Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 07/10/05 for Castle Dene, Combe Martin

Also see our care home review for Castle Dene, Combe Martin for more information

This inspection was carried out on 7th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Residents view the home as "home". The residents are seen as part of the family and treated as such. The home has a comfortable feel and residents appeared relaxed and at ease. One resident told the inspector, "They are very caring people. This is a lovely place." One centurion said their wonderful age was " due to the good care. Come to Castle Dene live to be 100!" The owners and two part time staff have worked together for many years at the home. The owners are very involved in the day-to-day care of the residents and demonstrated a clear understanding of their needs. They ensure the well-being and comfort of the residents and treat them with great respect and kindness. The home offers a pleasant and well-maintained environment for residents.

What has improved since the last inspection?

The owners have worked hard and invested considerably to ensure that the home is safe for residents and fire safety requirements are met. Devon Fire and Rescue (DF&R) have liaised with and advised the owners and are to visit to confirm compliance with fire regulations. Since the last inspection the system for recording medication has improved, reducing risks.

What the care home could do better:

Little progress has been made to improve record keeping and ensure that essential records are kept and up-dated regularly. Residents` assessments and care plans must include more detail, to better reflect the actual standard of care given. The owners and their staff require training to ensure that the standard of care is maintained and that their skills and competencies are up dated as needed.

CARE HOMES FOR OLDER PEOPLE Castle Dene, Combe Martin High Street Combe Martin Ilfracombe Devon EX34 0HS Lead Inspector Dee McEvoy Unannounced Inspection 7 October 2005 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.V253437.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 Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Castle Dene, Combe Martin Address High Street Combe Martin Ilfracombe Devon EX34 0HS 01271 882820 01271 882820 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.V253437.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6 May 2005 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. Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection of the current year and was undertaken in a little over four hours. The inspector spent time with each resident, talking about life in the home. All three residents told the inspector that they were very happy living at the home and complimented Mr & Mrs Goddard and the staff for all their ‘care and kindness’. During the inspection the residents were observed to be at ease moving around the home and happily occupied in their chosen way. The inspector looked around the home, which was extremely clean and comfortable. A number of records were inspected, including residents’ care notes. Mr & Mrs Goddard were not available for the early part of the inspection but arrived home by lunchtime. One member of staff was on duty in their absence. Since the last inspection the registration process was been completed and the home is now registered as a care home for older people rather than an adult placement. What the service does well: What has improved since the last inspection? The owners have worked hard and invested considerably to ensure that the home is safe for residents and fire safety requirements are met. Devon Fire and Rescue (DF&R) have liaised with and advised the owners and are to visit to confirm compliance with fire regulations. Since the last inspection the system for recording medication has improved, reducing risks. Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 6 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 Dene, Combe Martin DS0000022132.V253437.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 Dene, Combe Martin DS0000022132.V253437.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): 3 Little progress has been made to improve the home’s initial assessment procedure, which does not always ensure accurate information is obtained prior to people moving into the home. Without detailed information assurance cannot be given that care needs can be met. EVIDENCE: There has been one new admission since the last inspection; the resident told the inspector that they had known about the home before their admission and that it had a “good” reputation locally. The resident was confident that the home could meet their needs, she said, “I was made to feel very welcome. Everyone is so kind.” A pre-admission assessment had not been completed prior to the resident being admitted. This was a previous requirement and the providers are aware that they must develop pre-admission assessment documentation for residents. Castle Dene, Combe Martin DS0000022132.V253437.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): 7&9 Residents are looked after well in respect of their health and personal care needs but care plans and risk assessments must be developed and reviewed to reflect residents’ current and emerging care needs. The management of medication has improved. EVIDENCE: No progress has been made on the requirement to ensure that all aspects of health, personal and social care needs are identified and planned for; individual care plans remain basic with limited detail. A record of significant events is kept in the diary although daily records are not routinely kept. The quality of record keeping does not reflect the actual quality of the care given to the residents at this home. Basic risk assessments have been completed in respect of mobility, personal care abilities, allergies and medication for two residents but need further development to ensure the action to be taken to reduce risk is recorded. Some improvement was seen with the management of medication; simple records were available which recorded medication coming into the home and medication being administered to the residents. Training dates for the safe management of medicines are to be confirmed with the commission. Castle Dene, Combe Martin DS0000022132.V253437.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): These standards were met at the last inspection. EVIDENCE: Castle Dene, Combe Martin DS0000022132.V253437.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): 18 In order to protect residents from harm, staff would benefit from adult protection training and policies to guide them. EVIDENCE: A copy of the ‘Alerter’s Guide’ produced by the local Adult Protection Unit has been obtained in order to ensure that the correct procedures are followed in the event of any allegations or suspicion of abuse, however, the relevant polices and procedures for adult protection including a whistle blowing policy are yet to be developed. A date for adult protection training for staff is to be confirmed with the commission, as this is an outstanding requirement. Residents said they were treated well by staff and that they felt safe at the home; all expressed their confidence in the staff and Mr & Mrs Goddard. Castle Dene, Combe Martin DS0000022132.V253437.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): 25 & 26 The standard of the environment within this home is good providing residents with an attractive and homely place to live. Progress continues to ensure that the home is safe for the residents and staff but some radiators may still pose a risk. EVIDENCE: Radiators in the home are not covered or guarded; however the temperature of radiators is controlled individually. Some radiators in bedrooms were located behind items of furniture, which lowered the risk to residents. Risk assessments regarding the radiators have not been completed; where identified, covers for those radiators that pose a risk are to be provided. This is an outstanding requirement. The home does not have policies and procedures in respect of infection control but good standards of hygiene are maintained and the home was exceptionally clean. Castle Dene, Combe Martin DS0000022132.V253437.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): 27, 28, 29 & 30 Residents’ needs are well met by the owners and staff who are caring and experienced. Access to relevant training will consolidate experience and ensure that current best practice is maintained, which will benefit the residents. EVIDENCE: A staff rota has not been kept as required at the last inspection. The two care staff generally have set mornings to work and Mr & Mrs Goddard live on the premises providing 24-hour cover and support. The owners were advised that an accurate recorded rota must be kept, which should clearly identify which staff are on duty at any time of the day and night and in what capacity they are working. This is particularly necessary for when the owners are out or, as recently, away on holiday. Enhanced CRB checks had been completed for staff however other relevant information and documentation, such as ID, had not been obtained. Training has been planned since the last inspection and was due to start late October. Confirmation of training dates is to be sent to the commission. The inspector was told that all mandatory training should be completed by December 2005. Access to NVQ was discussed and the owners are aware of the National Minimum Standard. Castle Dene, Combe Martin DS0000022132.V253437.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): 31, 33, 35 & 38 The management of the home is open and inclusive and residents feel able to voice their opinions and preferences. Improvements have been made to ensure that a safe environment is maintained for residents; the planned staff training will promote safe practice. EVIDENCE: The owners have planned training in order to update knowledge, skills and competencies; dates are to be confirmed. Residents are consulted on various issues of daily life within the home; this was observed during the inspection with residents being consistently offered choices. A formal quality assurance system has not been implemented but will ensure that standards are maintained and that the service develops according to the needs and expectations of the residents. Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 15 The owners are not involved with any financial matters on behalf of the residents. Mr & Mrs Goddard have worked with Devon Fire & Rescue (DF&R) to ensure that the home complies with regulations and is safe for residents. Fire doors, a fire detector system and emergency lighting have been installed since the last inspection. DF&R are happy with the current standard and will inspect the premises again to ensure compliance. The inspector was told that all mandatory training should be completed by December 2005. The owners are to send confirmation of training dates to the commission. Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 16 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 1 X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 2 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 2 X X X X X X 1 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 1 Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 17 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 OP3 Regulation 14 (1) (a) (c) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so (a) The needs of the service user have been assessed by a suitably qualified or suitably trained person;(c) There has been appropriate consultation regarding the assessment with the service user or a representative of the service user.This refers to the need to ensure that all service users have an assessment of needs, prior to admission, that it is kept under review, and revised as necessary.(Previous timescale of 23/3/05 and 1/7/05 not met) Timescale for action 02/12/05 Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 18 2 OP7 15 (1) 3 OP18 13 (6) 4 OP25 13 (4) (a) 5 OP27 17 (2) Schedule 4 (7) Unless it is impracticable to carry out such consultation, the registered person shall, after consultation with the service user, or a representative, prepare a written plan (service user’s plan) as to how the service user’s needs in respect of his health and welfare are to be met.This relates to care plans. All service users to have an individual care plan.(Previous timescale of 23/3/05 & 1/7/05 not met) The registered provider shall make arrangements, by training staff or other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse.This relates to staff training.(Previous timescale of 26/5/05 & 2/9/05 extended due to over subscription for this training.) The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety.This relates to the need to ensure risk assessments are completed with regrard to pipework and radiators and action is taken to reduce identified risk. (Previous timescale of 23/3/05 & 5/8/05 not met) The Registered person shall maintain in the care home the records specified in Schedule 4.A copy of the duty roster of persons working at the care home, and a record of whether the roster was actually worked.(Previous timescale of 23/3/05 & 1/7/05 not met) 02/12/05 24/02/06 18/11/05 02/12/05 Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 19 6 OP33 24 (1) (a) (b) 7 OP38 18 (1) (c) (i) 8 OP38 13 (4) The registered person shall 24/02/06 establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home.The home must develop quality assurance systems (Previous timescale of 26/5/05 & 1/7/05 not met). The registered person shall, 30/12/05 having regard to the size of the care home, statement of purpose and number and needs of the service users ensure that the persons employed by the care home receive training appropriate to the work they are to perform.This relates to mandatory training such as safe manual handling, fire safety, food hygiene and infection control. (Previous timescale of 23/2/05 23/3/05 29/4/05 & 1/7/05 not met) The registered person shall make 30/12/05 suitable arrangements for the training of staff in first aid. (Previous timescale of 26/5/05 &2/9/05 not met) 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 2 Refer to Standard OP7 OP9 Good Practice Recommendations It is recommended that risk assessments be developed further, for each resident, in order to identify and reduce hazards. It is recommended that staff administering medicines receive the appropriate training. Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 20 3 4 5 6 7 OP18 OP26 OP28 OP29 OP30 Policies and procedures for the protection of vulnerable adults is to 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. It is recommended that staff receive training appropriate to the work they are to perform. Castle Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Dene, Combe Martin DS0000022132.V253437.R01.S.doc Version 5.0 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. 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!