42) of places Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2006 Brief Description of the Service: Cassandra House is a care home situated in a semi-rural area of Cottingham in the East Riding of Yorkshire. The home is registered to provide care and accommodation for 42 older people, including those with dementia. Fees paid range from £328.80 to £375.30 per week, and there is an additional charge for toiletries, hairdressing, chiropody and newspapers. The home is a detached Tudor style property built in 1910, with a modern extension. It is set in quiet surroundings and has an enclosed courtyard that is equipped with tables and chairs for residents to utilise. Private accommodation consists of both single and shared bedrooms, some with en suite facilities. Communal living space consists of five lounges, a dining room and a conservatory. Cassandra House is a family run business and is one of two care homes owned and managed by the family. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This key inspection has used information from different sources to provide evidence. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered provider on an Annual Quality Assurance Assessment (AQAA). Comment cards returned from service users, relatives and staff. A visit to the home carried out by one inspector. A site visit was carried out which lasted 6 hours. Service users, relatives and staff were spoken with. Records relating to service users, staff and the management activities of the home were inspected. During the visit care practices were observed, where appropriate, and time was also spent watching the general activity within the home. What the service does well: What has improved since the last inspection? The home was a victim of the recent floods and all of the ground floor was affected. As a result of this the whole home has been completely refurbished. It is credit to the management and the staff at the home that it has reopened Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 6 quickly and the service users who were evacuated have returned to their home. 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. The summary of this inspection report can be made available in other formats on request. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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 Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience good quality outcomes in this area. Service users needs are assessed prior to living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are assessed prior to admission by both the management of the home and the placing authority. The manager gathers pre-admission information to establish if the home can meet the service users’ needs; this also ensures a thorough matching process is undertaken. The manager then undertakes another assessment once the service user had been admitted to the home; this involves the service user, their relative and relevant health care professionals. The home does not admit service users for intermediate care. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use this service experience good quality outcomes in this area. All of the service users have a detailed plan of care. Service users have full access to health care professional on regular basis and when needed. Service users are protected by the home procedure on handling medication. Service users are treated with respect and their dignity is upheld. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of service users’ records were looked during the site visit. These contained written evidence of thorough assessments being undertaken by both the home’s manager and the placing authority; from these assessments detailed care plans are devised. The care plans identified areas of strength and areas which the service users needed help. Detailed recording of what action is to be taken and how to Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 10 enable the service users to lead an independent life style was provided for staff to follow. Risk assessments are undertaken around areas of falls, tissue viability, nutrition and daily living. The risk assessments were updated every month and changes made were appropriate. Risk assessments are undertaken for the use of bed rails, these are in line with Department of Health Guidelines. Care plans are reviewed monthly by the home and formally by the placing authority annually. There was written evidence within the service users’ records which indicated that they or their representative had agreed the care plans and that all interested parties are involved with reviews. Care plans include a ‘medication changes’ record and a record of any contact with GP’s and other health care professionals. Daily records are very detailed. Key workers record any input/time spent with service users and these records are checked by the registered manager. Arrangements continue to be in place to access advice and support from health service professionals through the general practitioner; there is written evidence of regular visits from the district nurse, chiropodist and optician. Medication is appropriately stored and recorded. Only staff who have received appropriate accredited medication training administer the medication. At the last inspection it was noted that medication was given to service users at the dinning room table before they had a drink. The staff were observed to administer medication to the service users appropriately and make sure no service users are at risk and that service users had drink to help them take their medication. A sample of all staffs’ signatures is now kept at the front of the medication book for reference. Staff were able to demonstrate how they treat service users with dignity and respect particularly when delivering personal care. Those service users spoken with commented positively on the competence of the staff and comments included “the girls are very good”, “the staff can’t do enough for you nothing is too much trouble”. Relatives spoken with during the site visit commented positively about the care provided comments included “this is a wonderful home it could not be better”. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience good quality outcomes in this area. Service users’ life styles at the home match their expectations. Service users’ relatives are warmly welcomed and there are no restrictions on visiting. Service users can exercise choice over their daily lives. Service users receive a wholesome, well-balanced, varied and nutritious diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans record social histories and leisure interests for service users. An activities coordinator is employed for four days per week and there is an activity programme in place. Key workers record any activities undertaken by service users in care plans, as well as visits out of the home and any visitors seen. There are five lounges in total so service users have plenty of choice, but tend to sit with service users with similar interests and capabilities. The home have recently purchased a Nintendo Wii Games consul. This has enabled some service users to be actively involved with games and activities. One service Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 12 user used to be a keen golfer and the games consul has enabled him to participate in something which is of particular interest to him, when spoken with he said “its like the real thing but without the fresh air”. There continues to be a four-week menu in operation. There continues to be notices on the dining room wall advertising the alternative choices available to the meal recorded on the menu. There continues to be two ‘sittings’ at lunchtime to ensure that there is always a member of staff available to assist those service users that need assistance. Adaptations continue to be available such as plate guards to enable service users to eat and drink independently, and special meals are provided for service users with diabetes. Service users were very complementary about the food provided comments included “the food is very good – I could not ask for better” “it’s nice and plain and simple just how I like it” “there is always plenty of tea”. The home has a dog which all service users liked, one service user said “it reminds me of my dog, he’s lovely” Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in this area. Service users and their relatives knew who to complain to and were confident these would be taken seriously. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure continue to be displayed around the home. The complaint procedure is now displayed in each service users’ room following a recent QA survey which revealed that some of the relatives did not know the home had a complaint procedure. Care staff spoken with during the site visit understood the complaint procedure and were able to describe what action should be taken if they suspected any form of abuse was occurring within the home. They confirmed that protection of vulnerable adults (POVA) constitutes part of the induction process. Service users were aware that they could approach the staff if they had any concerns or complaints. Relatives confirmed that they would approach the manager if they had any concerns and these would be taken seriously and dealt with satisfactorily. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 14 The home record complaint in a ‘niggles book’. Records showed that there had been 3 complaints received at the home since that last inspection all had achieved a satisfactory outcome. The book records what the complaint is, how the home dealt with it, what the outcome was and if the complainant was happy with this. The CSCI have received no concerns, complaints or allegation about the home since the last inspection. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in this area. Service users live in clean, safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was a victim of the recent floods and all of the ground floor was affected. As a result of this the whole home has been completely refurbished. It is credit to the management and the staff at the home that it has reopened quickly and the service users who were evacuated have returned to their home. There is plenty of communal space for the service user to choose from and this is clean well maintained and welcoming. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 16 There is a courtyard in the centre of the home and the service users use this during the summer months. There is plenty of garden space around the home and this used by the gardening club during the summer months. The home continues to have adequate laundry facilities. Service users rooms were clean and tidy some contained personal items which they had brought with them. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes I this area. Service Service Service Service users’ needs are met by the skill mix and amount of staff on duty. users are in safe hands. users are protected by the home recruitment procedure. users are cared for by staff who are trained and competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota records that there are four or five staff on duty throughout the day; there are three ‘waking’ care staff on duty during the night. Staff said that they feel there are enough staff on duty and that they usually have enough time to spend with service users. More than 50 of the care staff have achieved NVQ level 2. The staff files of the most recently recruited staff were looked at. These contained references from previous employers were possible, completed application form which identified gaps in employment history and Criminal Records Bureau (CRB) checks There is a training and development programme in place. There are appropriate arrangements in place for staff to receive induction training that Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 18 meets Skills for Care specifications. Staff spoken with on the day of the inspection had undertaken health and safety training such as moving and handling, health and safety, food hygiene, first aid and fire safety. Staff records include a record of their individual training achievements and training needed as part of short-term, medium term and long term development, including NVQ training. Various training programmes have taken place over the last year, including fire training, moving and handling, vulnerable adults, staff supervision and first aid. Future training planned includes dementia training for all staff. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. People who use this service experience good quality outcomes in this area. Service user live in a home which is run by some one who is fit to be charge. The home is run in the best interests of the service users. Service users financial rights are safeguarded. Service user and staffs health and safety are promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is currently undertaking the registered managers award, this is due to be completed by June 2008. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 20 The home has been awarded QDS parts one and two – this is the local authority quality scheme. Staff spoken with said that they attend staff meetings and that they are encouraged to contribute towards these. Surveys are sent to service users or relatives on such topics such as food. The results of these surveys are collated and there is a record of any action that needs to be taken. The outcome of these surveys is published via staff meetings and resident/relative meetings. Regular quality audits also take place. An annual service review is compiled and results of in-house surveys are recorded in this document. Some service users manage their own financial affairs; some are assisted by family members and a solicitor assists two of the service users. Records are in place for money held on behalf of service users and receipts are obtained for any expenditure or items purchased on their behalf. At the last inspection it was noted that personal allowances for service users was retained in a separate bank account and the service user did not benefit from any interest accrued. This account is no longer used and all the service users’ money is available to them. Some service users have been provided with lockable storage to ensure that their money and valuables can be held securely. All of the relevant safety and maintenance certificate are in place and there are arrangements in place to ensure safe working practices at the home, including appropriate risk assessments. The registered person does not undertake, or keep a record of, those visit required by virtue of Regulation 26 of the Care Homes Regulations 2001. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 22 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 OP36 Regulation 26 Requirement The registered person must undertake those visit as required by virtue of Regulation 26 and keep reports available for inspection. Timescale for action 01/04/08 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 OP29 Good Practice Recommendations The registered person should keep a record of dates so as to track the progress of the recruitment of employees. Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © 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 Cassandra House DS0000019656.V359441.R01.S.doc Version 5.2 Page 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. 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