Inspection on 17/11/05 for Cavendish House

This inspection was carried out on 17th November 2005.

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

Cavendish House 11/03/09

Cavendish House 26/02/08

Cavendish House 13/07/06

Cavendish House 18/03/06

Cavendish House 18/03/05

Cavendish House 17/05/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 Cavendish House Elizabeth Street Workington Cumbria CA14 4DA Lead Inspector Liz Kelley Unannounced Inspection 17th November 2005 2:00 Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 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 Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. 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. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cavendish House Address Elizabeth Street Workington Cumbria CA14 4DA 01900 605280 01900 871107 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) Cumbria Care Ms Jacquelin Reed Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 4 service users to include: up to 4 service users in the category of LD(Learning Disability under 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 18th March 2005 Date of last inspection Brief Description of the Service: Cumbria Care an internal Business Unit of Cumbria County Council operates Cavendish House. Cavendish House is a two-storey building situated a short distance from the centre of Workington a town on the West Coast of Cumbria. The ground floor is used for the registered care home providing respite breaks for up to four people with a learning disability. There is stairs access between the two floors. The ground floor is comprised of a large games room, lounge, dining room, kitchen, reception area and office. Private bedrooms are situated away from the communal and kitchen areas. There are sufficient bathrooms and toilets and specialist bathing facilities are available. The first floor is used by Cumbria Care and Social Services as a base for domiciliary staff and office space for meetings. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Home has been operating as a four-bed respite facility since September 2004 and a completely new staff team had been formed, led by Jackie Reed the newly appointed registered manager. This inspection took place over 3 hours, across the late afternoon. A full tour of the premises took place and staff records and residents files were examined. A visiting social worker was spoken to along with one service users. Earlier in the year a pre-inspection questionnaire was received from the manager, and in the month prior to the visit residents, relatives, and professionals returned a questionnaire on their experience of Cavendish House. What the service does well: What has improved since the last inspection? What they could do better: The use of Cavendish House remains a temporary measure while all options are explored to provide for the future of respite provision in the area. This means that although some measures have been put in place to improve the building, this has been limited due to the uncertainty. The building, therefore, remains rather institutional in appearance and feels too large for its present purpose. For example the kitchen is designed for large scale catering and the communal room is very large and unwelcoming. The general decoration of the building is now looking worn and dated. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 6 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. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 The homes Statement of Purpose and Service Users Guide is very informative, and assists prospective service users in making an informed decision about staying at the Home. The Home has good arrangements for carrying out thorough assessments and this makes sure that the home is suitable and that service users will enjoy their stay. EVIDENCE: Cavendish House has recently updated its Statement of Purpose and Service User Guide. These contain useful information for a person staying at the home. Details of the new manager and staff changes have been added to the Statement of Purpose. Service users are only admitted following a community care assessment and the manager follows the majority of these up with a home visit. One file examined detailed a series of visits for tea, for the day and building up to over night stays. The home takes emergency admissions from social services and a policy was in place to ensure these are managed as smoothly as possible. All admissions are managed by social services in consultation with the manager of the Home, to ensure the appropriateness of each placement. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, and 7 Service users felt confident that their needs could be met by having an individually tailored plan to help them enjoy their stay at the home. EVIDENCE: Each person had an individual plan based on social work assessments and on questionnaires of likes/dislikes, interests and daily routines which was sent out prior to a stay. These measures meant that staff had the most up-to-date information to ensure that each persons stay was both enjoyable and that basic needs are looked after in the way people would wish. The Home had developed a good set of documents and forms to be used with service users and their families. A recent addition made as a recommendation at a previous inspection had been the development of consent forms for administering medications and seeking emergency medical attention, this had included emergency contact telephone numbers. Each service user has an individual plan, which included risk assessments and the home had sought advice from appropriate professionals. The staff have been up-dating these plans to ensure they have, for example a recent photograph and detail of interests and hobbies. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, and 17 Service users are offered an interesting and varied range of activities and staff are skilled at supporting service users to make choices. Service users were involved in choosing healthy, good quality meals which promoted the development of new skills and encouraged healthy lifestyles. EVIDENCE: The majority of placements offered were weekend breaks or breaks of up to a week. While staying at the home service user are encouraged to maintain their usual social activities, if this is possible. This is enabled by the support of families who take people to their usual evening clubs. Other activities noted in care notes and discussed were videos and DVDs, the cinema, cafes, pubs, take-aways, car boots, and playing pool. The atmosphere within the home was observed to be relaxed and friendly with both staff and service users having friendly conversations that were warm, respectful, and supportive. Menus were examined and found to be well balanced and healthy; and service users questionnaires all stated that they enjoyed the meals. Food cupboards and freezers contained good quality food such as lean meat, and numerous fresh vegetables and fruit. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 11 Relatives report good communication and satisfaction with the service provided. One letter sent in as part of the inspection states “Like other longterm elderly carers, we find we can carry on with the regular help of a service that provides our sons and daughters with a temporary, individually appropriate and caring environment run by loving staff. Cavendish House has, for many years admirably provided all these securities.” Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Staff have a good awareness of each person’s health and personal care needs and strategies are achieved by external professional advice. EVIDENCE: The home does not have overall responsibility for managing healthcare but does monitor health across a person’s stay. The home had relevant contact details of GPs and details on medical conditions, and medications. At a previous inspection the manager was recommended to devise medical consent forms that would give them permission to seek emergency medical advice and treatment in the event of the service users families/legal guardian being unobtainable. The home had various aids and adaptations to assist in the care of service users and to ensure their comfort and safety. These included high/low beds, an assisted bath, and manual handling hoists and moving equipment. Staff provided support and care in a respectful and sensitive manner. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards will be assessed at the next inspection. EVIDENCE: Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The Home is not designed for respite stays, and is therefore not ideal for its current use. If it were to be used long-term it would require considerable adaptation and investment to change both the layout and to up-grade the property. EVIDENCE: As a temporary solution the building is a satisfactory stop gap. The building is safely maintained with all the necessary repairs and annual safety checks being carried out. The care staff are responsible for the cleaning of the home and this was done to high standards. Cleaning rotas were examined which included the kitchen areas which were in good detail and records were up-to-date. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33 and 36 Cavendish House had a well-motivated staff team who were skilled in supporting service users with learning disabilities. EVIDENCE: Staff were trained to work with people with learning difficulties and this included strategies to manage challenging behaviours. The Home has more than 50 of staff qualified in NVQ level 2 in Care, and staff have recently completed a number of short courses on the Safe Handling of Medication and health related issues. Evidence was seen through staff individual involvement in developing care plans and how they used their knowledge and skills to carry out duties in such a way that care plans met the needs of the service users. The home demonstrated that they had access to a pool of trained relief staff to accommodate sickness and emergencies and to allow for increased flexibility for service users. The staff team and manager had the capacity to offer flexibility in the hours offered depending upon the needs of individual service uses. Supervision takes place with the manager every 6/8 weeks and relief staff are supervised by the manager. Staff stated they had benefited recently from an intensive training programme provided by the organisation as part of induction and foundation training for new staff. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 16 The senior had managed the Home recently through the absence of the manager and had provided the home with continuity and in particular had ensured all the administration of the home was maintained and up-to-date. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 43 Service users staying here benefit from a well-managed and well-run service. EVIDENCE: From information gained from service users, staff and from documentary evidence the manager was judged to be competent and effectively managing the Home. The manager had previous experience of being a supervisor in a care home for people with disabilities. The manager had also undertaken a review of the service, including a customer satisfaction survey. The majority of comments were positive, only two negative comments were received on the building. These were some of the comments: We have never had any reason to complain” “I am more than satisfied with the service” “We know we can relax as our son is happy and secure here allowing us to relax and enjoy our short break” “He likes to go to Cavendish House and everyone is good with him” Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 18 The senior, who has run the home in the manager’s absence, said she had been well supported by the management of the organisation. Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cavendish House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x x 3 DS0000036777.V259991.R01.S.doc Version 5.0 Page 20 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. 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 Cavendish House DS0000036777.V259991.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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