Inspection on 21/05/07 for Castlegate House

This inspection was carried out on 21st May 2007.

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

Castlegate House 28/01/10

Castlegate House 13/10/09

Castlegate House 07/05/09

Castlegate House 01/06/06

Castlegate House 23/11/05

Castlegate House 28/06/05

Castlegate House 05/10/04

Castlegate House 14/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Castlegate House 49 Castlegate Grantham Lincs NG31 6SN Lead Inspector Roger Harrison Key Unannounced Inspection 21st May 2007 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 Castlegate House DS0000002342.V334716.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. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castlegate House Address 49 Castlegate Grantham Lincs NG31 6SN 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) 01476 560800 01476 565672 Castlegate House Rest Home Ltd Suzanne Lorraine Chambers Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20) of places Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) Old age, having dementia (DE/E) The maximum number of service users to be accommodated is 20. 2. Date of last inspection 1st June 2006 Brief Description of the Service: Castlegate House is an adapted, partially listed building situated a short walking distance from the town of Grantham. The home provides personal care for up to 20 residents. There are 10 single and 5 double bedrooms, which are mainly situated on 2 floors although 2 bedrooms are located between floors accessed by several steps. Access to these floors is by way of a shaft lift. There are 2 lounges and a separate dining area. Further seating is provided in two hallway areas. There is car parking for 4 vehicles at the side of the home and a small fenced terraced area with seats and plants providing an outside area for residents to sit. Fees charged by the home for care on 22/05/2007 range from: £348.00 - £432.00 pw. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by an inspector reviewing all the previous inspection records available, looking at information provided by the manager about The Castlegate House, and by undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying individual residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspection was also used to check that information provided by the manager matched the individual experiences of residents. This was done by talking to the manager, residents, visitors and care staff whilst observing day-to-day care practice within the home. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 6 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 Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 [Standard 6 N/A]. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager completes an assessment of residents’ needs and provides information to confirm that their needs can be met before any admission to the home takes place. EVIDENCE: Residents provided written comments to the Inspector before undertaking a visit to the home saying that information is given to them and assessments are undertaken to ensure any new resident is able to make a decision about moving to the home. Residents said that their needs were assessed before they moved in and that they had access to information about the home, which they said helped them to understand what the home provides. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 8 During the inspection visit a family carer said she was visiting with a social worker to have a look around before making a decision with a family member about moving into the home. The manager was observed providing information and arranging to make a visit to complete an assessment of need to check whether individual care needs could be met by the staff team. The manager listened to questions asked and gave clear answers about care arrangements. The family carer said, “I’m really impressed with the home, I came after hearing good things about it and am happy with the arrangements being made”. The manager has a resident’s guide and statement of purpose, which residents said is available to help them to know what to expect when they move in. Copies were available in residents’ rooms and the manager confirmed that these documents have been updated since the inspection visit was made to show that she has recently been registered as the manager of the home. The manager also said she would be adding more information to the statement of purpose to clearly show what she is trying to achieve for the people who live at the home. Care plan information included a record to show that the manager had completed an assessment of need before new residents had been admitted, and that she had involved residents and their family carers in the process. Castlegate House does not provide an intermediate care service. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are set out in an individual care plan and their health needs are met. There are policies and procedures in place, which staff follow in order to support residents with their medication needs. Residents are treated with respect and support to maintain their dignity. EVIDENCE: During the inspection visit the manager provided copies of individual care plans, which were set out in separate sections showing how the assessment completed at the time of admission is used to create the overall care plan. Care plans contained risk assessments, which contained a record to show they had been reviewed each month. The manager said she completes the review together with senior carers. Care plans show residents’ likes and dislikes and staff team members were able to provide a good verbal understanding of each Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 10 resident’s individual health and social care needs. Some care plans contained details of individual life histories, which the manager said is sought and used to enable them to offer the right support to people who have dementia needs. Residents said they had the choice to provide information or not about their personal history. During the inspection visit a nurse professional visited the home to provide support for some of the residents. The nurse made positive comments about the care provided with comments ranging from, “It’s a good team here, its so welcoming and we work well together”, to “The information here about each service user is clear and I am able to contribute fully to meeting needs”. One resident said, “My knee was swollen, the staff called in the doctor to attend to it”. Care plan information also contained details about the support given to people with their medicines. One resident said “I could look after my medication if I wanted to but I feel I need support and the manager makes sure I’m okay”. One resident sat together with the inspector and went through the care plan that showed how her needs are currently being met. Care plans showed details about personal care and how reviews are used to check that needs are being met. The resident said, “Yes this tells you all about my needs and how they look after me”. Since the last inspection the manager has set up a key-worker system in order to encourage and ensure that residents’ changing needs can be better identified. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 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. Residents are supported to take part in activities within the home and community and feel that they have control over their own lives. Residents receive a varied, balanced and nutritious diet. EVIDENCE: Before the inspection visit took place the manager provided an activity list, which included some of the regular activities that she said are made available to residents. The list included musical entertainers, movement to music, remembering games, story and poetry readings etc. During the inspection visit, residents were observed coming and going out into the community and receiving visitors as they said they wished. Residents said that they had a choice whether to get involved in the planned activities at the home or not and that they liked the activities available. Those residents who have dementia care needs were observed being supported in a sensitive way by staff members to take part in individual Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 12 activities. For example one staff member was observed taking time and using gentle encouragement to maintain one person’s mobility, and in doing so, her independence. The manager said that she uses the key worker system that she has introduced to encourage staff team members to get to know more about individual needs and to help build up more trust and understanding between staff members and people who live at Castlegate care home. Care plans contained some written details about what people liked to eat and whether they were on special diets. The information was brief but the manager said that staff members are updating the information. Since the inspection visit was made the manager has provided an example of how nutritional assessments are recorded with much more detail so that all staff will know each person’s likes and dislikes and how to meet any additional nutritional needs. Before visiting the home, the manager sent copies of the menus provided by the care team. Menus showed a variety of options, which residents said were available to them. During the inspection visit the manager showed that special diets are provided for those who need them and residents made positive comments about their experience of the food available, which ranged from, “No complaints about the food” to “Good range of food here” Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and care team take complaints seriously and wherever possible involve residents and carers in resolving issues as soon as they are raised. The manager and care team know how to act in order to protect residents from abuse. EVIDENCE: Before the inspection visit took place the manager provided a copy of the home’s statement of purpose, which contained information about what to do and who to speak to if people have concerns. During the inspection visit, information about how to raise concerns was readily available at the entrance to the home. The manager said that she would always keep a record of any formal concerns or complaints received but that there have been none raised with her about the services provided since the last inspection. One resident commented that she would feel happy to raise any concern direct with the manager and residents and family carers sent positive written comments to us before the visit, to show that they know how to raise concerns. One family carer said, “I regularly visit my mother and am on very good terms with the staff and Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 14 monitor my mothers care very carefully and am more than satisfied with the care she receives”. The manager and staff members said that they had received training in order to identify and know how to report concerns and take action in order to protect people from abuse. A copy of the adult protection policy and procedure for Lincolnshire was available in the home. One staff member said, “The training was relevant and I know that it’s important to report any issues direct to the manager”. Castlegate House DS0000002342.V334716.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well-maintained, homely and comfortable environment. EVIDENCE: Written information provided by the homeowner before the inspection visit confirmed there have been no structural changes to the environment since the last inspection. During the inspection visit rooms were observed to be well personalised and decorated with a range of equipment available throughout the home to enable staff to support residents’ safely. Each room had names and numbers on them, which people said helped them to know which was their room. Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 16 Care staff were observed following procedures to ensure good hygiene was maintained through the use of aprons, washing hands and supporting residents’ personal needs in a safe way. The two communal lounges, dining and kitchen areas were observed to be clean and one visitor commented that, “its always very clean and tidy”. Castlegate House DS0000002342.V334716.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 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. There are currently sufficient numbers of safely recruited care staff available at the home with appropriate training and skills to meet the needs of residents. EVIDENCE: Before the inspection visit took place the manager provided information about who works at the home, and during the visit the manager described how the staff team work together as a team to provide appropriate levels of support for residents who live at the home. The manager stated that all staff are recruited using proper checks to ensure residents are safely supported, and staff files held by the manager contained information, which confirmed that staff have been recruited safely. The manager said she has recently set up a system called a “key worker scheme”. She said this is used to match residents and staff together in order to develop more knowledge, understanding and trust. Residents said they felt the staff team are good with comments ranging from “The girls are lovely and kind” to “The staff are always helpful and willing to do anything I ask – within reason!!” Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 18 Staff members said they had been provided with an induction and staff files showed that they had received induction and training. The manager showed that since the last inspection she had introduced a booklet for new staff to complete as part of their induction to show that they had received an induction and that they are able to record their own training. The manager confirmed that training has been provided to make sure staff know how to provide support for residents. Training this year has included; adult protection, fire safety, moving and handling, food hygiene and dementia training. Staff members were able to describe how they apply their training to the work they do, for example when talking about providing support with people who have dementia needs one staff member said “It’s really important to spend time with people and not to rush, it does get busy but we are trying to use our training and the key worker system in place to understand and meet needs in a better way”. The manager showed how she keeps training records on individual staff files but added that she is creating a staff training plan to show exactly which training courses have been provided. She said this would help to easily show any gaps in training, which can be addressed through supervision with staff members. Since the inspection visit was completed the manager has sent us a copy of her full training plan, which clearly showed the training that each staff member has achieved. Castlegate House DS0000002342.V334716.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 31,33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a manager who supports the staff team to care for residents safely and encourage them to be as independent as possible. The manager encourages feedback from residents and staff and there is a formal system in place for consulting residents and family carers about the quality of care provided. The manager safeguards residents’ financial interests. EVIDENCE: The acting manager has recently been formally registered with us to manage the service. Residents said that they trust the manager and that she provides Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 20 support to help them to be independent. One resident said, “The manager is like a family member, it’s really good here and it couldn’t be better”. One staff member said, “The manager is part of the team, we work really well together and can help to develop things with her support”. The manager confirmed that since the last inspection she has produced a system for consulting regularly with residents and family carers about the quality of care provided. The manager provided a copy of a new questionnaire produced as part of the updated policies and procedures, which she said would soon be circulated to all residents and carers, and that copies will be made available for visitors to the home to complete if they choose to. The manager said she would use feedback she gets from the questionnaires to continue to review her statement of purpose and user guide in order to make improvements to the service provided. Residents said that they are able to manage their own financial arrangements with support from family members and the manager, and that they have access to their own day to day money. The manager said that whenever she is asked for support with managing daily finances she keeps a record to make sure she knows how much money each resident has. A check made during the inspection visit showed these records were accurate. Castlegate House DS0000002342.V334716.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 X 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 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 X 3 X 3 X X 3 Castlegate House DS0000002342.V334716.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 Castlegate House DS0000002342.V334716.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Castlegate House DS0000002342.V334716.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. 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