Inspection on 07/02/06 for Castle Keep Nursing Home

This inspection was carried out on 7th February 2006.

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 22/09/05

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 Inspection 7th February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Castle Keep Nursing Home DS0000000925.V264035.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 Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Castle Keep Nursing Home Address Noddle Hill Way Sutton On Hull East Yorkshire HU7 4FG 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) 01482 879334 01482 835651 castlearnchester.com Barchester Healthcare Plc Mrs Janet Cooper Care Home 58 Category(ies) of Dementia - over 65 years of age (58), Old age, registration, with number not falling within any other category (58), of places Physical disability (8), Physical disability over 65 years of age (58), Terminally ill over 65 years of age (58) Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd September 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 DS0000000925.V264035.R01.S.doc Version 5.0 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, visitors and residents of Castle Keep Care Home. The inspection took 3 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Two of the residents and one visitor were spoken to; their comments have been included in this report. All key standards have been looked at over the last year and information about these standards and their outcomes is written in the report for 22nd September 2005 and this one. What the service does well: What has improved since the last inspection? The home continues to make sure that the service and care given to the residents is specific to their needs and meets their expectations. Attention to detail is an important part of the philosophy of the home and has helped the service exceed the minimum requirements of eleven out of the twenty four standards assessed and achieve in full all of the key standards looked at over the past year. Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. 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: The home continues to meet the criteria of standard 3. All residents at the home have their own personal file and the three looked at included one for a fairly new resident. Each individual had a need assessment completed by the funding authority and the home has also completed its own detailed needs assessment before a placement was offered to the resident. The home develops a comprehensive care plan from the assessments, identifying the individual’s problems, needs and abilities using the information gathered from the resident and family. Two residents spoken to were able to discuss their individual 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. 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 DS0000000925.V264035.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. The medication at the home is well managed promoting good health. EVIDENCE: The home continues to produce and keep clear and well-written care plans for the residents, and medication is given to the residents by well-trained and professional staff. Individual care plans are in place for all residents and clearly set out the health, personal and social care needs identified for each person. Three 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 two of the individual resident’s plans. One plan for the new resident did not have assessments completed, for all the risks identified, and the unit manager said she would ensure this was Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 10 seen to immediately. One resident’s care plan indicated they receive wound care, the process is carefully documented in the plan, with information detailing the healing taking place and the progress being made. Two 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). One relative spoken to said that she attends her mother’s reviews and has always found the process to be a positive one, with her views being listened to and acted on as necessary. Discussion with the unit manager showed that she is aware of the changes to legislation around the disposal of medications from nursing homes, and that the home is organising a licensed waste management company to pick up any waste medicines on a monthly basis. Residents are able to self-medicate at the home if they are well enough to take on the responsibility; currently all those living there chose not to or are unable to do this. Checks of the medication records and the system used showed that these are up to date, accurate and well managed. Castle Keep Nursing Home DS0000000925.V264035.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): 13 and 14. Relatives and visitors are made welcome at the home and are encourage to join in with the residents social and leisure opportunities. The home promotes the residents right to exercise choice and control over their lives and offers information and contact details so they or their families can contact external agents, who will act in their interests. EVIDENCE: One relative who spoke to the inspector said that she enjoyed visiting her mother as the staff made her feel so welcome every time she came into the home. She was pleased that the staff kept her up to date with how her mother was progressing and would ring her if they had any worries about her health. The open visiting hours make it easy for visitors and relatives to see their family at a time suitable for everyone and this individual attended daily. Relatives and visitors are invited to stay for meals if wished and some individuals like to spend time feeding their loved one at mealtimes, as part of their input to their care routine. One individual said ‘ the staff are very welcoming and include you in all aspects of the residents care. The atmosphere within the building is friendly and makes you feel at home’. Two residents spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. The Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 12 unit manager said she is aware of the advocacy groups in the community that residents can access, and the contact information is on display within the home and recorded in the Service User Guide. All the residents said that the home encouraged them to bring in small items of furniture and personal possessions to decorate their bedrooms. Discussion with the residents showed that they were aware of their care plans and were able to input to them and access them through their key workers. Castle Keep Nursing Home DS0000000925.V264035.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): The home has a satisfactory complaints system with some evidence that residents’ views are listened to and acted upon. Visitors and residents are confident about reporting any concerns and the manager acts quickly on any issues raised. EVIDENCE: The home continues to meet the criteria of standard 16. 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. Two residents and one relative showed a clear understanding about how to make their views and opinions heard and said ‘the unit 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’. Castle Keep Nursing Home DS0000000925.V264035.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 and 26. The standard of the environment within this home is very good, providing residents with a comfortable and homely place to live. EVIDENCE: There is an ongoing programme of refurbishment and renewal at the home. Since the last inspection the smoking lounge at the home has been turned into a occupational therapy room, and the one resident who smokes now does so in her own bedroom under staff supervision. The unit manager said that future residents would be admitted on a no-smoking basis. Three bedrooms have been redecorated and had new carpets fitted and the Rainbow wing has had the corridor carpet replaced. The home was found to be clean, warm, bright and odour free. Discussion with the residents indicated that they are pleased with the laundry service for the home. Two individuals said ‘the staff do a good job and our clothes are well cared for’. Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 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 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. Sufficient staff are employed to ensure there is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: The home continues to employ sufficient staff to meet the needs of the residents. At the time of this inspection there were some bed vacancies at the home and the staffing has been adjusted accordingly. The staffing rotas show that there is some flexibility in the system, but on average there are two nurses (plus the unit manager) and nine 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 and relatives 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’ Discussion with the unit manager indicated that one resident has been funded for 1-1 care (15 hours a day), and dedicated staff are employed cover these shifts. Staff are logging their 1-1 input within the individual’s records and it is clearly marked on the rota who has this responsibility. The home employs nine overseas staff and two individuals from Uganda and Poland were spoken to. One staff member said she has been at the home for 2 years and has settled in well. She feels supported by the management team and has been given the opportunity to develop her skills and knowledge through regular training sessions. English lessons have been provided for one Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 16 staff member who struggled with her communication when she arrived at the home. These have been very successful and are available to anyone who needs this service, they are provided by the local educational college. The home has its own training department and the staff assist the new employees to adjust to life in Britain. They offer help with setting up financial accounts and finding suitable accommodation. Castle Keep Nursing Home DS0000000925.V264035.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 and 35. The management of the home is satisfactory overall, and robust accounting and financial systems are in place to protect and safeguard the interests of the residents. EVIDENCE: The registered manager has the qualifications, experience and competencies needed to run the home and meet its stated purpose, aims and objectives. The registered manager for the home manages three units on the same site, and each unit has its own unit manager. The registered manager has held this post for a number of years and has an up to date registration with the Nursing and Midwifery Council (NMC). She has also achieved suitable management qualifications. The registered manager undertakes periodic` training and development’ to maintain her knowledge, skills and competence, whilst managing the home. Castle Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 18 Checks of the financial systems found that these are computerised, up to date and maintained on a daily basis by the administrator of the home. All residents have their own personal allowance account, and these are independently audited each year. Where individuals have their families looking after their finances, relatives who are unable to visit very often are asked to send spending money for the residents as and when their personal allowance accounts show their monies are low. These requests from the home are accompanied by a print out of the resident’s account. The home only keeps a limited amount of money within the safe, surplus monies are kept in a communal resident account, which does not pay individuals any interest. This information is put into the Service User Guide so all those coming into the home are aware of the homes arrangement, and can decide if they wish to make their own. Castle Keep Nursing Home DS0000000925.V264035.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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 4 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X Castle Keep Nursing Home DS0000000925.V264035.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 Keep Nursing Home DS0000000925.V264035.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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