CARE HOMES FOR OLDER PEOPLE
Castlegate House 49 Castlegate Grantham Lincolnshire NG31 6SN Lead Inspector
Toby Payne Unannounced 28 June 2005 08:40 a.m 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. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Castlegate House Address 49 Castlegate Grantham Linconlshire NG31 6SN 01476 560800 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) Mr Kevin Gray Castlegate House Rest Home Ltd Miss Bianca Louise Hollingworth Care Home only 20 Category(ies) of OP Old Age Both 20 registration, with number of places Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 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 (20). The maximum number of service users to be accommodated is 20. Date of last inspection 5th October 2004 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 is car parking for 4 vehicles at the side of the home and a small fenced terraced area with seats and plants providing an outiside area for residents to sit. 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. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 8.40 a.m. It took place over 3½ hours. The inspector spoke to 9 residents, 3 visitors, 3 members of staff as well as the manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. What the service does well: What has improved since the last inspection?
An additional mobile hoist has been purchased to ensure that residents are transferred safely and staff do not put themselves at risk of injury. Radiator covers and systems to monitor the temperature of hot water have been installed to reduce risk of scalding. A new fridge has been provided in the kitchen to improve the temperature control of food. The patio area has been made more secure to enable residents to use this facility but not to put themselves by walking onto the roadway. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 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.
Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 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 Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 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, 2 and 3 Castlegate House meets the needs of residents coming into the home. People receive information to enable them to make a decision whether they wish to come into the home. People receive an assessment, which results in their assessed needs being met. EVIDENCE: The home has a detailed large print service user’s guide and statement of purpose. Each resident also receives a statement of their terms and conditions when moving into the home. There is also a comprehensive admission procedure, which identifies the needs of residents coming into the home. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 10 There is a clear and detailed care planning system in this home. This ensures that the health and welfare needs of people living in the home and fully met. EVIDENCE: All residents had a care plan outlining their care needs. These records included a life history and a detailed care plan including where assessed risk assessments. There was also a daily record and the signature of the resident in the care plan to show that they had been involved in identifying their needs. There was also evidence of review. Residents told the inspector that they felt their care needs were being met. The home receives visits where required from Community Nurses and GPs. The needs of residents are also covered during staff induction. Residents felt that staff respected their privacy and dignity and staff were seen to approach residents in a calm and sensitive manner. They were seen to be talking and laughing with them. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 10 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 Social activities are varied. Meals provided are nutritious, balanced and offer a healthy and varied diet. Visitors are made to feel welcome. EVIDENCE: All residents who spoke to the inspector said they liked the food. Staff ask residents what they wish to eat. Although there is a set menu an alternative can be made available. Menus were seen to be balanced with flexible mealtime arrangements with snacks and beverages and fresh fruit. There was one resident who told the inspector she liked to help out and lay the tables. Residents said, “the food is superb”. Staff members are responsible for arranging social activities. There was a daily programme of activities, which was displayed on a notice board at the entrance to the home. There were 3 people visiting during the inspection. Comments were “I can visit whenever I wish to do so” and “I always find the home friendly and welcoming”. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 11 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 ann 18 Any complaints received are handled properly and residents know that any complaints they have will be listened to and taken seriously. Residents are protected from abuse. EVIDENCE: Each resident receives a detailed complaints procedure when they are admitted to the home. In addition, a copy is also displayed on the notice board on the ground floor. No complaints have been received by the CSCI. The complaints register also showed no complaints had been received by the home. None of the residents or visitors had any complaints about the home and felt they could discuss any concerns with the staff or manager. Comments were “I have no complaints”, “I am always kept informed of any changes to my relative” and “staff are very approachable”. All staff receive training during their induction concerning abuse. One member of staff knew what abuse meant and what they should do if abuse was suspected. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 12 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, 22 and 25 Residents live in clean and safe accommodation. There are areas, which require redecoration, but the new owner is addressing these issues. EVIDENCE: Residents who spoke to the inspector said how much they liked their bedrooms. Comments were “I have a lovely bedroom which is so comfortable”. They also said their laundry was returned in a good, clean state. A new additional mobile hoist has been purchased since the last inspection. This is in addition to the other aids and adaptations provided to assist residents with their mobility and personal needs. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 13 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 and 29 There is a well trained and competent staff team. The numbers of staff were sufficient to meet he needs of the residents. Staff were correctly recruited. EVIDENCE: Examination of a staff file of a member of staff who had been recently recruited showed that they had been correctly recruited. None of the residents, visitors and staff expressed any concerns about the level or availability of staff. During the inspection, staff were seen to attend to residents promptly. Staff said they had sufficient time to care and support residents. Comments were “I feel safe working here”, “I can approach the manager if I have any concerns and I feel supported” and “we have a good staff team”. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 14 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) 31, 32and 36 The home is well lead by a competent, experienced and committed manager. This has resulted in a confident, supported and trained staff team. People living in the home are confident in the staff and management of the home and are asked to comment on the services provided for them. EVIDENCE: The manager has 6 years experience caring for older people and 3 years as a manager. Since the last inspection she has completed qualifications in both management and care. Staff commented that they received support and regular supervision from the manager. Residents commented, “staff are very nice” and “if I need any help they are there to help me”.
Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 15 An annual survey had just taken place where both residents and relatives were asked of their views concerning the home and services provided. These were sent out in June 2005 and results were being collected. Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x 3 x x 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 x x Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 17 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 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 Castlegate House C53 C04 S2342 Castlegate V234836 280605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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