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Inspection on 18/05/05 for Castle Bank Residential Home

Also see our care home review for Castle Bank Residential Home for more information

This inspection was carried out on 18th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Verbal comments received during the inspection were positive toward the improvements being made to the building and the care services for example, "loads of changes all for the better", " the foods grand, 1st class" and " the staff are good to you and help you". The changes being made to the building internally offer improvements in the quality of the lounge area, as well as providing a smaller more comfortable dining area.

What has improved since the last inspection?

Since the last inspection improvements have been made to the homes` care planning and risk assessment processes. The home is in the process of being redecorated and of having a number of new carpets fitted. The dining area has undergone some structural alterations in order to provide increased lounge space where residents can relax. The homes` manager has also managed to appoint a full time activities coordinator who will be responsible for developing a mixed range of activities, which residents may enjoy.

What the care home could do better:

Care plans have not been signed by individual residents to show their involvement and agreement. The homes` manager has tried to encourage residents to attend meetings about what concerns them and the running of the home although attendance has not been too good. A start has also been made at ensuring all staff members receive regular supervision but again this needs to be developed further.

CARE HOMES FOR OLDER PEOPLE Castle Bank Care Home 26 Castle Bank Tow Law Co Durham DL14 4AE Lead Inspector Bill Drumm Unannounced 18 May 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. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Castle Bank Care Home Address 26 Castle Bank Tow Law Co Durham DL14 4AE 01388 731152 01388 730891OP Old age 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) X9 Services Mrs June Pearson CRH 34 Category(ies) of OP Old age (34) registration, with number of places Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th March 2005 Brief Description of the Service: Castle Bank is a care home registered to provide care (not including nursing care) and accomodation 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. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Wednesday 18th May 2005 over six hours and was carried out as part of the annual inspection process. During the inspection time was spent talking to five residents and four members of staff. We also looked around the building and examined a number of records. On this occasion none of the residents’ relatives were contacted or spoken to. What the service does well: What has improved since the last inspection? What they could do better: Care plans have not been signed by individual residents to show their involvement and agreement. The homes’ manager has tried to encourage residents to attend meetings about what concerns them and the running of the home although attendance has not been too good. A start has also been made at ensuring all staff members receive regular supervision but again this needs to be developed further. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 6 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 Care Home B54 S50707 Castle Bank V219082 180505 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 Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 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) 3 New residents are admitted only on the basis of a full assessment undertaken by people trained to do so, and to which the prospective resident or their representative have been included in the process. This process of including and involving the resident or their representative in the admission process supports them with making the decision as to where they wish to live. EVIDENCE: Each residents file contained a copy of assessments carried out by the local authority care manager prior to admission, and a copy of the homes’ own preadmission assessment. Each resident also had an up to date care plan although these were not signed by residents to indicate their agreement or involvement. Records examined for those who are self-funding contained a pre-admission assessment carried out by the homes’ manager. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 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, 9 and 10. The care planning system provides information for staff to satisfactorily meet the needs of residents. EVIDENCE: Individual care plans are available but the homes’ manager needs to ensure that residents or their representatives sign these to show their agreement with the care plan. Risk assessments were also present on individual residents’ files although a more robust use of the “waterlow score” system would improve and enhance the risk assessment process. Care plans examined contained written evidence of input from other health care professionals and each resident is registered with a local GP. The home has comprehensive policies and procedures in place for the safe handling and administration of medication and has recently adopted the Boots monitored dosage system. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 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, 14 and 15. The appointment of an activities co-ordinator should help to improve the range and choice of activities available within the home. The improvement in the layout of the dining area has created a more comfortable environment for residents to enjoy a meal. There have been improvements made to the lounge area giving residents greater choice of where they sit and relax. Friends and family members of residents are welcomed to the home and are encouraged to remain in contact with residents. EVIDENCE: Discussion with the manager, staff and residents showed that the appointment of the activities co-ordinator will greatly increase the range and choice of activities available for residents. Two residents spoken to said their relatives are always made welcome by staff when they visit the home. Both spoke positively about the care they receive saying, “ they are very good, not bossy or anything”. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 11 The dining room layout has been reviewed and changes made have helped provide a more comfortable space for residents when they are dining. Menu’s examined provided a well balanced diet for residents and the food sampled was tasty. The manager confirmed that attempts at holding residents meetings had been met with little success although it is hoped that the appointment of the activities co-ordinator will promote greater involvement of residents in the running of the home. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 12 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 and 18. The home has satisfactory policies and procedures in place for dealing with complaints as well as the protection of vulnerable adults (POVA). EVIDENCE: A complaints policy and procedure is in place and there have been no recorded complaints since the last inspection. The procedure for dealing with allegations of abuse/exploitation has been amended slightly in order to ensure that the necessary sharing of information takes place when required in order to help protect both individual residents as well as other vulnerable people. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 13 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 and 26. The standard of the environment within the home is generally good providing residents with an attractive and homely place to live. The home is clean, pleasant and hygienic. EVIDENCE: Since the last inspection a ramp has been built from the “new lounge” to the rear yard in order to help remove a trip hazard for residents. However the ramp to the garden from the conservatory must be reviewed and made safe in order to maintain the health and safety of residents. The overall environment is improving which will increase standards of comfort for service users. The home is cleaned regularly and there were no offensive odours. A team of domestic staff are employed within the home and were on duty at the time of the inspection. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 14 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, 29 and 30. Staff employed within the homeare trained and competent to do their job maintaining the safety and well being of residents. EVIDENCE: The home has achieved approximately 75 of care staff obtaining NVQ level 2 in care, which enhances the skills and knowledge of the staff and enables them to deliver a higher standard of care to the residents of the home. Staff spoken to, were positive toward self-development and in improving their knowledge. Support staff within the home are, also undertaking NVQ level 2 in support services which will also help them to achieve higher standards. Records examined show that the process for the appointment of the activities co-ordinator has followed thorough recruitment procedures thereby helping to ensure the safety of residents. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 15 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) 33, 35, 36 and 38. The registered manager is positive towards self-development to enhance her skills and abilities to provide a good standard of care service delivery to service users. Robust procedures for the safe keeping of service users money are in place. Records in general including health and safety are up to date. Staff members employed within the home do not receive regular supervision. EVIDENCE: The homes’ owner Mr Squibb is positive about seeking the views of residents and carries out monthly Regulation 26 visits to the home during which he interacts with staff members, residents and their family members. Copies of Regulation 26 visits are received by the CSCi. Records in general including health and safety are up to date. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 16 The manager stated that resident surveys have been carried out in the past but the response has been poor. The manager went on to say that it is her intention to carry out these surveys on a more formal basis, perhaps every 3 months. Individual records examined for money held on behalf of residents in the home were accurate and up to date. Since the last inspection a process for ensuring all staff receive regular supervision has been implemented, however the manager confirmed that not all members of staff have yet received a supervision session. The manager was able to demonstrate that as far as is reasonably practical the health and safety, and welfare of residents, staff and visitors to the home are maintained. Staff confirmed during discussion that they had completed training in manual handling, fire safety and 1st aid. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 17 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 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 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 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 x x 3 x 3 2 x 3 Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 18 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 OP19 Regulation 23(2)(a) Timescale for action The physical design and layout of 18.08.05 the premises must meet the needs of service users. The ramp to the garden from the conservatory must be made safe for service users. This requirement is outstanding from the last inspection. The registered person must 18.08.05 ensure that persons working at the care home are appropriately supervised. This requirment is outstanding from the last inspection. Requirement 2. OP36 18(2) 3. 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 OP7 Good Practice Recommendations It is recommended that regular reviews of care plans should include a review of residents individual waterlow score and that these reviews are retained for future reference. Where possible care plans should be signed by the individual resident or their representative. It is recommended that procedures are introduced to help B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 19 2. OP33 Castle Bank Care Home ensure service user feedback with regard to how the home is run and what improvements can be made are implemented. 3. Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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 © 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 Castle Bank Care Home B54 S50707 Castle Bank V219082 180505 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!