Inspection on 05/05/09 for Castleview Care Home

This inspection was carried out on 5th May 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Castleview Care Home 08/10/08

Castleview Care Home 28/05/08

Castleview Care Home 06/06/07

Castleview Care Home 09/08/06

Castleview Care Home 06/12/05

Castleview Care Home 06/06/05

Castleview Care Home 20/12/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Castleview Care Home Howling Lane Alnwick Northumberland NE66 1HL     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne UrwinBrown     Date: 0 5 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Castleview Care Home Howling Lane Alnwick Northumberland NE66 1HL 01665605311 01665606633 castleview@ascotcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Trevor Nesbit care home 45 Number of places (if applicable): Under 65 Over 65 0 0 25 dementia learning disability old age, not falling within any other category Additional conditions: 25 3 0 The maximum number of service users who can be accommodated is: 45 The registered person may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 25 Dementia Code DE, maximum number of places 25 Learning Disability, maximum number of places 3 Date of last inspection Brief description of the care home Castleview is a purpose built home for older people situated in a residential area of Alnwick. It is a short distance from the centre of town. This two storey building has high quality accommodation that suits the needs of the people living there. The Home caters for older people, older people with dementia and has recently changes its registration to include three people with a learning disability. All the bedrooms have en-suite accommodation. There is a small paved area to the front of the Home and Care Homes for Older People Page 4 of 26 0 8 1 0 2 0 0 8 Brief description of the care home decking outside the conservatory on the first floor, which can be used by residents. Parking is also available. Public transport links are easily accessible in Alnwick town centre and train links are available from Alnmouth. A copy of the Statement of Purpose and Service User guide is available at the home that describes the service offered. Fees range from £436 to £470 per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that the people who use the service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit. How the service dealt with any complaints & Care Homes for Older People Page 6 of 26 concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 5th May, 2009 and the visit lasted seven hours. During the visit we: Talked with people who use the service, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe & comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: There is a lack of consistent recording and monitoring of the services care plans that Care Homes for Older People Page 8 of 26 means that people using the service may not get the care they need. Recruitment procedures including last employer reference and exploration of employment gaps must be available to confirm the suitability of people appointed to post in this service. This will ensure that people using the service are protected. The drain in the ground floor shower rooms needs attention to ensure that water drains effectively away preventing damage to existing surfaces and risks of cross infection. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear information and assessments processes enable residents to make a positive and informed choice before moving into the home. Evidence: There is a Statement of Purpose and Service User guide that provides clear information about what it is like to live at Castleview. The information available describes the service provided, staffing arrangements and the accommodation. Two people said that they had plenty of information about the home before they came to live there. Peoples needs were assessed before they were admitted to the home. The manager or deputy manager carry out the assessment using standard tools so that all the information is recorded and can be used to inform the individual care plan. Two people living in the home said that staff knew about their needs when they came to live at the Care Homes for Older People Page 11 of 26 Evidence: home. Staff said that they have enough information when people come to live at the home to ensure that their needs are met. Intermediate care is not provided. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs are met, but the varied and inconsistent recording of information affects the delivery of good quality care to people living in the home. Evidence: All care plans have now been completed using the organisations new format. Good information is available within the daily logs to show that peoples needs are being met, but further improvements are needed in the content and quality of care plans. There is a lack of consistent recording within individual plans to show that peoples needs are properly reviewed and updated. Of the four plans seen at this inspection one was up to date and contained good information. The other plans varied in content and quality of recording with some parts of plans not being updated regularly or changed to reflect peoples current needs. Three people living in the home said that staff were aware of their needs and provide them with good support. They said staff knew what assistance they required and come promptly when they request support. All said that the staff were kind and considerate Care Homes for Older People Page 13 of 26 Evidence: and treated them respectfully. Staff said that sometimes they do not have enough time to complete work on care plans. They said that they feel people living in the home get good care and support at Castleview. All staff showed a good understanding of peoples needs and were observed to be responsive to any requests from people living in the home during the inspection. Good systems are in place for the administration of medicines. A monitored dosage system is in use. Records are kept in good order. Staff receive appropriate training in administration of medicines. Equality and Diversity training has been arranged for staff so that they are clear about the principles in their day to day work. Staff generally treated people living in the home with dignity and respect during the inspection. It was observed that one person was having his breakfast in the dining room in his pyjamas, but staff quickly got his dressing gown to ensure that his dignity was not compromised. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to make choices about their routines and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. Evidence: People living in the home are able to make choices about their lifestyle and routines. This was evident from observation and from talking to people who live at Castleview. Two people said that staff support them to live the way in which they choose and they are able to spend the time how and where they wish. They said that staff are very flexible and their care needs are met at times convenient to them. Records are kept of individual activities and these are planned to suit peoples interests. The activity organiser said she is able to purchase materials for activities and can vary her hours to suit the needs of any organised activities. A piano has recently been acquired and two people living on the upper floor have started to play regularly in the conservatory. People living in the home said that the the food is good and that there is a choice at Care Homes for Older People Page 15 of 26 Evidence: each mealtime. They said that they could ask for an alternative if they did not like either of the choices on the menu. Menus are varied and showed that there is an emphasis on health eating and special diets are available as required. The cook said that vegetarian and diabetic meals are prepared daily. During breakfast time it was observed that at least four cereal bowls were chipped and these were replaced by staff. The manager said that new stocks of china are on order. Kitchen staff have undertaken appropriate Food Handling training. Drinks are provided regularly through the day and there is a varied selection offered. There was tea, coffee, or cold drinks of either juice or milk. There were biscuits provided. Fruit was also available. The bedrooms are of a very high standard, they are personalised according to the taste of the resident. Residents said they were happy with their rooms and that they had a lot their own personal items around them. Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. The relatives said that they are welcomed into the home. Residents said they were happy with the arrangements for visitors. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the good systems in place at Castleview for dealing with complaints and safeguarding. Evidence: There is a written complaints procedure that outlines the route for making a complaint and the action that is taken by the organisation in dealing with complaints. Systems are in place for recording complaints, and only one complaint has been made in the last year. Records of complaints are also kept in individuals records. People living in the home said that they felt confident that they could raise any issues about the quality of the service and were satisfied that these matters would be taken seriously. There are written procedures for dealing with safeguarding matters. One safeguarding referral has been made since the last inspection and records show that this has been satisfactorily dealt with. The manager said that all staff have completed safeguarding training. Whistle blowing procedures and staff recruitment checks also contribute to making people living in the home safe. Staff were able to describe the appropriate action to be taken in the event of an allegation being made. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Castleview provides a comfortable, well maintained and decorated environment that suits the needs of the people living there. Evidence: The home is clean, well decorated and odour free. The building is purpose built and designed to suit the needs of the people living there and provides comfortable accommodation. It is light and spacious with wide corridors and good sized rooms. The lounges and dining rooms are well designed. There is a conservatory overlooking the garden that provides a comfortable, quiet sitting area on each floor. A shaft lift is available for access to the first floor. The gardens are well maintained and attractive safe seating areas are available. Residents said that they are happy with the quality of the accommodation provided. One person said that she and her husband finds their room very comfortable and all the facilities are available that they need. She said We have been able to bring things in from our previous home and it makes us feel more comfortable having our own things around us. This is a nice place to live and we can get help whenever we need it. Maintenance records are kept to show that action is taken to address any repairs. Staff Care Homes for Older People Page 18 of 26 Evidence: said repairs are carried out promptly. There is an ongoing programme of redecoration and refurbishment. The sitting and dining rooms have been redecorated, as has the entrance hall and offices. Bathrooms and toilets are tidy and clean. One shower room needs attention as the water from the shower is not draining away. All bedrooms are fitted with en-suite accommodation, which is much appreciated by the people living in the home. There are appropriate aids and adaptations fitted to suit the needs of the people living in the home. Liquid soap and paper towels are available in bathrooms and toilets to minimise risks of cross infection. Bedrooms are well decorated and furnished offering spacious accommodation. People are encouraged to bring in items from their previous homes. Staff showed that they were aware of good health and safety practice during the inspection. The laundry was clean, well organised and equipped. Staff working in the laundry are aware of infection control procedures. There is sufficient appropriate laundry equipment. Infection control training is provided. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient well trained staff are available at all times to meet the needs of the people living in the home. Evidence: There were sufficient staff on duty during this inspection and the staff rota showed that sufficient staff are available to meet the needs of the current residents. There was a senior member of staff on each floor and two care staff upstairs and one downstairs. In addition the manager and deputy manager were on duty. People living in the home said that there are enough staff and that staff respond promptly to any requests for help. Staff said that there are enough staff and that morale is good. Sickness and annual leave is covered by existing staff working additional hours. Staff said that this is manageable within the current staffing levels. Seventy five per cent of staff have completed national qualifications in care and a further five staff are working towards these. There is an ongoing training plan in place to identify updates for essential training as well as identifying other specific training needed by staff to meet peoples needs. In the past year staff have had training opportunities that included Diabetes, Podiatry, Mental Capacity Act and Challenging Behaviour. Care Homes for Older People Page 20 of 26 Evidence: Staff meeting are held regularly and minutes were available to show that information is clearly transmitted to staff. Staff said that they feel able to put forward their views about the service and that they are encouraged to take an active part in meetings. Staff recruitment procedures are in place. Records of recently appointed staff show that appropriate recruitment procedures are followed and evidence of reference and Criminal Records Bureau checks are in place. One record of an existing member of staff showed that appropriate checks had not been made of employment gaps and previous employer reference. This was reported to the manager and she gave assurances that this would be done retrospectively. The current manager recognises the importance of good recruitment procedures in the delivery of a good quality service and is in the process of reorganising records so that information is easier to locate. Equality and diversity policies are reflected in recruitment procedures. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management and quality assurance systems are in place to allow people living in the home to contribute their views about the operation of this service. Evidence: The manager has been in post about one year. She is experienced and qualified in caring for older people. She receives regular supervision and support and has plenty of training opportunities to keep her up to date. In the past year she has completed training in Safeguarding, Alcohol Awareness, Workforce Development and is to undertake further management training. She operates an open door for people living in the home and staff. People living in the home said they could speak to her whenever they wished and that she is always approachable and helpful. Staff said that they feel satisfied with the support offered by the manager and her senior staff team. The manager is aware of equal opportunities, the importance of person centred care and promoting good outcomes for the people using the service. Care Homes for Older People Page 22 of 26 Evidence: Staff receive regular supervision and say that the manager has good people skills. They said that they feel well supported in their roles and that there is clarity about responsibilities in the home. Good systems are in place for auditing the quality of the service. These were up to date and showed that account is taken of the views of people using the service and their relatives. Regular use of surveys for people living in the home and for relatives provides information that is used to inform future planning of the service. People are encouraged to retain control of their own money for as long as possible. Systems are in place for effective recording of any money held on behalf of people living in the home. All transactions are recorded and receipts are retained of any spending. Arrangements for safekeeping of any money are satisfactory. Health and safety policies and procedures are in place to protect people living and working in the home. Staff are made aware of the policies and procedures at induction training and in further training provided at regular intervals. There are systems in place to monitor practice. Essential training is provided and records are kept to ensure that staff receive regular updating training. Staff said that new staff receive an appropriate induction and are supported by senior staff to ensure that they have appropriate skills to do the job. Fire checks, servicing of equipment and drills are recorded and were up to date. Accident records are in good order and correspond to entries in individual records. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Arrangements must be in place to ensure that the updating and review of care plans is effectively monitored. This will ensure that people receive the care and support they need. 31/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 21 Attention should be given to ensuring that the drain in the ground floor shower room is in good working order. This will ensure that water is not collecting on the floor and prevent Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!