Inspection on 26/02/08 for Cavendish House

This inspection was carried out on 26th February 2008.

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

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 13/07/06

Cavendish House 18/03/06

Cavendish House 17/11/05

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 26 February 2008 14:00 th Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 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.V353498.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 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.V353498.R01.S.doc Version 5.2 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) www.cumbriacare.org.uk Cumbria Care Post Vacant Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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) up to 4 service users in the category of LD(E) (Learning disability over 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. 13th July 2006 2. Date of last inspection Brief Description of the Service: Cavendish House is run by Cumbria Adult Social Care, formerly known as social services. The home had previously been a large home for people with learning disabilities which has now been scaled down to provide 4 respite beds. 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 games room, lounge, dining room, large 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. The current scale for charging is £501.81. A Service Users Guide is available for prospective residents, which includes a summary of the homes customer survey findings and details of how to get the latest Inspection report. All referrals and bookings are made through social services. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was an inspection where all the key standards were examined and included two visits to the home. Feedback cards had been received from residents, relatives and professionals. A tour of the building was carried out, and the home returned a questionnaire, which included the latest details of the service. The respite facility based at Cavendish House is a temporary measure until a new respite home is built in Cleator Moor. The new service will be an amalgamation of Cavendish House and The Elms, the latter is run by the Health Authority. Adult Social Care will continue to manage the service and work is underway to join the two services and staff teams. Due to the temporary nature of the service it is currently experiencing a lull in numbers, and on the day of the inspection visit only one person was staying at the home. The building is also looking run down and neglected, and having previously been a large care home the size and design is not very homely. However, while awaiting the new home planning is underway for significant invested in the old building to make it as comfortable and suited to peoples needs as possible. What the service does well: Cavendish House continues to provide a valued service as borne out by customer satisfaction surveys of service users, relatives and professionals. It offers not only respite holiday style breaks but also provides a service to people who have had a crisis, and need short-term care. This feedback card sums up the positive experience of those using the service “Brilliant” “Location good, staff excellent, property poor” “As a respite care centre Cavendish House is beyond critism, with a flawless staff team, roomy quarters and good cuisine” Professionals valued this service for being responsive to crisis and found the staff team competent and skilled in these situations. The home has good communication systems in place, both written and oral. The home has an effective admission and assessment process, covering all the necessary aspects of personal and social care. The process followed by the home to introduce new residents and their families is very good, it allows the Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 6 individual resident to set the pace for admission and involves the residents families and carers. What has improved since the last inspection? What they could do better: These areas should be included in the development of the new service: The Home is currently operating without a manager. However, suitable temporary measures have been in place to ensure that service users staying here benefit from a well-run service. The organisation now needs to submit an application for a registered manager, particularly as new developments can often experience delays. A number of feedback cards returned from service users and families felt that activities in the home could be improved. For example one person said: “If staff had the time, it would be nice if they could take people out now and again” The home should look at its resources and seek views from service users on meaningful activities that could take place during their stay. Currently it is common for there to be only one member of staff on duty which can limit choice. In the new service the plan is to have a minimum of three staff for up to six people, and this should lead to more choice being offered to people during there stay. The service is developing a tailor-made training programme for both staff teams. Whilst comprehensive this could be further improved by offering a Safe Guarding of Vulnerable Adults course. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 8 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.V353498.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service Users Guide is informative, and assists prospective service users in making an informed decision about staying at the Home. EVIDENCE: Cavendish House is currently updating its Statement of Purpose and Service User Guide to reflect the recent changes in the staff team and to increase its numbers from 4 to 6 people. The home provides potential new residents and their families with an information booklet about the home. Each time Social Services makes a referral to the home a thorough assessment process is implemented. The potential new resident and their family will be invited to come and look around the home. The family or carers will be asked to complete an in-depth form that looks at the likes and dislikes of the resident, normal daily routines, medical history and any other social or care needs the resident may have. The resident will then be invited to come for tea and to spend some time at the home. This process varies depending on the needs of the resident, some will Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 10 spend several weeks visiting and spending time at the home before they are happy to stay over night, others may only require one or two visits, the home bases this process around each individual. One resident commented on the questionnaire ‘I like to stay here’ and confirmed that they had attended visits first. All admissions are managed by social services in consultation with the manager of the Home, to endeavour to ensure the appropriateness and computability of each placement. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst each person has a plan of care these could be further strengthened by adopting a person centred style. EVIDENCE: Each person has 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 individual plans 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. The forms that are currently being used have been in operation for some years and are out dated. They would benefit from a review and the care planning Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 12 process should be developed along more person centred lines to make the most of engaging with people using the service. For example if they were written in the first person this would help in personalising them and giving the individual ownership. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While staff endeavour to offer people opportunities to have choice during their stay the staffing levels hamper this. EVIDENCE: A number of feedback cards returned from service users and families felt that activities in the home could be improved. “If staff had the time, it would be nice if they could take people out now and again” The home should look at its resources and seek views from service users on meaningful activities that could take place during their stay. Currently it is common for there to be only one member of staff on duty which limits choice for people. In the new service the plan is to have a minimum of three staff for up to six people. The staff team have recently been encouraging people to develop personal skills during their stay, rather than looking at respite as staying in a hotel and being looked after. This is a more positive approach and has proved more Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 14 stimulating for people who have enjoyed being more involved, for example in preparing snacks and meals. Menus were examined and found to be well balanced and healthy; and service users questionnaires all stated that they enjoyed the meals. Menus are planned with residents on a weekly basis and a communal evening meal is encouraged. Food cupboards and freezers contained good quality food such as lean meat, and numerous fresh vegetables and fruit. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems have been developed to monitor individual’s health and medication. EVIDENCE: Staff have a good understanding of residents healthcare needs and are managing complex healthcare issues. The staff team work positively with local health care professionals to offer a responsive and supportive approach in assisting people to maintain good health. Records on healthcare needs are well maintained and kept up-to-date, these are linked to care plans to alert staff on any changes, and include monitoring sheets for specific issues, such as monitoring epilepsy or changes in behaviour. The staff are aware of the personal support that each resident requires from the information gained from families and carers and also from assessment. The personal preferences for each resident were seen in the plans of care, these included morning washing/bathing preferences and bedtime routines. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 16 The staff team work to an efficient Medication Policy supported by procedures and practice guidelines. Staff follow robust systems to make sure that medication records are fully completed, contain required entries and are signed by staff. Staff have received Medication training. This is good practice and will ensure safe standards are met. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. EVIDENCE: The home had polices and practices that safe guarded the handling of residents monies. Personal monies and records were examined and found to be correct, with the signatures of both staff and the resident. The atmosphere developed in the home encourages open discussion and expression of views. The Home had a complaints procedure, with a response time of 28 days. A system was in place to record all complaints. All service users had a copy of the complaints procedure, and details of how to complain were posted in the home and was available in different formats. Up-to-date information about the Commission for Social Care Inspection was included. The organisation has policies and procedures for the safe-guarding of vulnerable adults. When interviewed the senior in charge was clear on lines of accountability and action she would take to protect people. However, the staff were less clear on the processes outside of the organisation and the MultiAgency guidelines booklet could not be found. As the staff team is to be newly formed from both health and social care it would be beneficial for staff to receive training in this area to ensure consistency and improve knowledge in safe-guarding issues. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Home is suitable for use as a temporary measure while a new facility is being built. EVIDENCE: As a temporary solution the building is a satisfactory stopgap. The relocation is anticipated to take place before the end of 2008 and in the meantime the building is safely maintained with all the necessary repairs and annual safety checks being carried out. To ensure peoples comfort during their stay Cumbria Adult Social Care are investing in a re-decoration and refurbishment programme to include a number of bedrooms, communal rooms and kitchens. To accommodate people from the NHS respite unit the home has also installed a walk-in shower room, and will be applying to use an extra two bedrooms, taking its numbers to 6. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 19 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.V353498.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are well-trained and recruited using robust procedures to ensure they have the skills and attributes to support people with a learning disability. On occasions the numbers of staff are not sufficient to allow for people to have a choice on how to spend their time. EVIDENCE: Currently it is common for there to be only one member of staff on duty which can limit choice. For example one person said: “If staff had the time, it would be nice if they could take people out now and again”. Staff try to be flexible and take people out as much as they can but this becomes difficult if one person wants to go bowling and another wants to go to the cinema. In the new service the plan is to have a minimum of three staff for up to six people, and this should lead to more choice being offered to people during there stay. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 21 A sample of staff files were examined and these contained all the relevant documentation and were clearly sectioned and well-organised. The selection procedure includes obtaining two written references, and a formal interview. All staff have CRB enhanced disclosure checks, and the supervisor was aware of extra precautions to be put in place when recruiting using POVA 1st. These records are held in accordance with the organisations policy. The Home does not use temporary or other employment agency staff. Staff had thorough job descriptions and were, therefore when interviewed, clear on their roles and responsibilities. Staff handbooks were issued on employment, which included important policies and key contacts and the General Social Care Council code of conduct is also issued to all staff. All staff undergo Learning Disability Awards Framework induction programme, and specialist training is sourced to assist staff in meeting the individual needs of service users. This ensures that training is targeted and focussed on improving outcomes for service users. All staff are qualified to NVQ level 2 in Care, 3 staff have progressed onto the Level 3 and the supervisor is undertaking level 4. Staff have recently completed a number of short courses on the Safe Handling of Medication and health related issues. Staff supervisions have improved since the last inspection and were carried out on a more regular basis. They contained a good level of detail and offered support to people to improve their work practice and identify further training. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Home is currently operating without a manager. However, suitable temporary measures are in place to ensure that service users staying here benefit from a well-run service. EVIDENCE: The Senior has managed the Home recently in the absence of a manager and has provided the home with continuity and in particular ensured all administration of the home is up-to-date. She reported that she had been well supported by the management of the organisation. The organisation now needs to submit an application for a registered manager, particularly as new developments can often experience delays. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 23 Fire Records, annual gas and electrical checks, and servicing of hoists were all checked and these were all up-to-date. The home had effective systems in place to ensure the safety and up keep of the physical environment, such as cleaning rotas and maintenance records. The administrative systems within the home were found to be up-to-date and in good order, ensuring the home was run in an efficient and effective manner. Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 3 2 3 3 x 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 2 x LIFESTYLES Standard No Score 11 3 12 2 13 2 14 x 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 2 x x 3 2 Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 25 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. 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 YA14 Good Practice Recommendations The home should consult with service users with a view to improving the range of activities available, and the new staffing structure should make allowances for individual choice Safe Guarding of Vulnerable Adults should be included in the new training programme 2 YA23 Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Cavendish House DS0000036777.V353498.R01.S.doc Version 5.2 Page 27 - 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!