Inspection on 01/12/09 for Charnwood

This inspection was carried out on 1st December 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Charnwood 07/07/10

Charnwood 22/02/10

Charnwood 17/08/09

Charnwood 08/04/09

Charnwood 10/07/08

Charnwood 06/12/07

Charnwood 16/05/07

Charnwood 22/05/06

Charnwood 19/10/05

Charnwood 03/05/05

Charnwood 20/09/04

Charnwood 19/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for older people Name: Address: Charnwood 68 Bidston Road Oxton Birkenhead Wirral CH43 6UW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Wendy Smith     Date: 0 1 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 23 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Charnwood 68 Bidston Road Oxton Birkenhead Wirral CH43 6UW 01516521984 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: sheila@charnwoodcarehome.co.uk Mr David Ashcroft,Mrs Sheila Margaret Ashcroft care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 19 Date of last inspection Brief description of the care home Charnwood is a large, four storey house on a main road served by bus routes to Birkenhead town centre and other parts of Wirral. There are shops and other local facilities within walking distance of the home. The home has been owned and managed by Mrs Sheils Ashcroft since 1988. There are five single bedrooms and seven that can be shared by two people. There is a spacious garden at the back of the house and a car parking area at the front. 0 8 0 4 2 0 0 9 0 Over 65 19 Care Homes for Older People Page 4 of 23 Brief description of the care home Care Homes for Older People Page 5 of 23 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: one star adequate 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 one star. This means that the people who use this service experience adequate quality outcomes. We (the Care Quality Commission) visited Charnwood unannounced on 1 December 2009 as part of this inspection. There were eight people living at the home when we visited. During the visit we spoke with a resident and the staff on duty. The manager showed us around the building to see all the communal areas and some of the bedrooms. We checked records kept at the home and spent time talking with the owner/manager. We also looked at any information that we had received about Charnwood since our last inspection there. Before the visit, the manager was asked to complete a questionnaire to give us up to date information about the service. This was not completed in full and we had some concerns about whether Charnwood was continuing Care Homes for Older People Page 6 of 23 to provide a good service for the people who live there, therefore the date of the inspection was brought forward. Care Homes for Older People Page 7 of 23 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 23 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 9 of 23 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. There have been no new residents since our last visit to the home. Evidence: There have been no new residents since our last key inspection. However we saw that the person who moved into the home most recently (in June 2008) was visited and assessed by the home owner before he moved to Charnwood. Comprehensive information is provided in the homes Statement of Purpose. Care Homes for Older People Page 10 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In general the care needs of the people living at the home are met and detailed care plans have been written but not kept up to date. Evidence: We looked at the care plans for three people who live at the home. They had been written in detail to reflect the abilities, needs, preferences and daily routines of each person. They were all dated July 2009 and there was no record that they had been reviewed or evaluated since then. Monthly reviews of the care plans had been recorded in detail up to July 2009, but not since. For one of these people the care plan stated remains continent of both bladder and bowels, however the manager told us that this person now had prostate problems and was prescribed continence products by a continence adviser. The care plans also contained some old documents that were no longer relevant, some forms that had not been filled in, and financial information that would be better kept elsewhere. Detailed daily reports, all written by the manager, were kept in a separate folder, with a copy of the care plan for each person. We saw records in the care plans to show that people have visits from their doctor as Care Homes for Older People Page 11 of 23 Evidence: required, all except one have the same GP. They also receive a service from district nurses for any nursing needs. An optician and a chiropodist visit regularly. One person who is frail and spending a lot of time in bed has a pressure relieving mattress on loan. This person had an armchair pushed up against each side of her bed and we discussed with the manager that this was not an effective way of keeping someone safe. She had discolouration around her right eye which suggested that she may have fallen, however the manager said that she hadnt had any falls but sometimes sleeps with her hand pushed up against her eye. We saw that she had very fragile skin that marks easily. The home does not have any moving and handling equipment but the manager said that this can be obtained from social services if needed. Medicines prescribed for the people living at the home are all stored in a locked trolley that is kept in the main hallway. It was not secured to a wall and when we arrived at the home the keys were on top of the trolley. There were good medicines records with all items checked in and no gaps on the administration record sheets. The manager told us that no controlled drugs were in use. The manager said that two of the people living at the home can be challenging, but the staff have experience in meeting their needs. One person sends written notes down to the office and we considered that a reply sent to him from a member of staff was inappropriate in its content and did not treat him with respect. We saw that the bedrooms which may be shared by two people have screens to protect privacy. Care Homes for Older People Page 12 of 23 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 are able to choose how they spend their time and pursue their interests and hobbies. Evidence: The home does not have an activities organiser at present but we saw that people can choose how they spend their time and can pursue their interests. The manager told us that three people go out regularly. Two residents choose not to socialise with the other people living at the home and one always stays in his room. Entertainers visit the home approximately once a month and members of the clergy also visit. We spoke with the person who stays in his room he said that the home is reasonably good. He does not like TV but has two radios and he gets a daily newspaper delivered. He also appreciates getting on-line shopping through the homes administrator. The manager told us that three of the people who live at the home do not have any relatives, and another has no contact with his relatives. The others have family members who visit them and they can meet their visitors in the privacy of their own bedroom or in the lounge. A choice of cereals, porridge and toast is served for breakfast and a light lunch is Care Homes for Older People Page 13 of 23 Evidence: prepared by the care staff. The main meal of the day is served in the evening. A choice of meals is offered and the staff are aware of each persons preferences. Most people have their meals in the dining room, but they can be served in peoples own bedrooms if they prefer. Care Homes for Older People Page 14 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People may not always be protected from abuse because the staff working at the home have not received training about safeguarding. Evidence: The home has a complaints procedure displayed in the foyer of the home, and this has been updated so that people have the information they need about how to make a complaint. The manager said that no complaints have been received at the home since the last inspection. The home has a policy in relation to the protection of vulnerable adults, and a procedure to be followed in the event of abuse being suspected. The manager attended a training course about safeguarding in 2008, but none of the other staff have had this training. Care Homes for Older People Page 15 of 23 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. Charnwood provides a comfortable, clean and homely environment for people to live in. Evidence: The home is in a residential area of Birkenhead and is on four floors. There is a lawned garden at the back of the house that is safe for residents to use and is well maintained. There is car parking space at the front. The lower floor is occupied by the home owner and her family and also contains a small office, the laundry and the kitchen. On the ground floor there is a spacious and comfortable lounge and dining room. Residents bedrooms are bright and spacious and have been personalised with pictures, photographs and other personal items. Some of the bedrooms have ensuite facilities and there are enough shared toilets and bathrooms for people to use. All parts of the home are furnished in a homely style, but some of the carpets had become worn and stained and need to be replaced. There has been water damage on the top floor and some areas need redecoration. We found all parts of the home to be clean and fresh and there were no unpleasant smells. Care Homes for Older People Page 16 of 23 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not have enough staff, and the staff have not received training to ensure that they know how to work safely. Evidence: The home has very few staff. There is the owner/manager, the deputy manager, one full-time care assistant and two part-time care assistants, one of whom was off sick. It was not clear how they are able to maintain two staff during the day and one at night with only these people. Another person cooks the evening meal six nights a week. There is also an administrator, but there are no housekeeping staff. The manager said that she is constantly recruiting staff and has interviewed two people this week. Not all of the people who work at the home have a Criminal Records Bureau disclosure. One person has a POVAfirst check but no disclosure and should always be supervised until the disclosure is received. A CRB application must be made without delay for the administrator and any other staff who do not have a current CRB to make sure that these people are safe to work in a care home. The manager said that there has been no training for staff in the last year. Our last inspection identified that It is essential that all staff who handle food complete a basic food hygiene training course to ensure that service users are protected., but we saw no evidence that this had been acted upon. Care Homes for Older People Page 17 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an experienced and committed manager, but more attention is needed to management and administration to ensure that it is run in the best interests of the people who live there. Evidence: The registered manager is also the owner of the home and lives on the premises. She has had the home for 21 years and is available to residents, staff and visitors at all times. The manager is a trained nurse and is working towards an NVQ in management. An administrator is employed to deal with day to day paperwork and to improve record keeping in the home. The annual quality assurance assessment (AQAA), that all registered services are required to complete, was not returned to us on time and did not give any information about staffing. It did not give us any evidence that areas for improvement have been identified. The AQAA told us that policies and procedures were being reviewed. The AQAA completed in 2008 also said that policies and procedures were being reviewed, Care Homes for Older People Page 18 of 23 Evidence: but many of them are still dated 2002. One person who lived at the home died this year, but we have no record that this was notified to CQC as required by regulation 37 of the Care Homes Regulations. The manager told us that she does not manage any money for the people who live at the home and this is attended to by relatives or advocates. Regular tests of fire detection equipment are made and recorded. A fire officer visited in September 2009 and we were shown his report. Recommendations were made to update the fire risk assessment and the emergency procedure for night staff, to provide fire training for staff, to replace glazing in one area, and to install a gas shut off button in the kitchen. There was no evidence that these recommendations had been acted on. The AQAA gave us dates when plant and equipment had been tested for safety. These were up to date except for the gas certificate, which was due for renewal in June 2009. The electrical wiring is due to be tested in December 2009. An environmental health officer visited in July 2009 and made some good practice recommendations. Care Homes for Older People Page 19 of 23 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 29 18 People must not be allowed 18/05/2009 to work at the home until all pre-employment checks have been verified and returned. Failure to do so may put vulnerable people at risk. Care Homes for Older People Page 20 of 23 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 18 13 All of the staff who work at the home must receive training about safeguarding. To ensure that people are protected from abuse. 26/02/2010 2 27 18 The registered person must 07/12/2009 provide enough staff to ensure that the needs of the people living at the home can be met. To ensure that the needs of residents are met at all times and they are kept safe. 3 29 19 All of the people working at the home must have a Criminals Records Bureau check. For the protection of residents. 07/12/2009 Care Homes for Older People Page 21 of 23 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 4 30 18 All staff working at the home 31/03/2010 must receive training appropriate to the work they perform. So that they always work safely with residents. 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 38 Ensure that the gas and electrical systems are tested at the required intervals to show that they are safe. Care Homes for Older People Page 22 of 23 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - 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!