Inspection on 23/08/06 for Castle Mount

This inspection was carried out on 23rd August 2006.

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.

Other inspections for this house

Castle Mount 09/01/06

Castle Mount 12/09/05

Castle Mount 17/11/04

Castle Mount 09/06/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Castle Mount Bookwell Egremont Cumbria CA22 2JP Lead Inspector Nancy Saich Unannounced Inspection 23rd August 2006 09:30 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 Mount DS0000036522.V301668.R01.S.doc Version 5.2 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 Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Mount Address Bookwell Egremont Cumbria CA22 2JP 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) 01946 820454 01946 825513 castle.mount@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care Mrs Amanda Jane Taylor Care Home 34 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (34) Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 34 service users to include: up to 34 service users in the category OP (Old age, not falling within any other category) up to 9 service users in the category DE(E) (Dementia over 65 years of age) 2 named service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age) 2 named service users in the category of DE(E) (Dementia over 65 years of age) When single rooms of less than 12 sqm usable floor space become available they must nto be used to accommodate wheelchair users, and where existing Wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 9th January 2006 3. Date of last inspection Brief Description of the Service: Castlemount is a purpose built home for older people that was refurbished to a good standard in 1999. Cumbria Care, the in-house Cumbria County Council provider, operates the home. Mandy Taylor manages the home. The home caters for older people within the limits of the registered categories listed above. The home is divided into group-living areas and one of these is especially for people with dementia and this part of the home also has a secure garden. Charges range from £317 to £422 per week depending on the level of care needs. Information about the home can be obtained from the manager at the home on the number above. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection for the year. The lead inspector Nancy Saich sent out questionnaires some weeks before the day of the visit and also asked for information from the manager. She received a good number of very positive questionnaires and a lot of useful information from the manager. She visited the home and spoke to residents, staff and visitors. She spoke to one or two relatives by telephone. She also read documents that backed up what they said and what she saw for herself. This work helped form a picture of a very good home where residents were happy with the levels of care and services provided. What the service does well: This home is good at giving out plenty of information for people who are interested in coming to live in the home. They are careful to only admit people when they are sure that they can look after them properly and that they will fit into the existing group of residents. The home is good at providing sensitive and prompt health care for residents. The inspector heard very positive things from doctors and nurses who come to the home. Residents said they had lots of support from staff when they were unwell. Stored medication was being looked after properly. They said that the good quality food helped them to stay as well as possible. Residents were very happy with the staff team. They had nothing but good things to say about everyone. • “They are all nice lassies.” • “The staff are kind and caring.” • “I have a lot of faith in the senior staff team and the manager.” • “We have a bit of fun but I can also talk to them about worries …”. • “They take a pride in this home and everything is done properly…” • “Very hard workers – they keep the place clean and make sure we have everything we want…”. Residents said that any minor ‘niggles’ are dealt with very quickly by the manager or the senior team. There was one issue on the day that the manager was going to deal with. There had been no other formal complaints received. Residents said they were able to complain if they needed to and they believed that the manager or Cumbria Care would deal with them properly. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 6 Staff knew how to support people if they wanted to complain. They were also very knowledgeable about what might be considered to be abusive and even very new members of staff knew how to ‘blow the whistle’ on bad practice. Residents said that nothing of the sort happened in the home as “Mandy wouldn’t let that happen”. There was evidence to show that the manager was able to protect vulnerable people. The inspector walked around the home and found that the home was clean, homely and comfortable. Residents’ bedrooms were very much their own personal space and staff had helped them to make these rooms reflect their interests and personality. The residents said that the staff looked after their rooms and their possessions. They said that they had nice clean bed linens and that their clothes were looked after properly. The home is run by a well-trained and enthusiastic team. Residents said that the staff team was working really well together under the guidance of the manager. The manager is careful to only take on new staff who are honest, respectful and physically well enough to do the important work of caring for vulnerable people. Staff said that they enjoyed working in the home and that they were trained properly. On the day staff were being trained in how to move people and a number of people had really enjoyed a special course that helped them to give the right kind of care to people with dementia. The systems in place that make sure the home is running smoothly were working very well. Things like maintenance and fire and food safety were in place. Residents’ money was being handled properly. The staff were being managed well. They said they could talk to the manager and had the opportunity to discuss their work and their training and development with their supervisor. What has improved since the last inspection? The inspector thought that the written plans that help staff to know how to care for residents have become much more detailed. This helps residents to get the kind of care they both want and need. There had been some problems in the past with errors in the way medicine is given to residents. The manager and Cumbria Care’s senior management have taken action so that any mistakes can be minimised. The inspector thinks that this is improving. There has been a big improvement in the kinds of activities offered to residents. During the summer there has been two trips out, a summer fair, parties and entertainments. There had also been monthly talks and other activities in the home. These have ranged from local history talks to fashion shows. Residents said that all of these things had really improved their lives and they were keen to talk about these activities. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 7 Mandy Taylor, the registered manager has not been in post for very long but she has shown that she is able to follow all the guidelines set out by Cumbria Care and that she can also make sound plans for Castlemount. She has consulted residents, staff and visitors about what is good in the home and what needs improving on. She has taken this information to help her plan for the future. A lot of change for the better has already taken place. This includes improving the way the specialist unit for people with dementia is run and making improvements to the menus. Her enthusiasm and dedication shows throughout the home and both staff and residents trust her and feel she is the right person for the job. 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 Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. This home is good at making sure they only take new people they are sure they can care for and who will fit into the existing groups. EVIDENCE: The home has a very good package of information for new residents that tells people everything they need to know about Castlemount and about Cumbria Care. The inspector spoke to some new residents who said they (or their relatives) had been given this information when the manager had visited them. They also said that they had been able to come to the home and have a look around. Staff said that the manager made sure that the new person would fit in with the existing residents. The inspector saw the paperwork done after these visits so that staff would get a good idea about the new resident. This was all in order. The inspector judged that there was no one living in the home that the staff couldn’t care for. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents in this home are well cared for and are given everything they need and want. EVIDENCE: Every person in this home has a written plan that describes what he or she need. These ‘care plans’ even tell staff that the person doesn’t need help. The plans were very detailed and this attention helps residents to get individual care and to stay as independent as possible. Residents said they had been fully consulted and that they were able to have “just what we want…”. The inspector thought that the plans had really improved over the past year or so and she was pleased to hear about the managers plans to make these even better. The inspector had contact with local GPs and nurses who said they were called out appropriately and that they worked well with the staff team. There was evidence in files and from residents that health staff were asked to look at things like medication and at ways to prevent ill health. Residents looked well Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 11 and said they were helped to stay as well as possible. One person put it down to “good care and good food…”. The staff team have had some problems with giving out medication but the manager and her managers have worked with them to get this right. Things had improved and all staff are now aware of how important it is to get this right all the time – which they did on the day of the visit. The inspector saw two staff giving out medication and they gave it their full concentration. Medication stored for residents was being handled properly. Residents spoke highly of the entire staff team and confirmed for the inspector that they were given their rights, their privacy and their dignity. It was nice that different residents mentioned different staff members as being very good at what they did and that they also said that the catering and cleaning staff did their job well. They also spoke highly of the night staff and appreciated their attention during what can be a long night. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. This home is very good at giving residents the kind of lifestyle that gives them a fulfilling, varied and interesting life. EVIDENCE: The inspector felt at the last visit that the residents might want more activities. This had been confirmed through the home’s own survey and an action plan had been completed with lots of good ideas from the residents about what they wanted to do. When she went to the home she discovered that residents had really enjoyed a full and interesting programme of trips, outings, talks and parties and other entertainment. The inspector judged that activities had really improved and was interested in the plans the manager had to do more activities with all of the residents and find things that people with dementia would benefit from. Residents said they could get up and go to bed when they wanted and when the inspection started some people were still in bed. They said they could do very much what they wanted and could spend as much time as they wanted in their own rooms. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 13 They could follow their own interests and hobbies and were supported and encouraged to do this. The residents said they had religious services in the home and one person spoke about her own religious needs and beliefs and how well they were met. The visitors’ book showed that residents have friends and family come to see them whenever they want. Returned questionnaires showed the inspector that visitors are considered to be important people and are made welcome in the home. Residents said they could make their own decisions and there was evidence in the home that the manager encourages them to voice their opinions and make there own choices whenever possible. People with dementia were encouraged to maintain their rights to choice by the support of the staff. The manager sent the inspector copies of the menus and these showed fairly good choices of nutritious food. The homes own planning shows that they are going to work on making these even better. This is being done even although the majority of residents were happy with the food. The inspector sat with residents during lunchtime and the food looked very nice. The kitchen was clean and there was plenty of food available for snacks at any time. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is good at listening to residents and at making sure any concerns are dealt with. This makes sure that vulnerable people are protected from harm. EVIDENCE: There was only one person who had a concern that was brought to the attention of the inspector. This was more a matter of concern for the health service. The manager and the resident agreed with the inspector on the best way forward. The manager will keep everyone involved of the outcome. No one else had any concerns. Residents said that the manager would listen to any problems and do her best to sort things out. Staff knew how to support residents in making complaints. The inspector found evidence that showed that the manager was aware of how to protect vulnerable adults. Residents said that there was nothing unpleasant going on and were sure the manager and her staff wouldn’t let anything abusive happen. Staff could tell the inspector how they would recognise and deal with abuse. Cumbria Care has good policies about this that help protect the residents. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 15 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, 21, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Castlemount is a safe and comfortable building where residents feel relaxed and at home. EVIDENCE: The home is divided into four separate areas, each with their own sitting and dining areas. Each ‘unit’ has its own separate small kitchen where staff help residents to snacks, light meals and drinks. All the bedrooms are single occupancy and some have their own ensuite toilets. There are enough bathrooms for residents use. The home has suitable equipment to help people who have problems moving around the home. The inspector walked around the building and found that everywhere was clean and tidy. The home was light and airy and the residents looked very comfortable in the home. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 16 Residents said that they liked the home and that the shared areas and their bedrooms were well decorated and kept clean. They said that the staff took a pride in the home and that they did their best to make them comfortable. There was evidence around the building and in care plans to show that staff were aware of how to stop infection spreading from person to person. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 17 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, 28, 29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is enough well trained, suitable staff to care for residents and give them a comfortable home. EVIDENCE: The inspector saw the previous four weeks of rostered hours. It showed that the home had enough staff at all times to give residents good levels of care. Residents and visitors said that staff worked really hard but that they thought there were enough staff on duty to make sure everyone had the care they needed. There is always one carer on each unit and two people covering the specialist unit. The roster showed that there is extra staff on at busy times. It also showed that experienced people worked with less experienced staff and that together the staff team had the right kind of skills to make sure that residents’ care was good. The manager follows the guidelines set out by the County Council when they take on new staff. This means that they cover all the areas the law says they must. They check that new people have no criminal record and haven’t been dismissed from another care setting. The manager interviews people thoroughly to make sure they are the right kind of people to work with residents. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 18 New staff are then given suitable training and are supported by more experienced staff. The manager has a full training plan that staff say they are encouraged and supported in getting the kind of training they feel they need. After they have finished the basic training they are then registered to complete their National Vocational Qualification in care. A number of staff have gone through this process and they felt that this gave them a really good, professional grounding that helped them to do their work Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The management systems in this home work smoothly and this means that residents don’t need to worry about how things are organised. EVIDENCE: The manager for this home has not been in post for very long but she has made a mark on the home. She has lots of experience of working with older people and has a nurse training. She is progressing well with her Registered Managers award. There was plenty of evidence to show that she has a good understanding of her role and knows what she needs to do to take the home forward in the Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 20 future. She has created an open and co-operative atmosphere in the home and the residents and staff team were all very complimentary about her skills and knowledge and they also felt that she was the right kind of person to run the home. Through out the day of the visit it was clear that she has the care of the residents at the heart of everything she does. One person said “She’s just grand and the home is a better place for having her here…”. Castlemount has undertaken a quality audit where they sought the opinions of the residents, their relatives and the staff group. They had a good response from their questionnaires and from meetings and general management observations. From this the manager has written a very good action plan and has used this to write a business plan with a lot of very realistic and achievable aims and objectives. The inspector judged that both these things were done very well and that the manager had considered the needs and wishes of residents first and foremost. Residents’ money is accounted for properly and the home has regular checks made on all financial transactions. The staff team said that they had the opportunity to sit down with their supervisor to talk through the work they did. This formal ‘supervision’ was being done on a regular basis and when the inspector read some of these notes she could see that the team were looking at developing each member to the best of their abilities. She also spoke to staff who could discuss how this individual approach had helped them to improve the way they did the job. The inspector read all the files related to health and safety. She also checked on how this was working on the day when she looked around the home. She thought that there were good systems in place that made sure that equipment was checked and that everything was well maintained. She also saw that food hygiene measures and fire safety were being followed properly. Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 21 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 4 X 3 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 X 3 Castle Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 22 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 Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Mount DS0000036522.V301668.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!