Inspection on 16/05/06 for Castle View Residential Home

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 View Residential Home 18/01/07

Castle View Residential Home 30/12/05

Castle View Residential Home 26/09/05

Castle View Residential Home 10/03/05

Castle View Residential Home 02/08/04

Castle View Residential Home 01/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Castle View Residential Home Spring Street Chipping Norton Oxfordshire OX7 5LU Lead Inspector Jane Handscombe Unannounced Inspection 16th May 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 View Residential Home DS0000039225.V295208.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 View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle View Residential Home Address Spring Street Chipping Norton Oxfordshire OX7 5LU 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) 01608 642364 01608 645679 manager.castleview@osjctoxon.co.uk The Orders Of St John Care Trust Mrs Sally Theresa Lyon Care Home 47 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (47), of places Physical disability over 65 years of age (4) Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The total number of persons that may be accommodated at any one time must not exceed 47. The continued registration of this service past April 2007 is dependent upon the physical environment meeting standards. 30th December 2005 Date of last inspection Brief Description of the Service: Castle View is a care home for older people within close proximity to the centre of the market town of Chipping Norton. The home itself was built in the early 1970s and, as such, the design was dictated by the principles of that time. As a result the building appears dated with small rooms, double rooms and a lack of en-suite facilities being notable. The home is owned and managed by The Orders Of St John Care Trust, which is a large charitable organisation that also runs a number of homes in Wiltshire and Lincolnshire. The home no longer meets the current spatial standards as set out in the Care Homes Regulations and a new home is to be built in another part of the town to address these issues. It is anticipated that the move to new premises will take place some time in 2007. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 11.00am and was in the service for 8.25 hours. The inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that the CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has, in this report, made judgements about the standard of the service. Comments from service users include: • • • ‘the carers are marvellous - they are very conscientious’ ‘I am quite happy, the carers are very good’ ‘Lovely food, we get two choices and plenty of it’ Comments from relatives/visitors include: • • ‘my friend (named resident) is happy here. I feel she is kindly treated and well cared for’ ‘the staff are very helpful and friendly, and the care my mum gets is very good’ The inspector would like to thank residents, relatives, staff and all those who kindly gave their time to help during this inspection. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There are a number of areas that the home needs to address to improve the outcomes for their service users. The home must ensure that all assessments of need, risk assessments and reviews of care plans are undertaken, kept under review and up to date to reflect the needs of the service users, and to provide staff with clear information as to the management of those needs. The manager must ensure that all residents are treated with respect and their right to privacy is upheld at all times. The manager must ensure to undertake a risk assessment in relation to the home’s cat. It is a good practice recommendation that, when reviewing care plans, these be more person-centred than they are at present. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 7 In instances where concerns are brought to the attention of the manager, it is recommended that these be logged within the complaints log and dealt with accordingly. Although the home is anticipating moving during 2007, it is recommended that the proprietors ensure to upkeep the décor and maintenance of the home to a satisfactory standard in the interim. 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 View Residential Home DS0000039225.V295208.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 View Residential Home DS0000039225.V295208.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): 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good assessment procedures in place and prospective service users are enabled to visit the home prior to being admitted. Standard 6 has not been assessed as this is not applicable to the home. EVIDENCE: A full care assessment is carried out on individuals by a person qualified to undertake these, before they are admitted to Castle View. All prospective service users are invited to the home for a day, to enable them to meet fellow service users and members of staff and to gain a feel of the home, to allow them to make an informed choice when choosing a home to meet their needs. Castle View Residential Home DS0000039225.V295208.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 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Health and personal needs are set out in a personal care plan although these were found to be missing important details and therefore of poor quality. EVIDENCE: All residents have a plan of care, which is drawn up from an individual assessment undertaken prior to moving into the home. The plan of care is drawn up with the active involvement of the resident, and the resident agrees and signs it where capable of doing so. Upon inspecting a sample of four care plans, it was found that they were not fully detailed and failed to note important medical histories, as was seen in one case in which the resident was prone to pressure sores and the care plan failed to address any needs around skin care and integrity. It is recommended that care plans be more detailed and more person centred than at present. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 11 Likewise, it was found that risk assessments were undertaken but failed to include important risks that could affect the health, safety and welfare of residents in their care. Two such cases were those in which the use of a hoist was needed but this failed to be included in the risk assessments. Whilst touring one of the communal rooms in which residents and visitors were occupied, the inspector became aware of an instance where one resident was being attended to. The resident was not taken to a private place and the highly sensitive issue was dealt with in a manner which did not give the resident any privacy or respect. Speaking with another resident the inspector was informed that some staff members spoke in an inappropriate manner. The inspector observed one such incident on the day of inspection, and both these incidents were reported back to the manager. The manager ensured that these issues would be dealt with immediately after the inspection, and she reported back to the inspector the following day that they had been dealt with. A requirement has been made within this report to ensure that all residents are treated with respect and their right to privacy is upheld at all times. Since the last inspection, undertaken in December 2005, concerns have been raised with the CSCI around medication, which have now been dealt with appropriately. The inspector accompanied a member of staff during the medication round and generally found good procedures taking place. Residents who wish to self medicate are enabled to do so within a risk assessment. A recommendation has been made to ensure that eye drops and ear drops are dated upon opening as they have a short shelf life. Castle View Residential Home DS0000039225.V295208.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is good provision for meals and mealtimes, and residents welcome the choices available. Visitors are welcomed to the home at any time. Residents are enabled to exercise choice and control over their lives. EVIDENCE: Residents informed the inspector that they are able to receive visitors and friends at any reasonable time, and are able to entertain them in the communal lounges or their own bedrooms, whichever is their choice. The home employs an activities co-ordinator who provides daily activities for those who wish to take part, which includes making peg dolls, making blankets to send to Africa, bingo, seated movement to music, in-house games and film shows, and a PAT (pets as therapy) dog visits the home which the residents look forward to. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 13 The menus examined showed that a varied diet is provided and there is always a choice, and that the chef notes individual preferences. The chef undertakes regular monitoring of the meals, gaining feedback from residents in order to ascertain what they would like to see more of/less of and their likes and dislikes, and welcomes both positive and negative comments. The responses from residents are used to inform the chef when planning the menus. Residents who spoke to the inspector were complimentary about the food provided and the choices available to them. Castle View Residential Home DS0000039225.V295208.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 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are good policies and procedures in place to ensure that service users are protected from any form of abuse. However, these are not always adhered to as was the case during the inspection. Residents are enabled to voice any concerns, allegations or complaints should the need arise, but more vigilant recording is recommended. EVIDENCE: There are good policies and procedures in place to ensure that service users are protected from any form of abuse. However, these are not always adhered to as was the case during the inspection, in which two issues were brought to the inspector’s attention (see section headed health and personal care) both of which could be viewed as abusive behaviour. Both these issues were dealt with appropriately after the inspection and the manager reported back to the inspector the following day. Speaking with residents on the day, it was apparent that they were aware of the complaints procedure and were generally confident that any concerns they may have would be acted upon appropriately. The inspector spoke to the manager regarding concerns raised during the inspection and recommends that all concerns brought to her attention, whether verbally or in writing, be logged in the complaints log and dealt with as per the home’s complaints procedure. All residents spoken to were aware of who to take any concerns to if the need should arise. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 15 There are regular residents’ meetings held in the home to which all residents are invited. These meetings are an open discussion in which residents can voice any concerns and make any suggestions, and the management can address issues and discuss points of interest relating to the home. The meetings are minuted and displayed within the home to keep all residents informed. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 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 the following standard(s): 19, 21 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some areas of the home were found to be in poor décor and grubby in places. EVIDENCE: Residents are enabled to access all their communal and private space, through the provision of specialist equipment which includes ramps and a passenger lift. The home provides grab rails in corridors, bathrooms and toilets and hoists and assisted toilets and baths are available to meet the residents’ needs. There is adequate provision of toilets, washing and bathing facilities throughout the home,. However, it was noted that one bathroom failed to provide paper towels and disposable gloves, whilst another was found to contain bars of soap. Recommendations have been made to address these health and safety issues. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 17 All rooms have a call system with an accessible alarm facility, which allows residents to call staff in the case of an emergency. Residents spoken to informed the inspector that in situations where they have had to use this alarm they have been answered swiftly and appropriately. Whilst some corridors within the home have undergone redecoration, it was noted that the décor on the upstairs corridor was grubby and dirty; tea and coffee stains were apparent on the walls, as was dried bits of food. It is recommended that the standard of décor to these walls is rectified and brought up to standard. As the last inspection reports indicate, Castle View does not meet the spatial standards and a new home is to be built in 2007. However, as this is some time away, the home must ensure to maintain and decorate in the interim period. The sluicing facilities were found to be clean and tidy although the storage of opened tinned cat food in the sluice is inappropriate and an alternative place of storage must be found. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 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 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has policies and procedures in recruiting staff to ensure the health and safety of its residents, although some omissions were found in relation to staff photographs being held on personnel files. All staff within the home are appropriately trained and supervised in order to provide quality care and undertake their roles competently. EVIDENCE: The staffing levels on the day of inspection were sufficient to meet the needs of the residents. The recruitment systems in place are of a good quality. A selection of staff files were sampled for inspection, all of which contained the relevant pre-employment checks, references and evidence of qualifications. There was an instance in which there was no recent photograph held on the staff member’s personnel file, which the manager informed would be rectified. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 19 The manager informed the inspector that four members of staff have NVQ Level 2 in Care, with a further ten staff waiting to undertake this qualification. Recent training for staff has included dementia care, safe handling of medication, fire instruction, emergency first aid and abuse training, and future training has been identified and planned for. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 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 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, 33, 35 and 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The manager is supported well by the senior staff and provides good, clear leadership throughout the home. Residents’ finances are adequately safeguarded through the home’s policies and procedures. Poor procedures are taking place which do not take into account residents’ rights to privacy and dignity at all times. There are a number of procedures taking place within the home which do not ensure the health, safety and welfare of those in their care appropriately. The inspector was informed that the home has a pet cat which was brought into the home by care staff. There is no evidence to demonstrate that residents approve of this. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home has a new manager in place who is currently undergoing the registration process with the Commission for Social Care Inspection. She has worked at Castle View for many years and has a good overall knowledge of her residents and their needs. She is undertaking the Registered Managers’ Award and therefore only a score of 2 can be awarded for this standard. Records required for the protection of service users were made available to the inspector, including the fire log, and were found to be up to date and complete. A number of issues have been highlighted within this report relating to the health, safety and welfare of residents, namely that of shortfalls around the issues of assessing residents’ needs and the care planning process, and issues around respecting residents’ rights to privacy and dignity for which requirements and recommendations have been made. The home’s cat is being kept at the home under the request of the staff team. No evidence is available to show that the residents approve or disapprove this arrangement. All funding to keep the cat is provided by the staff team. Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 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 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 2 x 2 x x x x 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 x x 2 Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 23 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 OP10 Regulation 12 Requirement The manager must ensure that all residents are treated with respect and their right to privacy is upheld at all times. The home must ensure that all assessments of needs, risk assessments and reviews of care plans are undertaken, and kept under review and up to date to reflect the needs of the service users, and to provide staff with clear information as to the management of those needs. The home must ensure to discuss the issues around dignity and respect and speaking to service users in a tone of voice that was found to be inappropriate during the inspection, with staff and ensure staff adhere to the home’s policies and procedures. All staff personnel files must contain a recent photograph Timescale for action 16/05/06 2 OP7 24(1)a 14 16/06/06 3 OP10 12 and 18 16/05/06 4 OP29 19 Schedule 2 30/05/06 Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 24 5 OP38 12 and 13 The manager must ensure to undertake a risk assessment in relation to the home’s cat and gain residents’ permission to keep pets. 30/06/06 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 2 3 Refer to Standard OP7 OP9 OP16 Good Practice Recommendations It is a good practice recommendation that when reviewing care plans, these be more person-centred than they are at present It is recommended that eye drops and ear drops are dated upon opening as they have a short shelf life. It is a good practice recommendation that all concerns brought to the manager’s attention, whether verbally or in writing, be logged in the complaints log and be dealt with as per the home’s complaints procedure. It is a good practice recommendation to ensure the provision of liquid soap, paper towels and gloves in communal bathing facilities and that these remain available at all times. It is recommended that the home ensures to maintain and decorate the premises and maintain them to a clean, hygienic order. The storage of opened tinned cat food in the sluice is inappropriate and an alternative place of storage must be found. 4 OP21 5 OP19 6 OP26 Castle View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 View Residential Home DS0000039225.V295208.R01.S.doc Version 5.2 Page 26 - 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. 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