Inspection on 17/12/08 for Cestria House

This inspection was carried out on 17th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cestria House 10/01/07

Cestria House 31/01/06

Cestria House 10/08/05

Cestria House 11/10/04

Cestria House 17/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cestria House 45 Sanderson Road Jesmond Newcastle Upon Tyne Tyne & Wear NE2 2DR     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: Anne Brown     Date: 2 2 1 2 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: Cestria House 45 Sanderson Road Jesmond Newcastle Upon Tyne Tyne & Wear NE2 2DR 01912818714 01912810377 noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Kathleen Burns Type of registration: Number of places registered: Bawi Homes Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Cestria House provides a home for up to 24 older people who require residential care. Three of the residents may also require care due to dementia care needs. Nursing care is not provided. The home is a three storey converted house. There is a passenger lift to each main floor. There are two mezzanine floors, which have a small number of bedrooms, which can be reached by a flight of stairs. Residents occupying these bedrooms would therefore need to be mobile. All of the bedrooms are single. The home has three bathrooms with assisted baths or showers. Four of the bedrooms also have en-suite toilets. Cestria House has a small town garden to the front of the property with seating and a large courtyard to the rear. Cestria House is located in a residential area of Jesmond, close to the main shopping area on Acorn Road, and other Care Homes for Older People Page 4 of 28 Over 65 3 21 0 0 Brief description of the care home local amenities including public transport links. The cost for the service is 383 to £389 pounds per week. Chiropody, hairdressing and newspapers are additional. Information, including inspection reports, is provided for service users to enable them to make a decision about moving to Cestria House. 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Care Homes for Older People Page 6 of 28 Before the visit We looked at Information we have received since the last inspection on 10th January 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives. Surveys were sent to ten people living in the home, ten members of staff and two health care professionals. Three were returned by people living in the home, three from members of staff and one from a health care professional. The visit. An unannounced visit was made on 22nd December 2008. During the visit we Talked with people living in the home, staff and the manager. Looked at information about the people who live in the home and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: Staff should ensure they sign the care plan evaluations to identify who has carried these out. Care Homes for Older People Page 8 of 28 Minor repairs should be carried out to the plaster in the downstairs bathroom and some vanity units should be paired or replaced. Written reports should be available to confirm monthly visits are made to the home by senior management to ensure standards are upheld and good care continues to be provided. 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home have their needs assessed prior to moving in to help ensure the home can meet individual needs. Evidence: The manager confirmed that everyone is issued with a written contract when they come to live in the home. One survey said the fees are not contained in the contract. The manager said letters are to be sent to indicate the current fees. Updates will be sent every time the fees change. People living in the home are assessed by their care manager and/or a senior member of staff from the home prior to moving in. The manager does her own assessment prior to admission and this forms the basis for the care plan. This helps to ensure peoples individual needs can be met. Care Homes for Older People Page 11 of 28 Evidence: Copies of the assessments were available on the case files. They contained information on social history, health and personal care needs. Care Homes for Older People Page 12 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. The care plans contain good information to help ensure the staff team are well informed about the needs of the people using the service. Evidence: Care plans are in place for each person using the service. The plans describe peoples individual needs and how the home will meet them. They give good information to the staff and tell them what they need to do to care for and support people. Each persons care and support is regularly evaluated and action is taken on any changes. Some evaluations carried out by the staff had not been signed which means it could be difficult to check who made the evaluation. The case files contained risk assessments and action plans to deal with the identified risks. Health needs are monitored by the staff who work closely with a range of other Care Homes for Older People Page 13 of 28 Evidence: professionals to ensure that any specialist needs are met. People living in the home are able to remain registered with their GP if this is geographically possible. The manager said their are currently 12 GP practices involved. The people using the service said the staff respect their privacy and dignity. Staff were observed to be working with people in a caring and sensitive way. They spoke to people in a caring manner and were spending time talking to them and involving them in things that were taking place. The staff on duty were able to describe the needs of the people living in the home and act appropriately to meet these needs. There is an appropriate system for storing and administering medications. However the medication administration record does not include a photograph so staff can easily identify people and prevent errors being made. People are able to retain their own medications if they are assessed as able. Lockable facilities are provided for storage. Care Homes for Older People Page 14 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. A good range of activities and events are provided in the home for the people using the service to enjoy and they are able to make personal choices. Evidence: The activities taking place in the home are chosen by the people who live there. These are discussed on a regular basis and people choose what they would like to do each day. Activities which are taking place are displayed in the hallway and staff inform people about these. On the day of the inspection some people were enjoying wrapping Christmas presents with the staff. People are also encouraged and assisted to access facilities in the local community. Risk assessments are in place to support these activities and staff provide practical support to enable people maintain their involvement. Some people enjoy using the Metro service to go to Newcastle, Sunderland and the coast. Outings are also arranged to visit local places of interest. These include garden centres, Beamish Museum, Durham Cathedral, circus and one person had been to see Status Quo in concert. Other people enjoy going to church services and celebrations. Representatives from local churches visit the home on a regular basis. Care Homes for Older People Page 15 of 28 Evidence: One relatives stated there is a very good range of activities provided - not too often to tire the client but often enough to provide interest. The home has an open visiting policy and family and friends are encouraged to visit at any time. Two visitors who were present during the inspection said the staff always made them feel very welcome. The people staying in the home confirmed that they can choose how and where to spend their time. Lunch time was relaxed and unhurried. People are asked for their choice from the menu the day before so they can have time to think about their choice. The dining room tables were appropriately set with condiments and napkins. The staff were dealing with individual needs in a sensitive and competent way. Comments included There is a very good range and choice of sensible, homely and healthy foods at each meal - the main meals at lunch time are particularly good and the fact that sandwiches and hot drinks are available for supper is reassuring. I enjoy all my meals. The food is very good and we get plenty of choice. 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. There is a good system in place for dealing with complaints and staff receive training in safeguarding adults. This helps to protect the people using the service. Evidence: A complaints procedure is in place and information on how to complain is displayed in all bedrooms. A complaints book is in place to record any complaints and the outcome of the investigation. No complaints have been received since the last inspection. The surveys returned by the people using the service, relatives and staff confirmed that they knew how to make a complaint. Several written compliments had been received by the home. Comments included:If I had a complaint I would go straight to the top which is Mrs Kathy Burns and it would be done quietly in the office. I have been given written information explaining this but I have never needed to make any complaint (nearly two years). Care Homes for Older People Page 17 of 28 Evidence: The manager stated that all staff were aware of equality and diversity issues. She stated that any unacceptable views, opinions or practice would be challenged through the Whistle Blowing Policy. It has been reinforced to staff that they have a duty of care to whistle blow should they observe any inappropriate behaviour or bad practice and any safeguarding issue must be alerted appropriately to the Safeguarding Adults Unit. The staff on duty confirmed they knew the procedure to follow. Training on safeguarding adults is regularly updated and staff have also been given training on mental capaity and deprivation of liberty. The staff files confirmed that Criminal Record Bureau checks and written referances are taken prior to staff being employed in the home to help protect people from abuse. 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. The home provides people with a comfortable and pleasant place to live. Hygiene standards are good. Evidence: The manager and staff team make every effort to ensure all areas of the home are homely and comfortable to provide people with a comfortable place to live. During the last year new carpets have been provided in the lounge and ground floor corridors. New dining room tables have been provided in the dining room and a large screen television has been purchased for the main lounge. A maintenance and renewal programme is in place. The manager stated that discussions are taking place to renew the flooring in the sun lounge which is damaged. Bedrooms were pleasant and equipped to meet the needs of the people using the service. However the vanity units in two bedrooms were damaged and the ceiling in one bedroom had flood damage. Care Homes for Older People Page 19 of 28 Evidence: The plaster work in the downstairs bathroom was damaged. All areas of the home were clean and hygienic. Protective clothing was available for the staff. One member of staff attends meetings with the infection control nurse and cascades up to date information to the staff team. The home has received a five star rating from the Environmental Services Department. Comments included:The cleaning ladies Gillian and Karen do a wonderful job and everywhere is cleaned to a superior standard. I always pop my head in the dining room/kitchen as I leave to say goodbye and therefore can vouch for the extremely high standards of cleanliness and hygiene in that area. The home is always very clean. 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 are good which helps ensure the needs of the people living in the home are met. Evidence: The manager, deputy manager, one senior carer, two carers, one domestic assistant and one cook. There are two waking night carers on duty every night. There are no staff vacancies at the present time. The majority of staff have worked in the home for a number of years and staff turnover is low. There are fourteen permanent care staff employed in the home, ten of these have achieved a National Vocational Qualification, Level 2 or above. The home has a rolling programme of training to ensure staff receive up to date health and safety training. They also receive training on specialised issues to help meet the individual needs of the people living in the home. The staff on duty said they felt they received a good level of training. This training includes food, nutritrion and assistance with eating, dementia, care of the dying, diabetes and mental health. Care Homes for Older People Page 21 of 28 Evidence: The staff files contain records which show that the recruitment and selection policies are in place to safeguard the people living in the home. The people using the services who commented said the staff were very kind and helpful. Comments included:Without doubt everything is done to make the residents and their family visiting feel at home. Medical needs are well looked after and social needs are also catered for. Nothing seems too much bother and the staff are always very cheerful. There are lots of good staff in this home. The staff are wonderful, nothing is a bother. Generally very good atmosphere, staff always very helpful and considerate. 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 run in the best interests of the people living in the home and there are systems are in place to ensure their safety. Evidence: The manager and deputy manager are experienced in managing care homes and hold appropriate qualifications. They are committed to ensuring the home is run in the best interests of the people living there. They promote an ethos amongst staff of involving the people living in the home in decision-making. Staff meetings and meetings with the people living in the home are held on a regular basis. The minutes of these were available for inspection. The home has a quality assurance system in place to help them to self-monitor areas of their practice. A system is in place to ensure a senior manager visits the home each month to check on standards and to produce a report outlining any improvements Care Homes for Older People Page 23 of 28 Evidence: which need to be made. However recent copies of these reports were not available, the last one being dated February 2008. Policies and procedures are in place for dealing with money and valuables held on behalf of the poeple staying in the home. A sample of records and money held was examined. This confirmed that all transactions were appropriately recorded. There are policies and procedures in place to promote the safety and welfare of the people staying in the home and the staff. Risk assessments are carried out for individuals and the premises. All accidents are recorded and monitored on a monthly basis. The staff on duty confirmed that they receive formal supervision from the senior staff on a regular basis. The staff and the people using the service confirmed that the manager is supportive and very approachable. Comments included:We are told that this is our home and we should treat it as such. I have no worries about my mother at all, the staff are very good and I never hear them speak to anyone without great respect. I am so pleased my mother is in this home. It is very good. The staff are patient, kind and you never hear a cross word. Good management, they are most pleasant and make everyone alike, keep us all happy and make sure we are kept clean. They take us on trips, its the best home I have been in. They make sure we are well respected, a wonderful home. Care Homes for Older People Page 24 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 25 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 1 9 13 Photographs must be placed on the medication administration record. To enable staff to identify people when administering medications to help prevent errors occurring. 30/01/2009 2 33 26 Copies of registered 31/03/2009 providers monthly visits to the home must be available. To help ensure that care standards continue to be met and health and welfare continues to be promoted. 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 2 7 21 The evaluations in the care plans should be signed to indicate which member of staff carried out the evaluation. Minor repairs should be made to plasterwork in downstairs bathroom to help ensure people are provide with a pleasant place to live. Care Homes for Older People Page 26 of 28 3 23 Vanity units should be repaired or replaced to help ensure people are providing with good quality facilities in their bedrooms 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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