Inspection on 09/08/06 for Castleview Care Home

This inspection was carried out on 9th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Castleview Care Home 05/05/09

Castleview Care Home 08/10/08

Castleview Care Home 28/05/08

Castleview Care Home 06/06/07

Castleview Care Home 06/12/05

Castleview Care Home 06/06/05

Castleview Care Home 20/12/04

Similar services:

22 Sandown Road

The Highlands

Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Prince Bishop Court

Park View (15)

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

CARE HOMES FOR OLDER PEOPLE Castleview Care Home Howling Lane Alnwick Northumberland NE66 1HL Lead Inspector Anne Urwin Brown Key Unannounced Inspection 9th August 2006 09:30 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 Castleview Care Home DS0000061171.V295440.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. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castleview Care Home Address Howling Lane Alnwick Northumberland NE66 1HL 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) 01665 605311 01665 606633 Mr Trevor Nesbit Mrs Leigh McLaren Care Home 45 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (21), Mental disorder, excluding learning of places disability or dementia (1), Old age, not falling within any other category (21) Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2005 Brief Description of the Service: 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. Accommodation is arranged on two floors. The Home caters for older people, older people with dementia and has one place for an adult with dementia. All the rooms have en-suite accommodation. There is a small paved area to the front of the Home, 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. Fees range from £378.45 to £383.52. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over seven hours. Before the visit the Inspector used information from the pre-inspection questionnaire to assist in planning the inspection. The inspection involved talking to the Manager, eight residents and five staff, a tour of the building and inspection of records. What the service does well: What has improved since the last inspection? What they could do better: A Quality Assurance system must be introduced. Care plans must be regularly updated to reflect changing needs. Assessments relating to pressure areas, falls and nutrition need to be regularly updated. The activity programme must take account of the needs of residents with disabilities to allow them to take an active part. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 6 Arrangements for serving food should be reviewed to ensure that it is at an appropriate temperature when it reaches residents. This is affected by staffing levels. Some premises issues were identified during the inspection that need to be addressed: • The seal is damaged in the ground floor shower room • The shower seat in the ground floor shower room needs to be replaced • Some toilets require redecoration • Room 13 needs repainting. Some toilets/bathrooms have no bin for paper towels. A review of staffing levels is needed to make sure that enough staff are available to cover sickness and annual leave. Training in safe working practices including fire training and moving handling must be provided at appropriate intervals for staff. This was discussed with the Acting Manager who is aware that this matter needs urgent attention. 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. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 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 Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 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): 3, 6 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service No resident moves into the home without having had his/her needs assessed and been assured that these needs will be met. Intermediate care is not provided at Castleview. EVIDENCE: Records showed that an appropriate assessment of residents‘ needs is carried out. Care management assessments were available for residents referred by the local authority. Each resident has a plan of care for daily living based on the home’s assessment. Castleview does not provide intermediate care. Records confirmed this. Castleview Care Home DS0000061171.V295440.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service Residents’ health, social and personal needs are set out in an individual plan of care, however more information is needed in some plans and others are not being updated to reflect changing needs. Residents are protected by the home’s policies and procedures for dealing with medicines. Residents feel that they are treated with respect and their right to privacy is maintained. EVIDENCE: Care plans are available for each resident that cover appropriate areas. Two plans seen did not have enough information about residents’ care needs. Assessments for falls, moving and handling are not regularly updated for all residents. Staff are not regularly reviewing care needs and recording changes in care plans. Residents do not regularly sign care plans. Information about residents’ health care needs is kept appropriately. Records of visits by health care professionals are in place. Some assessments for pressure areas and nutrition had not been regularly updated. Records show that residents have appropriate access to the general practitioner, district Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 10 nurse, chiropodist, dentist and other specialist healthcare services. Residents said that they could see their doctor when they wanted. Policies and procedures are in place for dealing with residents’ medicines. An assessment is carried out if a resident chooses to administer their own medicines and their doctor is consulted. Records of all medicines given to residents are kept in an appropriate form. Nomad monitored dosage system is used in the home. Training for staff in dealing with medicines has been provided. First aid training is provided at regular intervals for staff. Residents said that they are happy that staff respect their privacy. Privacy and dignity issues are referred to within guidance for staff. Staff induction training covers areas relating to privacy and dignity. Staff showed that they were aware of privacy and dignity during the inspection. Residents can choose to have a telephone fitted in their bedrooms. A public payphone is available, but is awaiting repair and in the meantime residents can use the office phone. Castleview Care Home DS0000061171.V295440.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service Residents find the lifestyle experienced in the home matches their expectations and preferences. Their social, cultural, religious and recreational interests and needs are generally met, although more support needs to be provided for residents who have disabilities. Residents maintain contact with family, friends, representatives and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing diet in pleasant surroundings at times convenient to them. EVIDENCE: Residents said that they were able to make choices about their daily life and gave examples of when they get up and go to bed, where they spend their time and whether they take part in activities. One person said that it was difficult to take part in activities because she was blind. Records show that residents’ wishes about their daily routines are followed. An activity organiser is employed and records show that there are regular organised events including arts and crafts, dominoes, card games, videos and music. Outings include trips to the library, shops and Alnwick Playhouse. During the inspection there were no events organised and residents in the dementia unit Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 12 would have benefited from more stimulation. From talking to staff and a visitor it was apparent that staffing levels do affect this. Visitors are welcomed at any time and can see residents in private. Visitors during the inspection also used the residents’ lounges. The visitor said that they had been provided with information about the home and visiting arrangements before their relative came to live at Castleview. The acting manager said that residents are encouraged to handle their own money for as long as possible. Residents are encouraged to bring in items of furniture and other personal possessions when they come to live at the home. Residents can have access to their records and policies confirm this. Menus show a good variety of food is provided. Residents said that they were happy with the quality and quantity of food available and that they could have drinks and snacks when they wanted. In one questionnaire a resident said that meals served in her room are sometimes cold when they reach her, but since she reported this to staff the food is hotter. During the inspection there were only two staff downstairs and they had difficulty serving the food and attending to residents’ needs at the same time. Special diets are catered for and one residents said she was satisfied with the arrangements for her diet. Staff have completed food hygiene training and regular updating training is provided. Castleview Care Home DS0000061171.V295440.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service Residents and their relatives are satisfied that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Guidance is in place for dealing with complaints. No complaints have been made since the last inspection. Residents said that they felt able to raise any concerns or complaints with staff. One person said that she always knew who to speak to if she wasn’t happy. An appropriate system is in place for recording complaints, the investigation and outcome. Guidance is available for staff on dealing with allegations of abuse. Staff were aware of the steps to be taken in the event of an allegation being made. Most staff have completed Protection of Vulnerable Adults training. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service Residents live in a safe and well-maintained environment. The home is clean, pleasant and hygienic. EVIDENCE: The home is designed to suit the needs of older people. Comfortable public accommodation is provided for residents. Residents’ rooms are well furnished and show evidence of individual interests and taste. The accommodation is on two floors and a shaft lift is fitted. There is a programme of routine maintenance and renewal in place and items identified within this inspection are on the list to be attended to. These included: • The seal is damaged in the ground floor shower room • The shower seat in the ground floor shower room needs to be replaced • Some toilets require redecoration • Room 13 needs repainting • Some toilets/bathrooms have no bin for paper towels Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 15 The grounds are well maintained, however a gate needs to be fitted to the fencing round the upstairs conservatory to ensure residents from the dementia unit can go outside safely. The building complies with the requirements of environmental health and the local fire service. Procedures are in place for control of infection. The premises are clean, hygienic and free from odours. Laundry facilities are good and are accessible from the main corridor on the ground floor. The washing machines have appropriate cycles for washing soiled linen. Hand washing facilities are provided. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service Residents’ needs are met by the numbers and skill mix of staff, but the level of staff cover is affected by staff sickness and annual leave. Residents are in safe hands at all times. The home’s recruitment policy and practices support and protect residents. Staff are trained and competent to do their jobs. EVIDENCE: There were five care staff, two of which were senior staff on duty at the time of the inspection and the rota confirmed this. The acting manager was also available. The manager said that staffing levels varied between five and seven care staff and that there is a senior member of staff on each shift. At night there is one senior member of staff and two care staff on duty. The rota confirmed this. An activity organiser is employed. There were three staff working upstairs in the dementia unit and two staff downstairs. A visitor said that she felt that at times there were not enough staff and that she often did not see them when she visited. One resident said she felt more care staff were needed. During the inspection the inspector saw that there were not enough staff available when staff were needed to provide personal care for residents when lunches were being served. The manager said that staff absences due to sickness and holidays were affecting the number of staff available. Sufficient domestic staff were available during the inspection. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 17 More than fifty per cent of staff have achieved national qualifications in care. Staff and management are to be commended for this. Guidance is in place for the recruitment of staff. Staff records show that appropriate reference and Criminal Records Bureau checks are carried out before any new staff start work. Staff records contain appropriate information. A staff training programme is in place. Induction training is provided for all new staff. The new manager needs an appropriate induction programme. Training provided in the last year included Food Hygiene, Continence, Protection of Vulnerable Adults, Health and Safety, Dementia and Person Centred Care. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service The management of the home is in a process of change. Residents live in a home that is run and managed appropriately. The home is generally run in the best interests of residents, but there is not an annual development plan in place. Residents’ financial interests are safeguarded. The health, safety and welfare of residents and staff could be better promoted by the provision of regular training. EVIDENCE: The registered manager is to take up the post of care manager and a new acting manager has been appointed on three months trial. The registered manager is experienced in caring for elderly people, but does not have a management qualification. The acting manager has the registered manager’s award and is experienced in caring for elderly people. An appropriate induction Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 19 programme is needed for the acting manager. A job description is in place for the manager. There is no annual development plan in place. A quality assurance system has not been introduced that takes account of residents’ views about the service. Guidance is in place about handling residents’ money. Records are kept of any money held on residents’ behalf and of any transactions. The money held was checked against the records and was in good order. Residents have lockable storage in their rooms for keeping valuables. Training in safe working practice including fire training and moving and handling has not been regularly updated for all staff. Training is being organised and the Acting Manager was able to provide dates for this. Some fire records were not up to date including fire alarm tests, emergency lighting tests and checking of fire doors. Records showed that the fire system and fire equipment had been serviced. There are thermostatic controls on the hot water system, but no arrangements are in place for random checks to be made of hot water temperatures. Accident records are kept in an appropriate form. All new staff receive appropriate induction training. Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 20 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 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 2 Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP24 Regulation 33 Requirement A Quality Assurance system must be introduced. This matter is outstanding from the last three reports. 2 3 4 OP7 OP8 OP12 15 12 16 Care plans must be updated to reflect changing needs. Assessments relating to pressure areas, falls and nutrition need to be regularly updated. The activity programme must take account of the needs of residents with disabilities to allow them to take an active part. Arrangements for serving food must be reviewed to ensure that it is at an appropriate temperature when it reaches residents. The following issues were identified during the inspection and action is needed to address these: • The seal is damaged in the ground floor shower room • The shower seat in the ground floor shower room DS0000061171.V295440.R01.S.doc Timescale for action 31/10/06 31/10/06 31/10/06 31/10/06 5 OP15 16 31/10/06 6 OP19 23 31/10/06 Castleview Care Home Version 5.2 Page 22 • • • needs to be replaced Some toilets require redecoration Room 13 needs repainting Some toilets/bathrooms have no bin for paper towels. 31/10/06 30/09/06 7 8 OP27 OP38 18 13 A staffing review needs to be undertaken. Training in safe working practices including fire training and moving handling must be provided at appropriate intervals for staff. 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 Castleview Care Home DS0000061171.V295440.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Castleview Care Home DS0000061171.V295440.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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