Inspection on 30/10/08 for Centenary House

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Good 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

Centenary House 30/06/09

Centenary House 22/04/09

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Centenary House 70 Charlton Road Shepton Mallet Somerset BA4 5PD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Justine Button     Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Centenary House 70 Charlton Road Shepton Mallet Somerset BA4 5PD 01749342727 01749342727 caremanager@centenaryhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Centenary Care Homes Ltd care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodates is 16. The proposed refurbishment of the first floor must be complet and deemed `fit` for purpose by the CSCI, which will include a further site visit, with no more than four bedrooms being added which meet or exceed 12 sq m before they can be used for prospective service users. Suitable access, other than stairs, to the first floor must also be available for service users. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Centenary House currenty provides residential care services for up to 13 people over the age of 65. The home faces a busy road but is within walking distance to the centre of Shepton Mallet. There is a convenience shop in a garage next door and a large supermarket nearby. There is car parking in front of the home. The home comprises the original house and a later extension. All service users rooms are on the ground Care Homes for Older People Page 4 of 28 Over 65 16 0 Brief description of the care home floor. The first floor is currently unoccupied. Many of the bedrooms have individual access to a pleasant garden and two have access to a side patio. There is a double bedroom with en-suite facilities. There are two lounges, a pleasant conservatory overlooking the garden and a dining room. There are two communal bathrooms, one has been redecorated and fitted with a spa bath. The shower room has been refurbished and now has a good sized walk in shower cubicle. The fees at the home are 390 to 430 pounds per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was carried out over an 6 hour period by one inspector. During the inspection a tour of the premises was made and individuals living at the home were seen and spoken with both in private and in the communal areas of the home. The outcome of these conversations are Incorporated into the report. The home was tidy and well maintained. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering living in Centenary House and those close to them are provided with information about the home in a variety of ways. This information needs updating, however, to show the current managerial arrangements at the home. All people moving to Centenary House have their individual care needs assessed before admission to the home is agreed. Evidence: The registered provider has produced a statement of purpose and service user guide that give prospective people thinking of moving into the home and relatives information on the home and service. The manager stated that this information currently needs some minor updating to ensure that it clearly states the current managerial arrangements at the home and the services to be provided. It is advised that a copy of the statement of purpose be available in the reception area of the home Care Homes for Older People Page 9 of 28 Evidence: to provide all interested parties with the information at any time. People spoken to during the inspection stated that they felt that they had received enough information prior to moving into the home. Admissions to the home are not made until a full needs assessment is made. The registered manager receives the social worker assessment and then carries out her own needs based assessment. A sample of these was seen in the care plans. They were detailed enough for a decision to be made about whether the home can meet the persons needs. All people living at the home have been issued with a contract. Care Homes for Older People Page 10 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be assured that their individual health and personal care needs will be met and they will be treated with respect at all times. Medication is on the whole well managed. Staff have undertaken some training caring for people at the end stages of their life. Evidence: All people living at the home have a robust care plan. This details the care needs of the individual providing clear instructions for the staff to follow. The plans seen were person centered detailing how and when the individual would like their care to be delivered. Risk assessments were not completed for all areas eg nutritional assessments and potential weight loss nor for the risk of falls. Centenary House however is not a nursing home and outcomes for people living at the home remain positive. The manager informed us after the inspection that these assessments were in place however they were not made available on the day of the inspection. It is advised Care Homes for Older People Page 11 of 28 Evidence: that all assessments relating to individuals are kept as part of the plan of care. Staff spoken to during the inspection stated that if they had identified any concerns with regard to health issues they would refer to the community nurse for advise. This was confirmed in the care plans viewed. Evidence seen confirmed that the care plan was a working tool and understood by staff. Evidence was seen in the plans of care and the diary of regular access and visits of the GP, community nurse, dentist, chiropody and optician. people spoken to stated that staff were very kind and that they always knocked on your door before coming in. During the inspection, the inspector observed staff interacting with service users in a professional, kindly and respectful manner. Staff are friendly, but professional in their approach. The inspector was able to speak to a group of service users at lunchtime and in the lounge about their care. One person said I see the doctor quite often. I have also seen the dentist. The inspector reviewed the receipt, administration, storage and disposal of medication in the home. Senior care staff were observed dispensing medication on the day of the inspection. The administration was completed in line with good practice guidance. Training records confirmed that staff who handle medication have received appropriate training. The medicine administration records were reviewed and no gaps were noted. The medicine stock cupboard had quantities of medicines that are not being used. Cream and lotions seen in peoples bedrooms had been marked with the date of opening. This ensure that these are not used after the expiry date. People living at the home confirmed that they are treated with respect and their dignity maintained during intimate tasks. One person said the girls are so good, they really look after you. Another said the staff are excellent, always respectful. The comments during the inspection were positive confirming to the inspector that the staff are respectful and have individuals interests at heart. The inspector observed staff greeting visitors into the home during the day and directing as needed. The death of any person who has lived at the home is commemorated. This allows people living at the home who may not have been able to attend a funeral service the opportunity to grieve. This commemoration service was described by one person as a celebration of the person life and not about death. In addition the manager and three Care Homes for Older People Page 12 of 28 Evidence: staff have completed end of life course at Dorothy House, a local hospice. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home maintain control over their day-to-day lives and their opinions are sought in the running of the home. People living at the home are able to have visitors at any time and are confident that friends and family will always be made welcome. People living at the home are able to continue to practice their chosen faith. Evidence: Throughout the day the inspector saw evidence that people living at the home were given choices about all aspects of their care. Individuals stated that they are able to choose when they got up, when they went to bed and how they spent their day. This was clearly documented in the plan of care to ensure clear communication to all staff. There are formal meetings at the home on a regular basis. Due to this people felt that Care Homes for Older People Page 14 of 28 Evidence: they were consulted on the running of the home on a daily basis. Everyone asked stated that they continued to feel in control of their day to day lives. People said that they were able to have visitors at anytime and felt comfortable to invite friends and family to the home. People living at the home spoke of their involvement in the recruitment process for new staff. This ensures that people living at the home have a say in who deliverers their care. This is to be commended People spoken to during the inspection stated that there were activities that you can take part in. People stated that they enjoyed the company of others and the staff. The inspector observed that there was socialising and laughter throughout the day. Activities are organized in line with the wishes and abilities of the individuals living at the home, people stated that they enjoyed quizzes, crossword puzzles, gentle exercises and scrabble. People said that there were trips out, especially in the better weather. Some people go out to church and visiting clergy offer communion on an individual basis at the home. The home has 4 communal rooms, two lounges, a dining room and a conservatory. People said because there was a choice of rooms they did not feel obliged to join in with organized activities if they did not interest them. Both lounges have large flat screen TVs which one person stated were particularly nice when watching a film. Newspapers and books are available in the home. Many of the service users stated that they liked to socialize in the conservatory during the day. During the inspection we observed lunch. This was a relaxed and social occasion. The quality of the food was good and people stated that this was always the case. There is a four- week menu, which offers a variety of meals. The meal of the day is displayed in the dining room and alternatives are always available. The main meal on the day of the inspection was soup followed by stew and dumplings and it was noted that an alternative was made available for people who did not like this meal. Butterscotch mousse was available for pudding One person spoken to stated that there was a choice at breakfast and that this included a cooked option. When people move to the home they are asked to fill out a comprehensive list of likes and dislikes, these are taken into account when planning menus and on a day to day basis. This was confirmed by the cook on the day of the inspection. Care Homes for Older People Page 15 of 28 Evidence: People stated that they were very happy with the quality of the food and received ample portions. The home shops locally and uses fresh fruit and vegetables where possible. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff and people using the service are confident that the homes management team would appropriately deal with any complaints or concerns. Policies, procedures and training are available to staff to ensure they have the knowledge to prevent people from the risk of abuse. Recruitment procedures on the whole protect people using the service from the risk of abuse. Evidence: The home has a complaints policy which was display at the home and also available within the Statement of Purpose/Service User Guide The home has received no complaints since the last inspection. We have received one complaint since the last inspection. This was investigated and any necessary remedial action has been taken by the management. The home has access to an advocacy service for people who may require an independent advocate. All staff who were spoken to during the inspection confirmed that they were aware of policies about protecting vulnerable adults and how you report any concerns about poor care practice or allegations of abuse. Care Homes for Older People Page 17 of 28 Evidence: The recruitment procedures followed by the home are on the whole robust and are in place to protect people using the service from the risk of abuse. All staff spoken to confirmed that they had received a Criminal Record Bureau Check and examination of recruitment files confirms that these check were undertaken before staff commenced employment. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Centenary House provides a comfortable homely environment for the people living there. Individuals are able to personalise their individual rooms. Evidence: The home is an older style property that has been extended to provide accommodation for up to 13 service users. One room can be used as a double but is currently used for single occupancy. All bedroom accommodation is located on the ground floor. All areas are fitted with a newly fitted fire detection and call bell system. Communal areas consist of two lounges, a dining room and a conservatory. All have been furnished to meet the needs of the service users and provide a comfortable environment. It was noted that one carpet in a corridor would need replacing in the near future. The manager was aware of this. Outside there is a pleasant garden with seating for service users. We viewed a selection of individual bedrooms and noted that all had been personalised to reflect the tastes and needs of their occupants. The majority of the rooms have Care Homes for Older People Page 19 of 28 Evidence: glazed doors onto the garden. There are no other windows in these rooms but doors are fitted with ventilation vents to allow fresh air into the rooms. Only one bedroom has an en suite but there are adequate numbers of toilets around the home. There is one assisted bath and a walk in shower with seat. All bedrooms have wash hand basins. All laundry is completed in house and people spoken during the inspection stated that this was completed to a good standard. On the day of the inspection all areas seen by the inspector were clean and free from odours. The manager had completed a range of risk assessments with regard to the environment thus ensuring that the building remains fit for use. . Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels at the home appear adequate to meet the assessed needs of people using the service. Staff training is promoted, comprehensive and well recorded. The recruitment process is robust and protects people using the service from the risk of harm. Evidence: The home has a low staff turnover. Due to this only one staff recruitment file was viewed during the inspection. This showed that on the whole a robust procedure is followed. All staff recruited to work with in a care home are required to undertake a Criminal Record Bureau and POVA check. These had been completed for staff at Centenary House. There was evidence in the recruitment file of this individual that people living at the home had been involved in the recruitment process. On the day of the inspection nine people were living at the home. The staffing levels seen were 1 domestic staff member, two care staff during the day. In addition to the manager. There is 1 waking and 1 sleeping night staff. These levels appear to be adequate given the low numbers of people living at the home. Staff training records were viewed. These showed that staff had attended all necessary Care Homes for Older People Page 21 of 28 Evidence: training. Staff spoken to during the inspection stated that they felt able to meet the needs of the people living at the home. A number of staff including the cleaner had been supported to undertake an NVQ. The inspector was able to observe care practices during the day. The ethos of Centenary House is very much that it is the home of the service users and staff are available to assist them in their chosen life style. Staff were very service user focussed and not task focussed, they spent time with indivduals providing on going social stimulation. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is effectively managed taking account of the views of the people living at the home and their representatives. Appropriate steps have been taken to ensure the health and safety of staff and people living at the home. Evidence: The Registered manager has many years experience in residential care and has achieved the Registered Managers Award (NVQ level 4) and an NVQ level four in care. The manager was available throughout the inspection, she demonstrated an excellent knowledge of the individuals living at the home and staff. Her practice is kept up to date by reading and attending relevant training courses. The manager and owners of the home have a clear vision and are able to demonstrate Care Homes for Older People Page 23 of 28 Evidence: this in their everyday work. Discussions with the manager demonstrated that a lot of time is spent consulting people and looking at ways to continually improve the service offered. A monthly newsletter is also produced which highlights the results of any surveys undertaken and forthcoming events. People living at the home meet are regularly held and there is a suggestion box in the entrance hall where anyone living or visiting the home can make a suggestion. Individuals living at the home and staff spoken to stated that the management is open and approachable and always keen to listen to ideas and opinions. All records requested by the inspector were made available, all were up to date and well maintained. The fire log shows that the alarms are tested weekly and emergency lighting on a monthly basis. The system is serviced annually by outside contractors. All lifting equipment is tested every six months and the we saw evidence of this. The gas and electrical installations are also checked on a regular basis by outside contractors. We viewed the accidents records pertaining to people living at the home and noted that these were adequately recorded. There is a relatively high incidence of accidents in the home, however this was not unduly concerning as this demonstrated, in part, that people living at the home are encouraged to maintain their independence. Action is taken to prevent falls and accidents where a pattern or frequent falls for any one individual is noted. No one working at the home acts as a financial appointee or power of attorney for any service user. Small amounts of money are held on behalf of some individuals and records keep correlated with monies held. Up to date certificates of registration and insurance are displayed in the main entrance. The owners of the home visit regularly and the manager stated that records are kept of these visits in line with Regulation 26. Care Homes for Older People Page 24 of 28 Evidence: A system of staff supervision is in place for all staff. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 It is recommended that the statement of purpose and service user guide is up dated to provide up to date information of the managerial structure within the home and the services to be provided. It is recommended that the statement of purpose and service user guide be on display in a predominant area of the home so that information is freely available to interested parties 2 1 Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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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