Inspection on 12/09/05 for Castleford Home for the Elderly

This inspection was carried out on 12th September 2005.

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

Castleford Home for the Elderly 27/08/07

Castleford Home for the Elderly 05/03/07

Castleford Home for the Elderly 13/02/06

Castleford Home for the Elderly 24/01/05

Castleford Home for the Elderly 09/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Castleford Home for the Elderly Queens Road Clitheroe Lancashire BB7 1AR Lead Inspector Christine Mulcahy Unannounced Inspection 12th September 2005 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 Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Castleford Home for the Elderly Address Queens Road Clitheroe Lancashire BB7 1AR 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) 01200 423417 01772 562304 Lancashire County Care Services Mrs Pamela Seed Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (6), Physical disability of places over 65 years of age (6) Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Within the overall total of 30, a maximum of 6 service users requiring personal care who fall into the category of PD(E) Within the overall total of 30, a maximum of 6 service users requiring personal care who fall into the category of PD. No more than 6 people who fall within the categories of PD/PD(E) to be accommodated at any one time. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the CSCI. 24th January 2005 Date of last inspection Brief Description of the Service: Castleford Home for the Elderly is registered with the Commission for Social Care to provide personal care and accommodation to thirty older people. Within the overall total there are 24 service users aged 65 years or over and 6 service users aged 65 years or over who have a physical disability. All require personal care. The home is located on Queens Road in close to local shops, a supermarket, train station and other amenities in the town centre of Clitheroe. The home is situated on a main bus route that offers transport to all towns in the Ribble Valley area. At the time of the inspection building work and refurbishment of the home was in progress. Plans seen and discussions with the Area Manager confirmed that the work in progress was extensive and nearing completion. The service operates a rehabilitation unit for 6 service users. This unit is separately staffed and service users were making use of this facility. Bedrooms were located on the ground floor and first floor of the building. On completion of the refurbishment it is intended that the home will continue to provide personal care and accommodation for up to 45 older people in 4 separate units. It is also intended for the home to have a number of assissted bathrooms, shower rooms and communal toilets for the service users. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first unannounced inspection in 2005. The inspection took place over one day. The service was inspected against the National Minimum Standards for Older People and involved examination of records and discussion with a number of service users. There are references to the case tracking process. This is a method where the inspector focuses on a small representative group of service users. All records pertaining to these people are inspected along with the rooms they occupy in the home. Observations are made of the care provided and the service users are invited to have a discussion with the inspector to discuss their experiences of life in the home. This is not to the exclusion of the other service users, with a number of other service users being involved in the inspection process in various other ways. Breaches in regulations and standards that pose an immediate risk to service users have been highlighted for urgent action. The inspection was carried out with the co-operation of the duty residential care officers. Over the course of the inspection the inspector spoke to 2 service users, 2 staff members, and the responsible individual. A tour of the premises took place including all bedrooms and the new building work that is nearing completion. Documents were read and care observed. What the service does well: The staff and management of Castleford try to make sure that all service users receive a high standard of care within a comfortable environment. All aspects of medication were well managed and service users were protected from mis administration. Service user care plans addressed areas of care such as routines, likes and dislikes, allergies, health needs, personal hygiene and general health. Past interests, hobbies, present needs and wishes were also included in care plans. The care plan of a service user on the rehabilitation unit was examined and highlighted the involvement of other care professionals. Service user care focused on achievement, maintaining independence and developing daily living skills like personal care and cooking. Service users had personal care assessments. Regular care professional team meetings took place daily and included the service user and their relatives. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards were not assessed at this inspection EVIDENCE: Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 7, 8, 9, 11 The health care needs of service users were identified and met through care plans. Care plans detailed the care that needed to be delivered. The control of medication was well managed promoting good health. EVIDENCE: Case tracking of two service user case files showed that care plans were drawn up from the initial service user assessment. Each care plan addressed areas of care and detailed the care to be given. Choices in day-to-day living, assistance, dietary needs, intellectual cultural needs, interests hobbies, background, life history, and lifestyle choices enabled staff to meet service users needs better. Care plans also contained a service user personal profile and reason for admission to the home that included a medical history, known allergies and last wishes. Care plans were reviewed regularly and monthly care plan review sheets had been completed and signed by staff. Care plans contained the relevant information required. Records on diary sheets examined had been written daily. The care plan of a service user on the rehabilitation unit was examined and highlighted the multidisciplinary work that took place at the home. Service Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 10 user care focused on achievement and moving out of the home within 6 weeks. Service user goals were shaped on maintaining independence and developing daily living skills like personal care and cooking. Service users were involved in kitchen skills and personal care assessments. Multidisciplinary team meetings took place daily and involved Occupational Therapists, Physiotherapists, care staff, care managers and other involved professionals with the service user and their relatives. Details from these meetings were recorded and included on service user care plans. Access to professionals had been arranged as needed and records examined confirmed that service users regularly saw their G.P and when necessary the District Nurse. Documents to record minor service user accidents at the home were accurate and up to date. There was a medication policy and procedure at the home. Written guidance was available for staff to follow when administering medication. Policies and procedures examined ensured service user safety. All medicines were stored in a locked trolley within a locked room ensuring service users were kept safe from harm. Service users at the home had completed an administration of medication declaration of wishes form. The form gave clear instructions to the staff team about who the service user wanted to be responsible for the administration of their medication. Service users were given a choice of all or some medication being administered by staff or for the service user to retain complete responsibility. Service users or their representatives had signed the forms to confirm their wishes. The inspector observed an RCO administering medication to service users at lunchtime and it was apparent that she was competent in this area of service user care. Eight care staff had been trained in “supervised administration of drugs”, and were now able to administer medication to service users whilst under the supervision of a senior officer. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Sandards were not assessed at this inspection. EVIDENCE: Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 12 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): Standards were not assessed at this inspection. EVIDENCE: Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 13 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): OP 19, 26 There were sufficient toilet and washing facilities in the home. Most areas in the home were safe and well maintained. The home was clean, pleasant, and hygienic. EVIDENCE: The location of the home was suitable for it’s stated purpose. A tour of the home showed a good standard of cleanliness and hygiene. At the time of the inspection building work and refurbishment of the home was in progress. Plans seen and discussions with the Area Manager confirmed that the work in progress was extensive and nearing completion. The inspector examined all bedrooms during the inspection. Bedrooms had been personalised with service user photographs and ornaments and were adequately furnished. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 14 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): OP 27, 29, 30 Staff numbers were adequate to meet the service user need. Staff training had taken place and was ongoing. Staff files held information required to ensure service users are safe from harm or abuse. EVIDENCE: Discussions with staff highlighted that the skill mix was appropriate to service user assessed needs. The inspector spoke to 1 member of staff who when asked were aware of the homes policies and procedures and knew where they could be located. There was a robust and thorough recruitment and selection process in place based on equal opportunities. Examination of one staff file confirmed that appropriate Criminal Record Bureau and POVA checks were carried out prior to them starting work for the organisation. Staff confirmed that training opportunities at the home were available. When asked staff confirmed they had undertaken training in first aid, moving and handling, basic food hygiene and supervised administration of drugs. Staff files examined confirmed that information required was held on each file. The staff rota was examined and complied with the minimum staffing levels required by the previous registering authority. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 15 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): OP 31, 38 The attitude of the staff and management is to ensure the home is friendly and flexible for the service users. Written procedures ensure the health and safety of staff and service users are safe guarded. EVIDENCE: A number of equipment maintenance certificates were examined and noted to be up to date. An emergency evacuation procedure was in place and staff had signed to confirm their awareness and knowledge. The homes fire log-book was examined and fire test equipment had been completed regularly by the contracted company. During a tour of the building the space near the fire exit leading to the roof was used to store large bags of loft insulation. Whilst the majority of these bags were stored appropriately a small number of bags had fallen from the larger pile and were close to the fire exit door. The registered manager was required to remove these bags from the exit area and ensure this area remained clear for access at all times. Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x X X X X X X 2 Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 17 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. 1 Standard OP38 Regulation Requirement Timescale for action 12/09/05 Regulation The registered person must take 23(4) adequate precautions against the risk of fire and provide adequate means of escape by ensuring that the rooftop fire exit is made clear so that clear access is maintained. Please ensure this standard is met immediately by the date shown. 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 Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Castleford Home for the Elderly DS0000035278.V251697.R01.S.doc Version 5.0 Page 19 - 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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