Inspection on 10/12/07 for Castle Court Nursing Home

This inspection was carried out on 10th December 2007.

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.

Other inspections for this house

Castle Court Nursing Home 25/08/10

Castle Court Nursing Home 16/06/10

Castle Court Nursing Home 19/11/09

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Castle Court Nursing Home Margrove Road Boosbeck Saltburn-by-Sea TS12 3BL Lead Inspector Val Daly Unannounced Inspection 10th December 2007 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 Castle Court Nursing Home DS0000070196.V356485.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. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Court Nursing Home Address Margrove Road Boosbeck Saltburn-by-Sea TS12 3BL 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) 01287 653990 01287 651600 Continuum Healthcare Limited Mrs Angela Moody Care Home 38 Category(ies) of Dementia (19), Old age, not falling within any registration, with number other category (19) of places Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP, maximum number of places 19 2. Dementia, Code DE - maximum number of places, 19 The maximum number of service users who can be accommodated is: 38 Date of last inspection Brief Description of the Service: Castle Court is a care home that provides nursing and personal care for up to 38 service users. In July 2007, Continuum Health Care Limited purchased the home. It is situated in Boosebeck on the outskirts of Guisborough and Skelton. A bus service is available to transport people locally. The building is a conversion and was formally a school. There are panoramic views of the Cleveland Hills and surrounding countryside. The home is a two storey building and there is a passenger lift. The new proprietor is in the process of making some changes to the home for all the bedrooms to be for single occupancy. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key unannounced inspection and was completed in one inspection day, by a Regulation Manager and an Inspector. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. A number of records were looked at including resident’s assessments and plans of care, staff recruitment records, complaints and maintenance records along with the annual quality assurance assessment. Two residents, two relatives, three members of staff and the deputy manager, were engaged in discussion about living at Castle Court. The manager had completed an Annual Quality Assurance Assessment prior to the inspection. The AQAA is the Registered Person’s own self-assessment of the service and care that is provided. The information was detailed and comprehensive. On the day of the visit the manager was on sick leave and the deputy manager provided the information and documentation required. The Commission for Social Care Inspection sent a number of questionnaires to the home for residents to complete. Seven were returned from residents and relatives. Comments received can be read within the report. This was a positive inspection, in which the Regulation Manager and Inspector was warmly welcomed by all. Feedback was well received and there was constructive discussion throughout. What the service does well: Castle Court provides a clean, pleasant and well-maintained home for people to live. It provides the residents with a comfortable and homely environment, offering a good standard of care to the residents. Relative comment cards stated ‘I am very pleased with all aspects of care provided and availability of staff when needed’, ‘The staff are good, I am pleased with the care and support given to my relative’, The staff in the home are excellent and have been there since my relative went into the home, which shows commitment’, ‘Staff appear friendly and caring’, ‘The matron appears to be a very ’hands on’ person and knows each resident personally’. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 6 The home is a large part of the community and all visitors are made welcome. Relatives are involved in the home and a large number attend activities/entertainment. Activity Co-ordinators provide a variety of activities in the home, games of cards, dominoes, bingo, quizzes, entertainment for the residents to join in with if they wish. On the day of the inspection there was a party with entertainment in the main lounge area. Residents and relatives were enjoying listening to and joining in with singing. Some of the relatives had brought in some food for a buffet tea and kitchen staffs were busy preparing more. The menu showed that a variety of food is offered to residents and more alternatives are available. Two resident’s spoken to say they enjoyed the food and were given choices by staff prior to the meal being served. They also said if they did not want the main meal an alternative would be offered. 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. The summary of this inspection report can be made available in other formats on request. Castle Court Nursing Home DS0000070196.V356485.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 Castle Court Nursing Home DS0000070196.V356485.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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their needs assessed. EVIDENCE: Assessments are carried out by Care Managers prior to a resident moving into the home to ensure their needs can be met. The manager also carries out her own assessment, meeting with the prospective resident, either in his or her own home or in hospital. This information in the four resident’s files viewed was comprehensive and covered all areas of needs. Two residents interviewed informed the inspector during discussion that their relatives had visited the home before they moved in. Relative comment cards stated that they had enough information before deciding if the home was right for their family member. The home does not provide intermediate care. Castle Court Nursing Home DS0000070196.V356485.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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Four care files were examined and they each contained an individual plan of care. The plans were evaluated and reviewed regularly. Information was also included regarding the resident’s former occupation, children, favourite memories, religion, likes and dislikes of food and hobbies and medical history. There was evidence that the resident’s health care needs were being met. Risk assessments were in place where needed, for one resident, risk of falling, and use of wheelchair straps. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. For residents wishing to manage their own medication a risk assessment and management process was in place. Staffs who administer medication were either qualified nurses or they had received Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 10 training. This was confirmed in staff training records and during staff interviews. Residents interviewed said the staffs were kind and respectful. Relative comment cards stated ‘I am very pleased with all aspects of care provided and availability of staff when needed’, ‘The staff are good, I am pleased with the care and support given to my relative’, The staff in the home are excellent and have been there since my relative went into the home, which shows commitment’, ‘Staff appear friendly and caring’. The matron appears to be a very ’hands on’ person and knows each resident personally’. Castle Court Nursing Home DS0000070196.V356485.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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use services are able to make choices about their lifestyle. A variety of food is offered. EVIDENCE: Activity Co-ordinators provide a variety of activities in the home, games of cards, dominoes, bingo, quizzes, entertainment for the residents to join in with if they wish. On the day of the inspection there was a party with entertainment in the main lounge area. Residents and relatives were enjoying listening to and joining in with singing. Some of the relatives had brought in some food for a buffet tea and kitchen staffs were busy preparing more. The home has a secure garden area for the residents to enjoy in the better weather. One resident and his relatives are involved in the planting of shrubs and flowers. Two residents interviewed during the inspection said they ‘enjoyed looking out into the garden area, and sitting outside in the summer’. Residents also have outings and one resident said ‘he had been taken to Stewart Park and had a lovely time’. Religious services take place in the home and residents are able to receive communion if they wish. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 12 Two relatives interviewed said they visit most days and are always made to feel welcome. The menu showed that a variety of food is offered to residents and more alternatives are available. Two resident’s spoken to say they enjoyed the food and were given choices by staff prior to the meal being served. They also said if they did not want the main meal an alternative would be offered. Timing of meals had recently been changed with tea being served at 4pm instead of 5pm. Two residents and relatives interviewed said they felt that tea was served too early and they weren’t ready for another meal. The majority of residents eat their meals in the dining areas but they are able to eat in their rooms if they wish. Castle Court Nursing Home DS0000070196.V356485.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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know how to complain and the home has an appropriate procedure in place. Training for staff in adult protection has taken place, keeping residents safeguarded. EVIDENCE: Two residents and two relatives interviewed said that they would be comfortable speaking to a member of staff if they had any concerns. The home has a complaints policy and procedure in place. However this requires updating to include details of the Contracts and Commissioning department of the Local Authority and the Primary Care Trusts. There had been one complaint made to the home since the previous inspection. Records showed that the complaint was investigated promptly and there were written reports of action taken in place. Following the outcome of the investigation the complainant was asked if they were satisfied or not. The home has a whistle blowing policy and an adult protection policy in place. There was evidence in the staff training file to show that staff had received training in Adult Protection’. During interviews with staff they confirmed they had received training were aware of the procedure to follow in the case of suspected abuse. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 14 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Castle Court is comfortable homely and well maintained. EVIDENCE: A tour of the home was carried out. Resident’s bedrooms contained personal possessions and were comfortable and homely. The new proprietor of the home was in the process of making some changes in the home. A ground floor office had been made into a bedroom and double bedrooms changed to become single rooms. The changes also included the dining room on the first floor being altered to become bedrooms. Subsequently the lounge on the first floor was also being used as a dining area. There must be evidence to show that there is sufficient communal space, which meets the national minimum standards, for the residents who live on the first floor. The Deputy Manager advised that Fire Safety have visited the home since the changes have been made and did not have any concerns. Relatives interviewed commented that Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 15 they felt the residents were crowded in the lounge with the extra dining furniture. The home was clean and odour free. A relative comment card stated that ‘ the home is always clean and smells fresh, no stale smells’. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 16 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 the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The vetting and recruitment practices are robust. Staffs is trained and qualified and relevant information that safeguards residents’ is in place. EVIDENCE: The home has a rota in place, which is flexible for the needs of the residents. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. However out of the four staff files examined only one contained a statement of terms and conditions relating to the current proprietors. This issue was discussed with the deputy manager who advised that the proprietors were in the process of issuing new staff terms and conditions. The home uses the Skills for Care Induction Standards for new staff. There is a training plan in place and since the previous inspection staff had undertaken training in many areas such as NVQ 2 and 3, Adult Protection, Fire Safety, Safe Handling of Medication, Continence Care, Crisis Management, Infection Control, Dementia Care and the Mental Capacity Act. At the time of the inspection 72 of the carers had achieved NVQ level 2 or above in care. Whilst staffs receive training in many aspects of care regularly, the training records need to reflect this. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 17 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, 36 & 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home regularly reviews aspects of its performance through a good programme of self-review, which include seeking the views of residents, staff and relatives. Finance systems are robust. EVIDENCE: Both the manager and deputy manager are qualified nurses, experienced and competent to run the home. The deputy manager said that the proprietor visits the home regularly and reports on many aspects of the home, the building, care records, health and safety. Surveys are sent out annually to residents to seek their views about life in the home. An action plan is formulated where any issues or concerns are raised. Resident and staff meetings are held regularly and minutes are kept. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 18 Records showed that whilst formal supervision for staff takes place this was not up to date. Resident’s finances and records were kept appropriately with signatures in place. Documentation showed that water temperatures are taken weekly and was within the recommended range. The manager completes a summary of accidents, which are analysed monthly. Staffs receive regular training in Health and Safety and there is a full training plan in place. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 19 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 X X 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 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 3 Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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) (g) Requirement Following the changes to the lounge/dining areas on the first floor, there needs to be evidence to show that the communal areas meet the National Minimum Standards. This is required to safeguard the people who use the service. Care staffs are required to receive formal supervision at least six times a year. This is required to safeguard the people who use the service. Timescale for action 31/01/08 2. OP36 18 (2) 31/01/08 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 All staff should have a statement of terms and conditions relating to the current provider. Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Darlington Area Office 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 Castle Court Nursing Home DS0000070196.V356485.R01.S.doc Version 5.2 Page 22 - 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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