CARE HOMES FOR OLDER PEOPLE
Caythorpe Residential Home 73 High Street Caythorpe Grantham NG32 3DP Lead Inspector
Jean Cope Unannounced 18 July 2005 @ 13.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Caythorpe Residential Home Address 73 High Street Caythorpe Grantham Lincolnshire NG32 3DP 01400 272552 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Christine Lyte Mrs M Barnes Care Home 14 Category(ies) of Old Age (OP) - 7 registration, with number Demential (DE) - 7 of places Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 7.10.04 Brief Description of the Service: The home is situated on the corner of main street in the village of Caythorpe. This is approximately 7 miles from Sleaford and 9 miles from Grantham. Within the village there are shops, a church and pubs. The home is currently registered to provide care and accommodation for 14 persons, 7 of which having Dementia. There are 10 single bedrooms and 2 double. There are three lounge areas and a separate dining room. A Home Care Agency operates from a separate building within the site although this did not form part of this inspection. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place with the assistance of the proprietor who is also acting as the manager and the care staff on duty on the day. One inspector undertook the inspection spending four and a half hours in the home. The inspector toured the building, spoke with staff and residents living in the home. The main method of inspection used was case tracking which involved selecting three residents and tracking the care that they receive through the checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection?
The proprietor has installed a new computerised fire system. A refurbishing and decorating programme has been ongoing since April this year, including communal areas as well as residents’ private accommodation. Since the last inspection the home has introduced a system where medication is pre-packed by the pharmacist for each individual resident. A system of monitoring the temperature of water coming from hot water taps has been installed to eliminate the risk of residents scalding themselves. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 and 4 Written information is available for prospective residents and their families to make an informed choice about the home. The proprietor assesses new residents to ensure that the home will be able to meet their needs. EVIDENCE: The home has a written statement of purpose and a brochure for the home. Brochures are left in residents’ rooms. A resident said how satisfied and happy they were with the care in the home and that they felt their needs were being met. Residents were clean, appropriately dressed and appeared settled and happy. The manager assesses new residents before they move into the home and will visit them in hospital or in their own home. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 9 The Commission received a comment card from a resident which said that they liked living in the home, felt well cared for and that the staff treated them very well. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 and 11 Residents can be sure that their health care needs are taken seriously. EVIDENCE: Each resident has a plan of care, which includes his or her likes and dislikes. There was evidence that residents’ doctors had visited whenever necessary and that staff in the home seek the advice of the community nursing team. Staff in the home said they have a good working relationship with the nursing team and receive a lot of support from them. One resident had been provided with a specialist mattress and the proprietor/manager said that the pressure sore the resident had acquired in hospital had now healed completely. Medications are stored in a locked cupboard. Medication administration sheets were examined and it was found that some medications had not been signed against which made it unclear as to whether medications had been administered or not. Some further precautions for particular medications were recommended.
Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 11 Staff said that they received support from the home’s pharmacist who undertakes regular checks. Staff and the proprietor were seen to knock on residents’ doors prior to entering and a resident felt that their privacy and dignity was respected. The care staff working in the home gave a sensitive account of how residents are looked after at the end of the lives. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 and 15 Residents are offered food, which is home cooked. Activities are provided for those residents who wish to participate. EVIDENCE: An activity co-ordinator is employed in the home for three afternoons a week and spends time with individual residents as well as organising group activities. Residents’ choices are respected if they wish not to participate in activities. A resident’s relative was seen to be visiting in the privacy of the resident’s own room and was being offered regular refreshments and snacks. One resident explained how staff assisted him to visit his doctor and the shops on his electric scooter. A two week menu is operated in the home, but staff adjust it to suit individual residents choice when necessary. Most of the food provided is home cooked, including pies and cakes, and fresh produce is purchased from the local butcher and farm shop. Two residents said they had enjoyed their midday meal. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: These outcomes were not inspected. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 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 standard(s) 19, 23, 24 and 26 Residents live in a clean and comfortable home and are able to make their own rooms more homely by bringing with them some of their personal belongings. EVIDENCE: The proprietor is decorating and refurbishing the home on an ongoing basis. Many of the residents’ bedrooms have been decorated and had new carpets and curtains fitted. New carpets have been fitted in communal areas. The home was clean and comfortable with each resident’s room being different. Residents are able to bring in small items of furniture and their own personal belongings. There is a small well-maintained garden where residents are able to sit when the weather is fine. Staff were seen to wear protective clothing and gloves to prevent the spread of infection when offering assistance with personal care to residents.
Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 Staff working in the home know the residents well and are committed to ensuring that they well cared for and happy. EVIDENCE: The proprietor/manager works in the home most days and is supported by two care staff during the day. At night time there is one waking member of staff and one member of staff sleeping in the home. A member of staff is employed to undertake cleaning duties, and the care staff cook the meals offered in the home and undertake some laundry duties. Some staff have achieved their National Vocational Qualification (NVQ) in Care at Level 2, with one member of staff commencing the course in September and another member of staff waiting for an opportunity to take up a place. The proprietor hopes to achieve the target of 50 of care staff being qualified to NVQ Level 2 by the end of 2005. Staff said that they had received training in basic food hygiene, moving and handling, first aid and fire training, but had not received training in how to work with people with dementia. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 36 Residents benefit from an acting manager who communicates with and supervises her staff regularly. EVIDENCE: The proprietor, who has almost finished the Registered Manager’s Award, is currently working as the acting manager. Staff said that she was supportive and that there was good communication between them. Regular supervision sessions are offered to staff from their manager. Discussion with staff and examination of the communication book and minutes of staff meetings showed that residents’ views and staff suggestions are acted upon in order to respond to the best interests of the residents living in the home. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 3 3 x x 3 x x Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 18 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 9 Regulation 13(2) Requirement Staff adminstering medication must sign medication administration records so that it is clear whether medication has been given or not. The registered person must ensure that staff receive training in the work they are to perform. Training on how to care for residents with dementia care needs must be provided. The home must have a registered manager. Timescale for action Immediate 2. 30 18(1) c, i 31.10.05 3. 31 8, 9, 10 31.10.05 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. 2. Refer to Standard 9 27 Good Practice Recommendations It is recommended that further secure provision for the storage of medication is provided for specialist medication. It is recommended that the rota identifies who is in charge of the shift in the absence of the manager. Caythorpe Residential Home C53 C04 S2343 Caythorpe V239368 180705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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