Inspection on 19/06/08 for Castle Dene, Combe Martin

This inspection was carried out on 19th June 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

Castle Dene, Combe Martin 15/06/06

Castle Dene, Combe Martin 07/10/05

Castle Dene, Combe Martin 26/01/05

Castle Dene, Combe Martin 24/08/04

Castle Dene, Combe Martin 15/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Castle Dene, Combe Martin High Street Combe Martin Ilfracombe Devon EX34 0HS Lead Inspector Jo Walsh Unannounced Inspection 19th June 2008 10:00 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 Dene, Combe Martin DS0000022132.V366601.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 Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Dene, Combe Martin Address High Street Combe Martin Ilfracombe Devon EX34 0HS 01271 882820 01271 882820 leonard@lgoddard.wanadoo.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) Mrs Kay Jean Goddard Mr Leonard Philip Goddard Mrs Kay Jean Goddard Care Home 3 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (3), Old age, of places not falling within any other category (3) Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th June 2006 Brief Description of the Service: Castle Dene is a family-run home, which provides personal care and accommodation for three older people. It is situated in the heart of Combe Martin, and therefore offers the residents easy access to the local amenities. Castle Dene is a large terraced house with well-maintained and attractive gardens to the back of the property. A conservatory has been added to the rear of the property, which residents enjoy. Single accommodation is provided for residents on first floor of the building, which is accessed via a stair lift. The providers live on the premises. On the ground floor the communal rooms are homely and spacious. The average cost of care is £326.00 per week at the time of inspection. Additional costs, not covered in the fees, include chiropody, hairdressing and personal items such as toiletries and newspapers. Current information about the service, including CSCI reports, is available to prospective residents. Castle Dene, Combe Martin DS0000022132.V366601.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 stars. This means the people who use this service experience good quality outcomes. This inspection took place on a week day in June 2008 and lasted approximately 5 hours. During the inspection all three people who live at the home were spoken to and their views about life at the home and the care and support they receive are included throughout this report. The registered manager and provider, Mr and Mrs Goddard were available throughout the inspection and assisted in ensuring key documents were made available, such as plans of care, staff files and medication records. One of the two members of staff that are employed was present during the inspection and their views about care and support provided was also sought. Prior to the inspection the home completed an Annual Quality Assurance Assessment (AQAA), which gives us information about how the home maintains a safe environment, what training has been completed and tells us how they are reviewing their services to improve the care and support provided. This information helps to inform the inspection process. What the service does well: Castle Dene provides a homely environment for up to three people. One person living there described it as ‘’like being part of the family, much more like being in your own home than a larger home would be.’’ The registered providers and two carers ensure good quality care and support is given to individuals. They know their needs well and have developed caring relationships with each person living there. Comments from people living at Castle Dene included • We are treated like one of the family. • You couldn’t ask for better care, I would very much recommend this home. Kay and Len are wonderful so caring. The home provides a good range and choice of meals, which takes into consideration individuals likes and dislikes. One person living at the home commented ‘’ the food is very good, we all eat together as one family.’’ Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 6 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 Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 8 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 Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential new people benefit from a good admission and assessment process, which ensures that the home can meet their needs. EVIDENCE: This standard was not looked at in any detail as the providers have said they are unlikely to take any further new admissions. The previous inspection report stated ‘’ There have been no new admissions to the home for over a year. Admissions to the home are rare but appear to be well managed ensuring that the ‘stability’ of the house is maintained, which is important with only three residents. One resident said of their admission, “I felt very welcome – couldn’t have been better.” Mrs Goddard will always visit prospective residents before admission to talk about the person’s needs and the service offered by the home. It was clear from speaking with the residents and observing the care provided that their needs were understood and met by Mr & Mrs Goddard.’’ Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 10 Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals’ personal, social and health care needs are well met. EVIDENCE: All three plans of care were looked at and discussed with Mrs Goddard, who has tried to make the information more detailed so that the plans reflect the high quality of care and support individuals receive. Individuals spoken to said that the care and support they receive was very good. Comments included • We are treated like one of the family. • You couldn’t ask for better care, I would very much recommend this home. Kay and Len are wonderful so caring. One area where this could be improved is to ensure that any medication changes or new medications are clearly recorded within the plan of care. When checking medications it was noted that one medication for an individual had not been recorded on the administering records, so there was no clear audit trail. All other medication records were up to date and appeared accurate. Medications are safely stored in a locked drawer. One individual looks after and Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 12 administers their own medication. A risk assessment has been completed for this, and is included in the detail of their plan of care. People living at Castle Dene said that they were treated with respect and dignity, and practice observed reflected a caring and respectful manner form staff and the providers. Being a very small home, they can ensure that individuals get attention and one to one support throughout the day. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individuals experience a lifestyle, which meets their preference and expectations, and they are encouraged to exercise control and choice over their lives. Meals provided at the home are nutritious and balanced and offer a variety to suite individual needs and preferences. EVIDENCE: Being a very small home means that routines are flexible and fit around the needs and wishes of the individuals who live there. One person said ‘’ we can do as we please, like in your own home, I consider this to be my home and am treated very well, all my needs are met.’’ One staff member said hat the people who live at the home can choose what time the get up, what they do and are always involved in any social events and activities with the family of the providers and local village life. Individuals are encouraged to have visitors who one person said ‘’are always made very welcome, cups of tea and cake are always offered.’’ Individuals are supported to have active lives, going to local events, attending church if hey wish, and spending time at the home enjoying visitors. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 14 The home does not have a weekly menu, but offers choices each day depending on what individuals say they like and wish. One person said ‘’ the food is very good, we all eat together as one family.’’ They record what meals they have had in the diary so that they have a record of meals provided. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Castle Dene, their family and friends can be confident their views and concerns will be listened to and acted upon. EVIDENCE: The home have a stated complaints procedure and people spoken to said that they could make their concerns known and their views would be listened to. One person commented ‘‘we have no complaints here, everything is very good.’’ Neither the home nor the Commission have received any complaints about the service. Staff and the registered providers are aware of what they should do if they suspect abuse has occurred, but still should do adult protection training when Devon County Council offers this. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Castle Dene provides a clean homely and safe environment for the people who live there. EVIDENCE: During this inspection a tour was completed in all parts of the home. There is a pleasant living room, kitchen/dinning area, small quite room and large conservatory for individuals to spend time in. The providers have worked hard to provide a beautiful garden area with seating and shade for people to enjoy. All bedrooms are well furnished and personalised to suit the individual. The upstairs is accessed via a stair lift and there are grab rails to assist people to be as independent as possible. One of the bathrooms has a walk in shower to ensure that individuals personal needs can be met safely. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 17 The providers ensure that the home is well maintained, comfortable and homely. All areas were very clean and procedures are in place to ensure that infection control is not compromised. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff group are experienced and well trained and supported to ensure the needs of the people who live at the home are well met. EVIDENCE: The registered providers, Mr and Mrs Goddard, provide most of the care and support. They have two part time carers who support them during the weekday mornings and provide some cover for holidays. As they are such as small team, they have a good knowledge of individuals needs and preferred routines to ensure that care is provided in a person centred way. One carer is working towards an NVQ as part of another job she is employed in. She said that her current training has helped her to understand better the needs of elderly people, and that she believes this home provides ‘’ excellent care and individual attention for people.’’ Staff files were looked at to ensure individuals are protected by robust recruitment procedures. The providers are advised that they need to keep copies of staff members’ identifications as specified in schedule 4 of the Care Standards Act. Training was discussed and the providers have ensured that core training in health and safety is maintained. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 19 Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Castle Dene is well managed and run in the best interests of the people who live there. EVIDENCE: The registered owners have many years experience of working with older people and managing a home however neither have formal qualifications for example NVQ 4 or the Registered Managers Award. They do not intend to take any new people into the service but continue to be committed to providing a good quality home for the current people who live there. Information provide by the home prior to the inspection shows that they have up to date policies and procedures in place for most safe working practices, staff have training in these areas to ensure both they and the people they support are safe. An Infection control policy still needs to be developed. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 21 The home is now making the views of the people who live at the home into a more formal process by the use of questionnaires. This will then help them to evidence how individual views assist them to review the quality of care. Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 22 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 4 13 4 14 4 15 4 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 Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13(2) Requirement The home must ensure that all medication is recorded when administered to ensure there is a clear audit trail Timescale for action 30/08/08 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 OP18 Good Practice Recommendations It is recommended that policies and procedures for the protection of vulnerable adults be developed and training undertaken by the registered providers and staff. Policies and procedures for the control of infection are to be developed. Consideration needs to be given to ensuring that staff have access to NVQ training. The appropriate ID needs to be obtained for staff files. DS0000022132.V366601.R01.S.doc Version 5.2 Page 24 2. OP26 3. OP28 4. OP29 Castle Dene, Combe Martin Castle Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Dene, Combe Martin DS0000022132.V366601.R01.S.doc Version 5.2 Page 26 - 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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