CARE HOMES FOR OLDER PEOPLE
Castle Grove Nursing Home Castle Street Bampton Tiverton Devon EX16 9NS Lead Inspector
Dee McEvoy Unannounced Inspection 10:00 5 January 2006
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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 Grove Nursing Home DS0000026704.V270675.R02.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 Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Castle Grove Nursing Home Address Castle Street Bampton Tiverton Devon EX16 9NS 01398 331317 01398 331329 info@castle-grove.co.uk www.castle-grove.co.uk Mr Raymon Francis Kenny Mrs Isabelle Marjorie Kenny Mrs Susan Thomas Care Home 20 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) Category(ies) of Old age, not falling within any other category registration, with number (20) of places Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. This variation allows admission of one named person aged under 65. The maximum number of placements including that of the named person, will remain at 20. 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. 20th July 2005 Date of last inspection 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 DS0000026704.V270675.R02.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was the second inspection of the current year. The standards met at the previous inspection on 20 July 2005 were not inspected on this occasion, it is therefore recommended that the reports be read together to gain a full understanding of the service provided. The majority of inspection time was taken speaking with residents and staff. During the inspection the inspector spoke with five residents in some depth as well as meeting others around the home. One relative was also briefly spoken to. All staff on duty were spoken with, either individually or as a small group, and the providers, Mr & Mrs Kenny were also available during the inspection. The inspector toured the premises and inspected a number of records including residents’ assessments and care plans and records relating to recruitment and training. Finally, the outcome of the inspection was discussed with the providers and registered manager. What the service does well:
When residents were asked what the home did best, four said “everything” or “most things”. Residents were particularly happy with the environment and personal accommodation provided, and the food at the home was also highly commended. Admissions to the home are well managed; prospective residents’ needs are carefully assessed to ensure the home can meet their existing requirements. All residents were happy with the care they received, staff were described as “respectful”, “kind” and “helpful”. One residents said, “I can’t speak highly enough of the staff, they are marvellous.” The staff team appeared respectful and caring and had a good understanding of the residents’ needs. Residents appreciated the “easy” routine within the home, one said, “You can please yourself here”, another said, “The routine is flexible and that suits me.” The home makes great efforts to enable residents to maintain their independence and continue to be part of the local community. Staff training and development is encouraged; a high number of staff at the home have obtained National Vocation Qualifications (NVQ), ensuring that residents are in safe hands. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 6 The home is well organised with systems in place to ensure that care needs are met and records are kept up to date and are accurate. 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 Grove Nursing Home DS0000026704.V270675.R02.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 Grove Nursing Home DS0000026704.V270675.R02.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 The homes assessment process is thorough and ensures that it is able to meet residents’ needs. EVIDENCE: Individual assessments are completed by the manager prior to residents being admitted to the home to ensure their needs can be met. Pre-admission assessments were seen for two newly admitted resident which contained relevant and valuable information about the individual needs. One contained some important personal information about past life experiences, enabling staff to relate appropriately to the resident. Two recently admitted residents were spoken with; both described how they had been helped to settle in and were appreciative of the “friendly” atmosphere at the home. When asked why they had chosen the home, the inspector was told by both, “it has a good reputation”. Castle Grove Nursing Home DS0000026704.V270675.R02.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 Detailed care plans and staff knowledge ensure that residents’ health and personal care needs are met. The management of medication systems is good. EVIDENCE: There is a comprehensive care planning system in place to provide staff with the information they need to meet the needs of the residents. Care plan records were up to date and had been reviewed monthly. Risk assessments were comprehensive identifying potential hazards and action to reduce or manage the risk. One diabetic plan was looked at, this was generally well developed but did not contain guidance for staff as to what is a ‘normal’ range of blood sugar levels for that resident or what staff should do if blood glucose levels fall outside this range. The manager said that this would be reviewed and amended. During conversation staff demonstrated a good knowledge of residents’ needs and were keen to ensure that preferences were met. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 10 Since the last inspection suitable arrangements have been made to ensure the correct and safe disposal of medicines. Medicine Administration Records (MAR) were looked at and found to be accurate and up to date. Castle Grove Nursing Home DS0000026704.V270675.R02.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): These standards were met at the previous inspection. EVIDENCE: Residents were happy with the flexible routine at the home. Where possible, residents are enabled and encouraged to maintain contact with the local community; one resident told the inspector that they enjoyed getting a daily newspaper from the village, another was supported to visit their own home in the village regularly. One resident was taken to their church regularly, which was much appreciated. Residents were happy with the quality and quantity of the food provided. The dining room was ‘laid-up’ beautifully, with excellent attention to detail, for example linen napkins and condiments were available and residents enjoy a silver service at mealtimes. One resident said, “It is very nice to dine in the dining room. Very sociable.” One resident did comment that on occasion the food was not as hot as they would like, but this was an isolated comment. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 12 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 Robust procedures and well informed staff protect residents from abuse or harm. EVIDENCE: Staff spoken with were aware of their personal responsibilities with regards to reporting any concerns or incidents and were aware of the policies and procedures adapted by the home to protect residents from harm. Residents spoken with said they felt safe at the home and were confident in the staff’s ability. All said they were treated with respect. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 13 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): These standards were met at the previous inspection. EVIDENCE: All areas of the home were clean and free from unpleasant odours on the day of the inspection. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 14 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): 28 & 29 Residents are supported by skilled, experienced and friendly staff who have a good understanding of their needs. The procedures for recruiting new staff are good and offer protection to residents. EVIDENCE: Staff identified training and development as a strength of the home. The majority of staff have completed or are undertaking NVQ courses to ensure skills are developed and maintained to meet the needs of the residents. Currently 70 of staff hold NVQ 2 or above. Residents felt their needs were understood and met by a caring staff team, comments included, “Staff are very helpful, I can’t speak highly enough of them” and “The staff know me well. Many have been here a long time.” Two staff recruitment files were inspected on this occasion, including one that had not contained a reference at the previous inspection; both contained the necessary information to ensure that residents are protected. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 15 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 The home is well managed and residents and staff benefit from the experience and positive approach of the providers and manager. EVIDENCE: Many residents said that the home was well managed and that Mr & Mrs Kenny were approachable and “always ready to listen”. The registered manager has been in post for some time and, as well as being a registered nurse, has completed the Registered Managers Award (RMA). She has good support from the owners. Staff were positive about the management approach within the home, which gives a clear lead and direction to staff. Castle Grove Nursing Home DS0000026704.V270675.R02.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 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 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 3 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 17 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. 1 Refer to Standard OP7 Good Practice Recommendations It is recommended that ‘normal’ blood sugar ranges be recorded on individual care plans, with the necessary action to be taken by staff in response to outcomes. Castle Grove Nursing Home DS0000026704.V270675.R02.S.doc Version 5.0 Page 18 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
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