CARE HOMES FOR OLDER PEOPLE
Castle Donington Nursing & Residential Home Delven Lane Castle Donington Derbyshire DE74 2LJ Lead Inspector
Mrs C A Burgess Unannounced Inspection 10:00 19 December 2005
th 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 Donington Nursing & Residential Home DS0000032271.V261545.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 Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Castle Donington Nursing & Residential Home Address Delven Lane Castle Donington Derbyshire DE74 2LJ 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) 01332 853588 01332 853465 Rushcliffe Care Limited Francis Halili Martir Care Home 60 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (30), of places Physical disability over 65 years of age (60), Terminally ill (3) Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Ground Floor The ground floor may accommodate no more than 30 service users who fall within category OP (older persons), PD(E) (older persons with a physical disability and TI (terminal illnes) of which 15 service users are accommodated in the Eaton Unit also located within the ground floor. Ground Floor No person falling within category TI (terminal illness) may be admitted to the home (ground floor) where there are 3 persons of category TI already accommodated within the home. Ground Floor Within the Eaton Unit the home may accommodate up to 15 service users of which up to 8 service users in total who fall within category PD (physical disability) may also be accommodated. Ground Floor Within the Eaton Unit the home may accommodate up to 8 persons between the ages of 45 and 65 years who have a diagnosed degenerative neurological disorder and fall within category PD. Ground Floor Within the Eaton Unit the home may accommodate up to 2 persons between the ages of 35 and 45 years who have a diagnosed degenerative neurological disorder and fall within category PD. Ground Floor The service provided to persons asdmitted to the home who fall within category PD must be in accordance with the Home Statement of Purpose as submitted to the CSCI on 12 August 2004. First Floor The first floor may accommodate no more than 30 service users who fall within the category/combined categories PD,DE. First Floor No one may be admitted to the first floor who falls within category PD (physical disability) unless they also fall within category DE (dementia). First Floor No one may be accommodated on the first floor under 55 years of age. To be able to admit the named service user, aged 44 years named in variation application number V21817 2. 3. 4. 5. 6. 7. 8. 9. 10. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 5 Date of last inspection 19th October 2005 Brief Description of the Service: Castle Donington Nursing & Residential Care Home is purpose built on two floors, and can accommodate residents over 55 years with dementia, a physical disability or terminal illness, within a safe environment. There is a separate unit, within the home, for eight residents with a diagnosed neurological condition (35 years and above). Trained nurses and care assistants staff the home, with a trained nurse on duty at all times. All residents’ rooms have en-suite facilities and there are additional toilets and assisted bathing facilities. There are a number of pleasant, separate sitting rooms and dining areas throughout the building and a safe enclosed garden. All areas of the home and garden, accessible to the residents, are ‘wheelchair friendly’, and there is a passenger lift to the first floor. The home is situated in the pleasant village of Castle Donington, on the boarders of Leicestershire, Nottinghamshire and Derbyshire. Village amenities are close by with local buses to nearby towns of Coalville, Ashby-de-la- Zouch and Loughborough. There are car-parking facilities next to the home. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over four hours. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff, residents and their relatives and visitors. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they receive through a review of their records, discussion with their relatives (where available), the care staff and observation of care practices. Many of the residents were seen during the inspection. Five of the residents’ relatives, spoken with gave the Inspector their impressions of the home. What the service does well:
Castle Donington provides safe and supportive care for residents within the nominated categories. The home has many adaptations to assist with care and to help residents achieve their optimum independence, and exercise personal choice within their capacity to do so. The home is well managed by the Registered Manager. Care planning and risk assessment are detailed to ensure that the residents’ health and welfare needs are met. Staff relationships with residents and their relatives are excellent - sharing information through regular residents/relatives meetings and on an individual basis - demonstrating care, patience and understanding of each resident’s individual care needs. The standard of care is high, and the home is clean and well maintained and has a cheerful and busy atmosphere. Five visitors said that their relatives were very well cared for; that the standard of care and cleanliness in the home was high; that the food was very good and well presented, and they were welcomed and well supported by the staff. Relatives said that staff always smiled, that they were consulted and kept informed and were included in the care planning process for their relative. One relative commented that staff treat all of the residents with a high degree of dignity and respect. The home continues to provide a very high standard of care for the residents for which all of the staff are to be commended. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The admission process is well managed and residents receive a comprehensive assessment, thereby ensuring that their health and welfare needs are being met. EVIDENCE: In the three residents’ files reviewed during the inspection the pre-assessment process, completed by either the Senior Manager or the Registered Manager, both of whom are experienced and well qualified nurses, was detailed and reflective of the health, welfare and social needs of prospective residents. The remaining standards were inspected in October 2005 and found to be met. Standards 1 & 4 were commended. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 10 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, 8 & 10. Residents are well looked after in respect of their health and personal care. EVIDENCE: Individual care plans were detailed and comprehensive to ensure that the residents’ needs were fully met. Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity. Residents’ room are locked when residents are elsewhere to ensure that other residents, who are confused, do not have access. Staff were seen to be kind and patient and treat the residents in a respectful, friendly and supportive manner. Five residents’ relatives spoken with said that staff are respectful, patient, very caring and kind and smiled a lot, which reassured residents and made relatives feel welcome. One relative specifically commented that staff treated all of the residents with dignity and respect. The remaining standards were inspected in October 2005 and found to be met. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13. The staff work very hard to ensure that residents experience a safe, homely life style. EVIDENCE: The home has a routine, which includes specific meal times and activity timetables. Routine is important to the specific client group of residents at Castle Donington, many of whom are unable to be consistent in their choices and tend to be very forgetful and confused. There is an Activities Organiser who arranges a weekly programme of activities, suited to the residents’ particular needs and abilities. There is an entertainments committee that includes relatives and staff. Additional outside entertainment is arranged. Relatives said that they could visit at any time. There are celebrations throughout the year at Christmas, Valentines Day, and Easter etc; this enables residents and their relatives to enjoy seasonal and community activities. Birthdays and special days are celebrated. The staff and relatives had worked together to provide beautiful Christmas decorations throughout the home for the residents, which demonstrates the
Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 12 partnership approach to care promoted by the Registered Manager and staff, for which they should be commended. The remaining standards were inspected in October 2005 and found to be met. Standards 14 & 15 were commended. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. Arrangements for receiving and responding to complaints are sound resulting in satisfactory protection of residents’ rights. EVIDENCE: The home’s complaints process reflects the government’s adult protection guidelines, set out in the No Secrets’ publication. Staff are aware of these procedures and receive relevant training. Complaints and concerns made to the home are dealt with appropriately. The CSCI have not received any complaints relating to the home. The remaining standards were inspected in October 2005 and found to be met. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. A comfortable, clean and safe standard of accommodation is provided for the residents. EVIDENCE: The home is safe and well maintained with many adaptations to suit residents’ specific needs. It is decorated and furnished to a high standard which creates a comfortable and homely environment, and there is a system of maintenance and refurbishment. Resident’ rooms were clean and well decorated. Residents are able to bring items of their own furniture and possessions with them to personalise their rooms. Many rooms were personalised with photographs, posters and ornaments etc. All rooms have en suite facilities and there are additional toilet, bathing and assisted bathing facilities.
Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 15 The home is responsive to the specific requirements of individual residents and their relatives, where additional space and privacy is required. On the day of inspection all areas of the home were clean and maintained to a high standard, which was commented upon by all of the relatives spoken with. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. Staff at the home are sufficient in numbers to meet the residents’ needs. EVIDENCE: Staffing levels, at the point of inspection were satisfactory and in accordance with that indicated by the Department of Health Residential Forum Guidelines, and were sufficient to meet the resident’ needs. The home employs a mixed staff group consisting of Registered Nurses and care staff, supported by domestic, catering and maintenance personnel. There are always qualified nurses on duty, day and night to ensure that the residents’ nursing needs are met. Staff have a positive, proactive and committed attitude towards the care of the residents. Relatives said that the staff were capable and caring, and both relatives and staff said that they felt that there are sufficient staff on duty to meet the needs of the residents. Rushcliffe Care Limited, Epinal Way Care Centre undertakes the recruitment process centrally and this is inspected when inspecting the care homes at the Epinal Way Care Centre. The remaining standards were inspected in October 2005 and found to be met. Standard 30 was commended.
Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33 & 38. The Registered Manager is a trained nurse, and is knowledgeable, experienced and professional, and effectively supervises staff and manages the home to protect the rights and needs of the residents. EVIDENCE: A Senior Manager is in day-to-day contact with the home. The Registered Manager is a Registered Nurse and has many years of experience and is well supported by a professional senior care staff team. He should be commended for his professionalism, cheerful demeanour, energy and positive attitude towards improving the care for the residents, which has been noted and much appreciated by the residents’ relatives. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 18 There is an ethos of openness in the home; staff are friendly, helpful and very caring towards the residents, their relatives and each other. Health & Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed, to assure the health and safety of the residents and staff. The remaining standards were inspected in October 2005 and found to be met. Standard 36 was commended. Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 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 X X 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 X 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X X X X 3 Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 20 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Castle Donington Nursing & Residential Home DS0000032271.V261545.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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