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Inspection on 20/07/05 for Castle Grove Nursing Home

Also see our care home review for Castle Grove Nursing Home for more information

This inspection was carried out on 20th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 said `It`s all very convenient...they look after us well`, `The staff are cheerful - we have great fun`. They commented generally on the friendly atmosphere. Residents benefit from well planned and delivered care. Their daily life is enhanced by community involvement, and good food. They and other stakeholders are able to contribute to the running of the Home through giving their views and making suggestions. Staff felt the Home was quick to admit responsibility for any weaknesses in the service, and quick to try to resolve any such problems. They felt the owners were proactive, trying to pre-empt any problems arising in the first place. The environment is very pleasant, with residents enjoying the gardens as well as their accommodation.

What has improved since the last inspection?

There were no requirements or recommendations made at the last inspection. Residents remain very satisfied with the care they receive.

What the care home could do better:

When staff files were sampled, whilst most required documentation had been obtained before employing new staff, one of the files seen had one reference instead of two. Required information must be obtained for all prospective staff.

CARE HOMES FOR OLDER PEOPLE Castle Grove Nursing Home Castle Street Bampton Tiverton EX16 9NS Lead Inspector Rachel Fleet Announced 20 July 2005 10:00hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Castle Grove Nursing Home Address Castle Street Bampton Tiverton Devon EX16 9NS 01398 331317 01398 331329 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr & Mrs Raymon Francis Kenny Mrs Susan Thomas Care Home with Nursing 20 Category(ies) of OP Old age (20) registration, with number of places Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 This variation allows admission of one named person aged under 65. 2 The maximum number of placements including that of the named person, will remain at 20. 3 On the termination of the placement of the named service user, the registered person will notify the Commission in writing and the particulars and conditions of this registration will revert to those held on the 5th February 2004. Date of last inspection 27 January 2005 Brief Description of the Service: Castle Grove Retirement and Nursing Home is in the small mid Devon town of Bampton, with the residents able to benefit from its location in this rural community. It is a mainly Georgian building, although some parts date back to Elizabethan times. There are four acres of beautiful gardens, which are accessible to residents and visitors. There are two double and sixteen single bedrooms, with one lounge/reading room and separate dining room. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were 18 residents at the Home on the day of the inspection, with another away on holiday. Mr & Mrs Kenny, as well as the Manager Sue Thomas, were present for the day. The inspector spoke individually with four residents and a relative of a resident who was too frail to speak to the inspector. Five residents and two relatives/visitors returned CSCI comment cards. The inspector also spoke with two nurses, two care assistants and a housekeeper – some as a group, some individually. Residents were very positive about the Home – some of their comments are included elsewhere. Staff clearly enjoyed working with the residents and caring for them. A high quality service was achieved through the good management systems in place for every aspect of care provision. What the service does well: What has improved since the last inspection? What they could do better: When staff files were sampled, whilst most required documentation had been obtained before employing new staff, one of the files seen had one reference instead of two. Required information must be obtained for all prospective staff. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standard 3 was not fully assessed on this occasion. Standard 6 does not apply. EVIDENCE: Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 There are clear care planning systems to fully inform staff about residents’ needs. Health needs are well met, with good multidisciplinary involvement ensuring this is achieved. Residents’ wellbeing is protected by good medication procedures. Care is offered in such a way as to ensure residents’ privacy and dignity. EVIDENCE: Care plans included social and spiritual needs. One resident said they had been consulted about their care plan. Some residents had signed their care plan reviews. Evaluations of care were reflective and useful. New nutritional risk assessments and assessments of risk of falling were carried out regularly for each resident. A resident spoke about the various health-related services they had had contact with recently (dentist, district nurse, optician, chiropody). There was multidisciplinary involvement and guidance for staff regarding resuscitation, where residents had expressed their wishes about this. A resident confirmed they had agreed to the Home looking after their medication for them. A comprehensive assessment was carried out with residents who wanted to be self-medicating. Medication stock levels were minimal. No controlled drugs were currently used, but one medication was appropriately stored as such. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 10 The Home is addressing legislated changes in disposal of medication, and the manager confirmed the medication policy would be updated as soon as details are finalised. Comment cards and those asked indicated staff respected their privacy, and that they felt treated well by staff. One resident said a door had been fitted for her (to the en suite) where there had been a curtain before. Staff were observed to be respectful yet friendly when attending to residents. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 & 15 The range of activities on offer and links with the local community enrich residents’ lives. Meals are good, offering choice and variety, whilst catering for individuals’ dietary needs and preferences. EVIDENCE: One resident particularly enjoyed the musical events organised at the Home. Residents also spoke about outings, as well as enjoying visits by the hairdresser. Some residents could have their own plot, in the gardens, to look after. One had remained part of a reading group they belonged to prior to admission, the group sometimes meeting at the Home (using the garden on occasion). Two residents went out for lunch to a local club/group during the inspection. Details of community transport were pinned on a notice board by the Home’s ‘shop’. Both comment cards from visitors were positive about their contact with the Home. One resident said staff were considerate of individuals’ needs, including the need for independence. One resident said they wanted two baths a week and were given help to do this. Staff spoke about the Home primarily being the residents’ home. There was a sense that whilst they wanted to create a family atmosphere, they would still strive to offer a skilled, professional service. A resident said the chef had attended a residents’ meeting, to discuss menus. Comment cards indicated respondents were happy with the food provided. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 12 Written menus looked balanced, and offered an interesting variety of dishes. Residents confirmed they could ask for an alternative when they wanted one. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 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 standard(s) 16 The Home has a satisfactory complaints system, with evidence that residents’ concerns are listened to and acted upon. EVIDENCE: Residents said (either directly or through comment cards) that they felt able to raise issues with staff about their care, or about any other issue they might have. The Complaints procedure was pinned on a notice board outside the dining room. Both visitors’ comment cards indicated they were aware of the complaints procedure, though neither had had to make a complaint. CSCI has not received any complaints about the Home in the months since the last inspection. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 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 standard(s) 19 & 26 The standard of the environment within and around this Home is very good, providing residents with an attractive, clean, safe and homely place to live. EVIDENCE: Residents confirmed the Home was always kept clean. They said the facilities in their own rooms suited them. They had been able to bring their own furniture, etc. with them if they wished. They spoke about jobs the handyman had done. The environment is very well maintained – both the décor internally (shared and individuals’ accommodation) and externally (the grounds around the Home). The laundry area was well managed, and machines had recommended wash programmes. Staff undertook infection control training as part of the NVQ in Care course, which all staff were undertaking or had achieved. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 Sufficient numbers of staff are employed, with an appropriate variety of training and skills, to meet residents’ needs. Recruitment procedures are not entirely robust, creating a possibility that residents’ welfare is not as fully protected as possible. EVIDENCE: Residents said the staff were very helpful, skilled, and aware of residents’ needs. In conversation with the inspector, staff evidenced they had a holistic approach to caring for the residents, and were interested in the work they did. Residents and the three visitors from whom comments were received felt staffing levels were sufficient, as did staff. One resident added that meals were served promptly, and call bells were answered quickly. One resident who was very positive about the staff (their key worker in particular), but who of late had been spending more time in their room, said they would like to see more of the staff. The owners - aware that this person’s general needs were changing - were going to look into this matter having now been made aware of it. Staff said they were not complacent, and undertook courses offered to continue to give the best care they could. They had training days on a variety of topics, in addition to any time spent on the NVQ course. One staff said they felt able to ask any questions if they were unsure about their work. Employment of agency staff is well managed. Staff files included the GSCC code of conduct and TOPSS-linked induction material where relevant. Appraisals were carried out as part of the ‘Investors In People’ programme. Staff said the various staff meetings were useful. The Home checked nursing Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 16 staff PIN cards, but was advised a more robust system would be for the NMC to verify registration status. Of three staff files checked, two were satisfactory but one did not contain all recruitment information required by regulation (in that one reference was still to be obtained). Mr & Mrs Kenny said this individual was known to the Home and therefore felt to be entirely suitable for employment, offering no risk to residents. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 38 There are excellent systems for obtaining residents’ views and involving them in the running of the Home, a variety of strategies being used. Residents’ personal monies are safeguarded by good practices. Systems are in place to ensure safe working practices and to promote the safety and health of residents. EVIDENCE: A resident said residents’ meetings (-held six-monthly) were useful, and an opportunity to suggest improvements. Another said they were always being asked for suggestions. A Focus group (a resident, a relative, the owner and two staff) meets three-monthly. The latest Residents’ meeting minutes and CSCI inspection report was pinned on a notice board outside the dining room. Both residents and others associated with the Home had been consulted for the latest ‘quality of care’ survey. The report on findings included action to be taken to address any issues identified. There was other evidence of good quality assurance systems being in place. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 18 The Home does not keep personal monies for residents. A lockable facility is provided in a resident’s room if requested, or there is a petty cash system for expenses, with residents billed in arrears for any purchases made on their behalf. Recommendations from a recent Environmental Health Officer’s visit (to fit fly screens in the kitchen and record food temperatures) had been followed up. Residents confirmed fire alarms were tested regularly, and said that smoke alarms and call bells had also been serviced recently. Fire log records showed checks were carried out at recommended intervals, apart from checks on fire exits. Mr Kenny has since confirmed that all doors on escape routes are used at least daily thus ensuring this aspect of fire safety is addressed. Recent fire training for staff, carried out by an external company, included use of equipment. Accident records were appropriately kept, with action taken as indicated by risk assessments. Staff confirmed they had received mandatory training at what was regular, recommended intervals. Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 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 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x 3 x x 3 Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 20 NA Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 29 Regulation 19(1)(b) Sched. 2. Timescale for action You must not employ a person to 31 08 05 work at the care home unless you have obtained the information & documents specified in Schedule 2. Requirement 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 Good Practice Recommendations Castle Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 Grove Nursing Home D54 D06_s26704_castlegrove_v232640 stage 4.doc Version 1.40 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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