CARE HOMES FOR OLDER PEOPLE
Castle Bank Residential Home Castle Bank Care Home 26 Castle Bank Tow Law Co Durham DL14 4AE Lead Inspector
Gavin Purdon Unannounced Inspection 14th December 2005 11:00 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 Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Castle Bank Residential Home Address Castle Bank Care Home 26 Castle Bank Tow Law Co Durham DL14 4AE 01388 731152 01388 730891 june.pearson@x9healthcare.com 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) X9 Services Ltd Mrs June Pearson Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18th May 2005 Brief Description of the Service: Castle Bank is a care home registered to provide care (not including nursing care) and accommodation for 34 older people. The home is owned by X9 Services Ltd. The home is located in the small town of Tow Law, which is in the West of County Durham and is convenient for all the towns amenities. The home consists of an extended and adapted, two storey building. All bedrooms are currently in single use although there are three rooms which can be used as doubles should the need arise. There are an adequate number of toilets and bathrooms to meet the needs of residents; the homes owner is also considering further developments with the installation of a level access flat floor shower. There is a through floor lift to the first floor. The home has a pleasant garden to the rear, which offers views over the local countryside and the town itself. The home also has a conservatory where residents can enjoy the views when the weather is unpleasant. The home has recently developed a facility for residents with a dementia. The CSCI is satisfied with arrangements for providing this service and will amend the home’s registration as soon as possible. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. When the home was last inspected, in May 2005, the 20 key national minimum standards that require inspection at least once a year were looked at. Generally the findings of that inspection were positive The purpose of this second inspection was to follow up on progress with the small number of requirements and recommendations made in May 2005, and to confirm with residents and staff that good care was still being provided at the home. Castle Bank has 28 residents, 26 of them were at home at the time of the inspection. The inspection was unannounced and lasted 3 and a half hours. It included individual discussions, held in private, with 3 residents. All 3 of them were happy with the home and the care provided. A variety of staff were also interviewed, including the home’s registered manager, 2 senior care workers, 1 care worker, the home’s activities coordinator, and the home’s cook. All staff thought they were working in a good home that did a good job looking after its residents. Some care records were inspected. These records showed that improvements recommended at the last inspection were made. Parts of the building were looked at including public and private areas. These were clean pleasant. What the service does well:
Residents said, “You are well looked after here, better than in hospital. You get the help you need. Staff are very friendly, and that cheers you up. You can have a laugh. If you ring the bell they’re here quickly. Look at this bedroom. It’s warm. It’s clean as a new pin. The staff work hard. There’s a lot to do. We have a good cook. There’s good variety. They ask you what you want and are happy to give you it.” “Staff know you and they know your family. We have a bit of fun. You often get a good laugh. I like to join in the activities. If there’s anything on I’ll go to it. It might be just a game of bingo or a bit of chat. The meals here are fine. The staff always ask you how you like things done. The place is always kept nice and tidy.” “The activities here are good, and that cheers you up. The food’s good. Very good. Well-cooked, good variety. We have good staff. I have never had cause to complaint. In fact I don’t know of anybody that has. I’m happy with my care.” Staff said,
Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 6 “Staff are friendly and they think a lot of the residents. We’re a happy group. I would say we are a good home with a good reputation.” “Residents get good care here. It’s up to standard. The home is well run and that helps the staff. It’s a big bonus. You are shown how to do things the right way. There’s good entertainment and time spent with residents. Staff understand the residents. You respect their wishes. You listen to them. Food’s very good. There’s a lot of choice.” What has improved since the last inspection? 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. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 was not assessed during this inspection. The last inspection, in May 2005, found that residents’ benefit from having their care needs assessed, and that residents are involved in that process. EVIDENCE: Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 the following standard(s): Standards 7,8,9, &10 were not assessed in full. The last inspection, in May 2005, found that residents benefited from well developed care plans. These plans showed how best residents’ social, health and medicinal needs could be met. The care plans looked at supported the privacy and dignity of residents. EVIDENCE: The residents’ care plan files selected all contained care plans signed by residents or by their relatives. They also contained updated assessments of the risk of residents developing pressure sores. Both of these improvements were recommended at the last inspection and had been followed through by the home. The senior carer who assisted with the first part of the inspection confirmed that these improvements had been applied to all residents’ care plans and care plan reviews and not just to those inspected. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 the following standard(s): Standards 12, 13,14, & 15 were not assessed in full. The last inspection in May 2005, found that residents benefited from recent improvements to lounge and dining arrangements and an improved programme of activities, led by a coordinator. EVIDENCE: Staff and residents confirmed that the activities programme was now well established and a very successful and popular development. Staff and residents thought the changes to the ground floor lounge and dining areas of the home were a big improvement, creating warmer and friendlier areas for residents to use, compared to the previous open plan layout. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 the following standard(s): Standards 16 & 18 were not assessed. The last inspection, in May 2005, found that residents were well protected by the home’s procedures and practices for preventing the abuse of residents and for dealing thoroughly with any allegations of mistreatment. EVIDENCE: Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 the following standard(s): Standards 19 & 26 were not assessed in full. The last inspection in May 2005 found that residents benefit from a homely, attractive, and well cared for environment. EVIDENCE: Residents were very happy with the home’s clean and pleasant appearance. Access to the rear garden is via outward opening patio doors and a small outdoor paved ramp. If handrails are not practical the home needs to consider what measures are necessary to maintain the safety of residents using the ramp. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 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): Standards 27,29, & 30 were not assessed in full. The last inspection, in May 2005, found that residents benefited from being cared for by staff who are trained and competent to look after them. EVIDENCE: At the time of the inspection, 11am, 28 of Castle Bank’s 26 residents were at home. The home was staffed according to its rota, with 1 senior carer and 3 carers, 1 cook, 1 handyman, 1 cleaner, and 1 activities coordinator, on duty. Residents said that staff saw to their needs promptly and pleasantly. Staff thought that number of staff on duty, and the quality of staff, did make sure that residents were well cared for. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 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 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): Standards 33,35 & 38 were not assessed in full. The last inspection, in May 2005, found that residents were asked whether or not they were happy with their care. The inspection also found that generally residents benefited from being cared for in a home where services are well managed. EVIDENCE: Residents and staff said that the home does try to find out what residents think about their care, whether they are comfortable, and whether they would like things to be done in a different way. Staff said that they felt well supported and well managed. Staff said supervision arrangements had improved since the last inspection. Group staff meetings are held monthly. Individual supervision meetings are held every 2 months, and staff appraisals take place once a year.
Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 15 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X X Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 16 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 OP19 Regulation 23(2)(a) Requirement If handrails are not practical, the home must consider what other measures need to be in place to ensure the safety of residents using the ramped access from the conservatory to the rear garden. Timescale for action 15/03/06 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 OP33 Good Practice Recommendations It is recommended that the home should use the information it gathers from residents to publish a summary of their views and opinions about the quality of care provided at Castle Bank. Castle Bank Residential Home DS0000050707.V259785.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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