Inspection on 22/09/05 for Castle Keep Nursing Home

This inspection was carried out on 22nd September 2005.

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

Other inspections for this house

Castle Keep Nursing Home 24/02/10

Castle Keep Nursing Home 03/05/07

Castle Keep Nursing Home 07/02/06

Castle Keep Nursing Home 08/03/05

Castle Keep Nursing Home 31/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Staveley Birk Leas Nursing Home

Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Castle Keep Nursing Home Noddle Hill Way Sutton on Hull East Yorkshire HU7 4FG Lead Inspector Eileen Engelmann Unannounced 22 September 2005 nd 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 Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Castle Keep Nursing Home Address Noddle Hill Way Sutton on Hull East Yorkshire HU7 4FG 01482 879334 01482 835651 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) Barchester Healthcare Plc Mrs Janet Cooper Care Home with Nursing 58 Category(ies) of PD(E) Physical Disability over 65 (58) registration, with number PD Physical Disability (8) of places DE(E) Dementia over 65 (58 OP Old Age (58) TI(E) Terminally Ill over 65 (58)) Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 8th March 2005 Brief Description of the Service: Castle Keep is a purpose built, single storey building providing nursing and personal care for male and female service users (over the age of 65) and for those who are terminally ill. The home is also registered to take up to six people under the age of 65. The home has up to fifty-eight placements within single and double room accommodation. Service users have the choice of two lounge/dining rooms in which they can relax and enjoy the company of others. The home provides an additional lounge for those service users who like to smoke. An activities organiser is employed, who will see each individual to discuss their interests and hobbies and arrange outings on the homes minibus. Service users also have access to the spacious grounds at the home, which are designed to be accessible to those in wheelchairs and with mobility problems. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the unit manager; staff, and residents of Castle Keep Care Home. The inspection took 4 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. One of the staff on duty and three of the residents were spoken to; their comments have been included in this report. What the service does well: What has improved since the last inspection? What they could do better: The home has met all the standards assessed at this inspection and has exceeded the minimum requirements in many areas. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 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 Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 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 Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 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) 3. The needs assessment process at the home is robust and thorough, enabling residents to be confident that their needs can be met by the service. EVIDENCE: Each resident has their own individual file and all five of those looked at had a full needs assessment completed within them. The information from the assessment process is used to formulate the individuals care plan. The unit manager said that she visits all prospective residents before they are offered a place at the home, so she can also assess their needs. She takes them a statement of purpose for the home and a service user guide, so each individual has information about the home and knows what to expect from the service. Three residents spoken to were able to give detailed information about their care needs and the input they required from the staff, service and outside professionals, and this was found to be accurately documented within their care plans. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 9 Those residents at the home who receive nursing care have undergone an assessment by a NHS registered nurse from the Health Authority, to determine the level of nursing input required by each individual. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. Residents are encouraged to be independent within their daily lives using a risk assessment approach to care. EVIDENCE: Individual care plans are in place for all residents and clearly set out the health, personal and social care needs identified for each person. Five plans were looked at and all have been evaluated on a monthly basis, any changes to the care being given is documented and implemented by the staff. The care plans are well written and include detailed information about the needs and expectations of the residents and the care being given on a daily basis. Risk assessments around daily activities of living have been carried out and are recorded, where appropriate, within the individual resident’s plan. Two residents receive wound care, and the process is carefully documented in the plan, with information detailing the healing taking place and the progress being made. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 11 Three residents said that they are aware of their care plans and are able to input to the records through talking to their key worker and attending reviews with their Social Worker and family (where applicable). Three residents said that they have good access to their GP and staff are very efficient at arranging visits, they also enjoy regular input from the local dentist, chiropody service and optician. Information in the care plans indicates that outside professionals are contacted on an as and when needed basis including the Parkinson’s Nurse, Macmillan nurses and dieticians. The residents have regular access to a physiotherapist (provided by the home), who was attending to individuals on the day of the inspection. Risk assessments were seen in the care plans regarding development of pressure sores and include the necessary interventions as part of the plan of care. There is a wide range of pressure relieving equipment available for care of the residents and this includes specialist beds, mattresses and cushions. The home has a number of hoists and moving/handling aids in place to assist the staff in carrying out the necessary care for the residents, and the provider has bought seven profiling beds since the last inspection. Residents are able to self-medicate at the home if they are well enough to take on the responsibility. The three residents spoken to said they prefer the staff to give them their medication and that they are satisfied with how this practice is carried out. The home uses the Nomad system and checks of the paperwork showed that the home has a positive identification process in place and that records of the medication received, administered and leaving the home are up to date and correct. Stock levels correspond to the records kept and are in date and stored correctly. Checks on the controlled drugs at the home indicated that all stock is accounted for and accurate records are kept in the controlled drugs register. Fridge medication was seen to be stored correctly and the staff recorded daily temperature checks. Comments from the residents spoken to revealed that they are very satisfied with the way personal care is given in the home, and they feel that the staff respect their wishes and choices regarding privacy and dignity. One individual said ‘the staff are smashing, they are so friendly and the care is excellent’. The residents said that staff are always available for assistance with washing, bathing and toileting and that care is given in a cheerful and friendly manner. Observations of the staff at work showed that they have a good relationship with the residents and enjoy chatting to them and exchanging banter. One resident said that ‘ the staff are lovely, they tell you what is going on outside the home and we can have a laugh with them’. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 12 Two individuals commented that staff helped them to remain as independent as possible and they gave the resident’s the opportunity to make their own choices and decisions around their care. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15. Residents are provided with choice and diversity in the meals and activities provided by the home. Individual wishes and needs are catered for and people have the option of where, when and how they participate in both eating and leisure activities. EVIDENCE: Discussion with the activities co-ordinator indicated she has twenty hours a week (flexible) to carry out social activities with the residents. Every Tuesday there is a minibus trip from the home to the local community to go shopping, visit the marina or have a meal out. Two individuals spoken to said that they like to stay in their bedrooms and ‘the activities lady comes to talk to us, keeps us up to date with the news and outside events’. Comments from three residents showed that they enjoy watching television, listening to the radio and one person has his own scooter and is able to go outside into the local community, ‘under his own steam’. Everyone spoken to is satisfied with the level of activities and social events within the home, there is a record kept in their care plans of what activities they have joined in with and information of forthcoming events is on display around the home. All residents spoken with were satisfied with the meals provided at the home. Comments made indicate the food is good quality and that individual’s are Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 14 offered choices of meals at each sitting. Menus are on display in the entrance hall of the home and the service continues to attain the local Council’s Heartbeat Award for kitchens serving healthy and well balanced diets. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. Staff and residents are confident about reporting any concerns and the unit manager acts quickly on any issues raised. EVIDENCE: The home has a clear and simple complaints procedure that residents, relatives and staff are aware of and are confident of using if needed. The complaints records show that no formal complaints have been made since the last inspection. Three residents showed a clear understanding about how to make their views and opinions heard and said ‘the manager comes round every day to see us and will discuss any problems at this time. She will take immediate action, if needed, to resolve any issues brought to her attention’. The three residents spoken to said they felt safe and well protected at the home. The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint and management of resident’s money and financial affairs. The staff on duty displayed a good understanding of the vulnerable adults procedure. They are confident about reporting any concerns and certain that any allegations would be followed up promptly and the correct action taken. Information in the staff training files showed that they all have received Protection of Vulnerable Adults training and also have the opportunity to attend training around challenging behaviour and breakaway techniques. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 and 24. Residents are provided with a safe, comfortable and clean environment. They are able to personalise their own rooms and have the option of having a door lock fitted or not, depending on their wishes. EVIDENCE: Re-furbishing and re-decorating has been ongoing at the home since the last inspection. All areas seen by the inspector were in a good state of repair/decoration, clean and tidy. There have been additional ‘specialist’ beds and pressure relieving mattresses bought to ensure residents are comfortable whilst in bed and make it easier for staff to give the care needed. A new fridge-freezer has been purchased for the small kitchen and the last Environmental Health report indicates the service was found to be satisfactory. Work has been completed on a second walk in shower room for the residents, comments from individuals spoken to indicate that they like the new bathing facility and find it easy to use. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 17 Residents are provided with two large lounge/dining rooms to sit in. The separate smoking lounge was in the process of being redecorated and the transformation was very noticeable. There are large grassed/garden areas outside of the home providing a peaceful and relaxing surrounding for residents who like to be outside on warmer days. A number of the rooms have patio doors leading directly onto the gardens outside and the residents have personalised their immediate areas with planters, bird tables and small ornaments. Three residents spoken to were very pleased with their individual rooms and said that they had ‘brought in a number of personal possessions to make them feel more at home’. Each room is individually decorated and residents are able to choose the colours to reflect their own tastes. Lockable storage space is provided in each room so residents can keep their personal papers and valuables safe. Not all rooms have a door lock fitted; the unit manager told the inspector that door locks would be provided if requested by a resident or relative and there are consent forms in the care plans to indicate if an individual wants a lock or not. The unit manager said that provision has been made on next years budget to fit all rooms with locks. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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, 28, 29 and 30. The standards of recruitment, induction and training of staff are very good with appropriate checks being carried out and staff demonstrating a clear understanding of their roles, ensuring that residents are protected from risk and looked after by motivated and knowledgeable people. EVIDENCE: Information from the staffing rota and discussion with the unit manager indicated that the home has two nurses and eight care assistants on duty from 07.00 to 13.30, two nurses and seven care assistants from 13.30 to 20.00 and one nurse and four care assistants from 20.00 to 07.00. Residents spoken to are very happy with the amount of staff on duty and said ‘they are always helpful and available to see to anything you need doing and nothing is too much bother’. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 19 The home has a separate recruitment department on site, which organises and monitors the recruitment/employment procedures as necessary. There is a comprehensive recruitment policy and procedure and when three staff files were checked it was evident that the recruitment department follows the procedure, and ensures the interview process, police/CRB checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. Nurses at the home undergo regular registration audits with the Nursing and Midwifery Council to ensure they are able to practice. The company has achieved City and Guild training status and new staff members are undertaking their NVQ 2/3 with the homes training officer. The home continues to have well above 50 of care staff who have achieved an NVQ. Staff who spoke to the inspector are enthusiastic and motivated about their training and development opportunities. The home offers staff a wide range of training aimed at meeting the needs of the residents, in addition to a comprehensive induction and foundation programme, which meets the NTO workforce training targets. Staff receive in excess of three days paid training per year and the home has individual staff training plans that are discussed through supervision and appraisal. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 36 and 38. The manager is supported well by the senior staff in providing clear leadership throughout the home, with all staff demonstrating an awareness of their roles and responsibilities. The safe working practices carried out within the home protects residents’ health, safety and wellbeing. EVIDENCE: The home has an up to date quality award from Investors in People, the local councils quality award (QDS) parts one and two and the local councils Heartbeat award. Continuous monitoring and assessment of the home and its practice/service by the various authorised bodies is an essential part of the process leading to the awards being reaffirmed year after year. Policies and procedures within the home have been reviewed and updated to meet current legislation and good practice advice from the Department of Health, local/health authorities and specialist/professional organisations. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 21 Staff supervision files show that individuals receive formal supervision on a regular basis and staff appraisals are also completed each year. The responsible individual completes a monthly Regulation 26 report, and sends a copy to the Commission. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. Staff have received training in safe working practices; with designated persons appointed for fire warden duties, health and safety audits and safe working practices. The manager has completed generic risk assessments for a safe environment within the home and risk assessments were seen regarding fire, moving and handling, cot sides and pressure relieving equipment. Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 x x x 3 x x STAFFING Standard No Score 27 4 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 4 x x 4 x x 4 x 4 Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 23 No 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 Regulation Requirement Not applicable 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 Good Practice Recommendations Not applicable Castle Keep Nursing Home 20050922 Castle Keep IR J54 v221257 s925 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF Address 4 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. 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