Inspection on 31/08/05 for Castle Rise Nursing Home

This inspection was carried out on 31st August 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 Rise Nursing Home 13/04/07

Castle Rise Nursing Home 31/01/06

Castle Rise Nursing Home 11/01/05

Castle Rise Nursing Home 02/09/04

Castle Rise Nursing Home 05/02/04

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 Rise Nursing Home Wawne Road Sutton on Hull East Yorkshire HU7 4YU Lead Inspector Eileen Engelmann Unannounced 31st August 2005 @ 9:30 am 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Castle Rise Nursing Home Address Wawne Road Sutton on Hull East Yorkshire HU7 4YU 01482 839115 01482 821666 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 Pauline Elizabeth Sidebottom Care Home with Nursing 40 Category(ies) of PD Physical Disability (40) registration, with number TI Terminally ill (40) of places OP Old age (40) DE Dementia (40) PD(E) Physical dis - over 65 (40) Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To admit one service user under 65 years in nursing category. To include 4 service users in the younger physically disabled category. Date of last inspection 11TH January 2005 Brief Description of the Service: Castle Rise is a Care Home with nursing that provides a service for service users who meet the following criteria of need: - Dementia, Old age, Physical disability and Terminal illness for those over the age of 65 and four placements for service user’s who have a physical disability and are under the age of 65. The home is situated close to the village of Sutton and enables easy access to the local shops and North Point Shopping Centre. Accommodation consists of forty placements within single (and one double) rooms on two floors with lift access. Service users have the choice of three lounges and two dining rooms in which they can relax and enjoy the company of others, although the staff do recognise that individuals need time to themselves. The home provides a specified lounge for those service users who smoke. An activities organiser is employed, who will see each individual to discuss their interests and hobbies and arrange outings on the home’s minibus. Service users also have access to the grounds of the home, which are designed to be accessible to those in wheelchairs and with mobility problems. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_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 registered manager; staff, visitors and residents of Castle Rise 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. Two of the staff on duty, three of the residents and one visitor were spoken to; their comments have been included in this report. What the service does well: What has improved since the last inspection? The medication systems at the home have been audited and checked to make sure that residents health is being monitored and promoted. Living space within the home has been repainted, had new floorings fitted and furniture supplied, to make a more homely and comfortable environment for the residents. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_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) 1 and 3. The home’s Statement of Purpose and Service User Guide are excellent, providing residents and prospective residents with details of the services the home provides enabling an informed decision about admission to the home. EVIDENCE: The statement of purpose and the service user guide has been up dated and reviewed since the last inspection. These documents are available in the entrance hall and contain a wealth of information about the home and the service provided. One resident spoken to is fairly new into the home and said that his family had been able to visit the home prior to him making the decision to come in. The resident had been provided with sufficient information about the home to make an informed choice about the placement. Each resident has their own individual file and three 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. Two 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_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, 9,10 and 11. The health care needs of the residents are well met, with evidence of good multi disciplinary working taking place on a regular basis. Staff have a good understanding of the resident’s support needs and offer personal care in a way that promotes the residents privacy, dignity and independence. 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. Three of the plans looked at have been evaluated on a monthly basis and 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 individuals said’ the home has arranged for us to have a local GP and he/she comes to see us whenever we need him’. One individual spoken to said he had problems with his teeth and that he has seen a dentist about this, but there was not a lot they could do to help him. Comments from the residents Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 11 indicated that they have good access to local dentists, opticians and chiropody services. Feedback from the relative spoken to indicated that the staff are conscientious about giving the resident’s mouth care (where needed), and individuals with PEG tubes have access to a dietician and other professionals as required. 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. One individual said that he is happy with the staff administering his medication and he receives his pain relief on time and when needed. Checks of the medication records and the system used showed that these are up to date, accurate and well managed. The three residents and one relative spoken to were very please with the way that care is given within the home. One individual said ‘the staff are very approachable and quickly respond to requests for assistance’. Other comments made indicate that staff communicate effectively with each other and those living in the home or visiting relatives, and people are encouraged to ask questions or raise queries about the care or services offered. Observation of the interaction between the staff and residents showed there is a friendly atmosphere and good communication between all parties. Two staff spoken to demonstrated a good understanding of the individual needs of the residents and both said ‘we have a good team of staff at the home who are committed to giving the best care possible’. Discussion with the manager and staff indicated the home continues to follow the Liverpool Pathway of Care for the Dying. This process has been in place for some time and focuses on the needs of the individual person and ensures they are able to die with dignity, with their wishes and choices being respected at all times. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 standard(s) 12, 13 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: The Activity Co-ordinator for the home works twenty hours a week and is available within the home Monday through to Friday. As many of the residents are quite poorly and spend much of their time in bed, the activities taking place within the home focus on 1-1 time with the residents. This includes doing passive exercises, reading books, writing letters to families, discussing the local news and sports and listening to individual’s problems. Each resident receives a birthday card and cake from the home for their birthday and staff do their best to help residents celebrate all major events throughout the year, such as Christmas and Easter. One individual said he is fairly new into the home and likes to spend time in his room reading and watching television. He was pleased that staff had taken the time to make him feel welcome and was satisfied with the activities on offer. One individual visiting the home 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’. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 13 The home has an open visiting policy and relatives and friends were seen to come and go from the home throughout the day. All residents spoken to were satisfied with the meals provided at the home. Comments made indicate the food is good quality and that individual’s are 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 standard(s) 16 and 18. The home has a satisfactory complaints system with evidence that residents’ views are listened to and acted upon. Staff and residents are confident about reporting any concerns and the 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 there has been one complaint made since the last inspection and this was dealt with by the manager and resolved quickly. Residents spoken to said ‘the manager comes round to see us every day and talks to us about any niggles we may have. She tries to solve them immediately and will get back to us if she needs to take time to resolve them’. 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 24 and 26. Residents are provided with a safe, comfortable and clean environment. They are able to personalise their own rooms, and the provision of door locks means that their personal belongings can be kept secure. EVIDENCE: Re-furbishing and re-decorating has been ongoing at the home since the last inspection. Work completed includes repainting of the manager’s office, communal toilets and bathrooms being repainted and new flooring fitted, new bedroom furniture to all rooms, new carpets to selected corridors and bedrooms and new light fittings to the corridors. Discussion with the residents and visitors indicates disruption to their lives is minimal and they are pleased with the environment. The manager is hoping that the current decorating in the corridors will be finished by the end of September 2005. Further alterations are planned for the existing kitchen area and staff room and notification of these changes has been sent into the Commission. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 16 At the last inspection the home had converted the upstairs lounge into another bedroom and an immediate requirement was left for the home to send in a Variation to Registration application. This requirement was complied with, but the home later decided to return the room to its former use. It has been agreed with the Commission that whilst decoration of the bedrooms is ongoing, the resident’s may use this facility to stay in until their own rooms are finished. The residents have use of two lounges and two dining areas downstairs and outside of the home is a spacious garden with lawns and paved areas. Residents are supplied with seating and tables and a number of individuals were sat out in the sunshine enjoying their breakfast. Inspection of the outside of the home showed that the window and doorframes require some attention. This has been recognised by the manager and provider and work to rectify the problems is due to take place before the end of 2005. 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. Bedrooms are supplied with door locks and lockable storage space to ensure resident’s valuables are kept safe. Staff have a master key, which can be used to gain access in an emergency. The home is clean, warm and comfortable and no malodours were present. Residents and visitors remarked that ‘ the domestic staff do a lovely job and make sure the home looks fresh and welcoming’. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 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 rotas and discussion with the manager indicates the home has increased its staffing levels by an extra 24 nurse hours during the daytime and 40 care assistant hours at night. This ensures the manager has some supernumerary time to deal with administration duties and also reflects the increasing dependency levels of the people living within the home. The rotas show that on average there are two nurses (plus the manager 8-4) and five care assistants on duty in the morning, one nurse and four care assistants in the afternoon and one nurse and three care assistants at night. 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’. The home has a comprehensive recruitment policy and procedure and when three staff files were checked it was evident that the manager 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. One staff member whose file was looked at is from another country and has undergone all checks necessary for Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 18 foreign workers including work permits, passport and immunisation records. 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. 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 service users, 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. The home continues to be recognises as a Practice Development Unit (PDU), which is linked to Leeds University. Staff take part in additional training and development as part of the PDU process and use research based practice during their care giving. Information about the PDU status is contained within the service user guide, and this includes letters of praise for the teams commitment and hard work from the programme leaders based at the university. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 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, 37 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 assurance award from the local council (QDS 1 and 2). It is an accredited Practice Development unit and has 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. Feedback is sought from the residents and relatives through regular meetings and satisfaction questionnaires. Policies and procedures are up dated and reviewed as an ongoing practice and action is being taken to ensure the requirements of the inspection reports are met. Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 20 The manager completes in-house audits of the home and its service on a monthly basis, and the registered individual does spot checks on the regulation 26 visits. 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. The registered manager and staff work hard to ensure records required by regulation are up to date and accurate. The attention to detail and consistent high standards in the homes paperwork has ensured that the service exceeds the minimum standards in a number of areas throughout this report. Residents who spoke to the inspector were aware they could access their personal records on request and information about how to do this was seen in the policy and procedure file. Inspection of the home indicated that all records are kept safe and secure and used in accordance with the Data Protection Act 1998. 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 4 x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 4 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 4 4 Castle Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 22 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 Rise Nursing Home J54_s928_Castle Rise Nursing Home_V221235_260805_Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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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