CARE HOMES FOR OLDER PEOPLE
Colindale Care Home 1 Richmond Park Avenue Charminster Bournemouth Dorset BH8 9DL Lead Inspector
Debra Jones Unannounced 27 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Colindale Care Home Address 1 Richmond Park Avenue Charminster Bournemouth Dorset BH8 9DL 01202 514733 01202 258817 iangray@colindalecaregroup.fs.net.co.uk Mrs Jene Hart Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) CRH PC - Care Home Only 14 Category(ies) of DE(E) Dementia - over 65 (14) registration, with number MD(E) Mental Disorder -over 65 (14) of places Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home may accommodate two named service users (as known to CSCI) under the age of 65 years. Date of last inspection 27 January 2005 Brief Description of the Service: Colindale Care Home is a large 1920s detached house that was converted for use as a residential home. It is located in a quiet residential area of Winton, within easy walking distance of a local park with a bowling green and cricket pitch. Local amenities include shops, a post office, restaurants, cafes and places of worship. A bus route to Bournemouth town centre is readily accessible. The home until recently was known as Four Seasons and provided care for up to 10 people. 14 people are now accommodated there after substantial redevelopment and the name has changed to Colindale (following the closure of the sister home formerly known as Colindale). Bedrooms are now located on the lower ground, ground, first and second floors of the home. All service users have single rooms. Some have en suite faciltiies. The premises are centrally heated. Communal facilities consist of a separate lounge and dining room and a quiet room on the first floor. Outside there is a large patio area at the rear of the building with a raised grassy area. The summerhouse is used as an office for the Business Manager and Head of Human Resources. Colindale Care Home is a specialist home providing care and support for older people with enduring mental health problems and dementia. The home is “accredited” as being family friendly and staff often bring their children into the premises adding to the feeling of being in a family home.
Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours on the 27th July 2005 and was one of the two anticipated inspections of the year. The 1 recommendation made at the last inspection was followed up to see if it had been addressed. It had. The Inspector looked around some of the building and a number of records and related documentation were inspected including care records. The owner/ manager – Jane Hart and Ian Gray – Business Manager and Head of Human Resources were spoken to, along with staff on duty at the home. The Inspector met, chatted with and sat in the lounge with some residents during the course of the inspection in order to get a feel for what it is like to live at Colindale. At the time of the visit 14 people were living at the home. What the service does well:
Colindale provides a service for older people with dementia and long term mental disorders in a well-decorated and comfortably furnished house. The home has a comfortable and relaxed atmosphere and residents are clearly at ease. The home is well organised and the care and contentment of residents is clearly at the heart of the way the home is run. Residents are cared for in a family setting by professional, caring people. Ms Hart and her staff have developed good relationships with the residents and this results in a supportive and caring environment in which the residents are well cared for, respected, safe and comfortable. A good admissions procedure is in place that ensures that only people whose needs can be met are offered places at the home. Prospective residents and their representatives have the opportunity to visit the home to see if they like it before they move in. Information is available about what the home has to offer to help people make their choice. Some residents enjoyed day and respite services at the home prior to their need for long term residential care there. Thorough assessments and excellent care plans are in place for all residents and these are regularly updated to make sure that staff know how to care for the residents living at the home. Daily notes provide evidence to show the
Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 6 way that care is delivered. A range of community health professionals support the care staff in caring for residents. Staff were observed throughout the inspection to be treating residents with courtesy, patience and kindness and were clear about how they ensured that residents’ privacy and dignity were respected at all times. Residents are able to do as they wish at the home and join in or not with the activities on offer. Activities are informal and responsive to what residents want to do that day and have a natural, easy feel to them Meals are varied and planned around the likes and dislikes of residents. Meal needs and preferences are always taken into account and mealtime arrangements are flexible enough to accommodate individual preferences. The complaints procedure reassures residents that their well-being and comfort are important to the home and that any concerns raised will be properly investigated and resolved. Residents are able to exercise their civic rights and can continue to be supported by people of their choice outside the home should they so wish. The home is well maintained, comfortable and safe for the residents living there and anyone visiting. Further improvements are underway and others planned to enhance the living and working environment. The home is kept clean and smells pleasant. Sufficient, well supervised and well-trained care staff are employed and deployed to meet the current needs of residents. Systems are in place and records kept, that demonstrate the homes commitment to keeping residents safe. What has improved since the last inspection?
The home has continued to function at the high standard that has been noted at previous inspections. An excellent supervision system is now in place at the home. This incorporates training and observation and gives staff the opportunity to really reflect on their practice and performance, which can only be to the benefit of the residents living at the home. Since the last inspection the major works to the home have been completed and the home has had its registration increased to 14. Bedrooms are now
Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 7 available on the lower ground, ground, 1st and 2nd floors. The new rooms have en suite facilities and are decorated and furnished to a high standard. People spoke positively of the changes to the home. Commenting that the facilities were better for the residents and this enabled staff to do more with them e.g. activities, more staff were available and the family atmosphere had not been lost by increasing the numbers. The home felt very settled and the residents seemed very relaxed. Ms Hart was also pleased that the major changes were now behind them. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 and 5. 6 is not applicable to this home. Information provided about the home and a good admissions procedure enables prospective residents to make informed decisions about admission to the home and ensures that only service users whose needs can be met by the home are offered places there. EVIDENCE: The Statement of Purpose / Service User’s Guide has recently been updated and contain all the information required about the home and its facilities. This document is well written and informative giving a good indication of what prospective residents and their supporters can expect from the home. Paper and e-mail copies are available so people can get a good idea about what is on offer before they visit or move in. Two files of recently admitted residents were inspected. One resident had enjoyed day care and respite at the home and so was familiar with the staff and premises prior to taking up a long-term residential place there. Staff knew the resident well and no pre admission assessment was needed, all their previous paperwork was transferred. The other resident had been visited by
Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 10 Ms Hart who assessed their needs prior to them moving to the home. Prospective residents are given the opportunity to visit the home, as are their representatives. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 10. There is an excellent care planning system in place to make sure that staff have the information they need to meet the needs of the residents. The health needs of the residents are also well met with evidence of good support from a range of community health professionals. Residents are treated with respect and their privacy and dignity are promoted at all times. EVIDENCE: Care plans seen were of a very high standard. They flowed from the assessments made by the home, were easy to read and were full and informative about the needs of the resident and of how the home was to meet their needs. All information contained in the care plans was relevant and up to date with plans being regularly reviewed. Care plans echoed the ethos of the home to provide total care to the person and treat them with respect and dignity. Language used was sensitive and respectful referring to the need for staff to ‘explain, prompt, encourage, and reassure’ and for staff to use non verbal communication. The appearance and general demeanour of the residents demonstrated that these plans are put into action and people are very well cared for. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 12 Risk assessments are also in place for residents and plans developed to minimise any risks identified. Accidents are recorded and analysed and feed into the updating of care plans. Daily notes support and evidence the delivery of care to residents. These notes give a good picture of the daily lives of residents, the care that is delivered to them by staff in the home and by visiting community health professionals such as District Nurses and Community Psychiatric Nurses. A GP visited during the inspection and commented on the excellent care the home were providing to his patient. Continence assessments are requested as appropriate and continence products are discretely yet accessibly stored. Residents are accessing other community health services such as dentists and chiropodists. Residents are treated with respect and their dignity preserved by the staff at the home. Staff were very clear that they felt this to be important and easily described the ways in which they ensured that this happened in practice. It was apparent that real care is taken Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 Residents’ lives are enriched by the activities on offer at the home, the choices made available to them and the social opportunities afforded by spending time with other residents, the staff and their families. The meals in this home are good and varied and are served in a pleasant environment. EVIDENCE: Colindale is very much the home of the residents and is run in a manner that supports them to live their lives making the choices they can. Information is collected where possible about residents’ interests, life histories and previous occupations. Activities are informal and in response to what residents want to do that day and have a natural, easy feel to them. Residents are stimulated mentally; encouraged to move around and interact socially with each other and with staff, and a little pampering is thrown in for good measure. On the day of inspection residents had their nails painted, enjoyed a game of throwing beanbags into baskets, did some knitting and had a good laugh. All are welcome to join in with anything going on or to wander off and do other things. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 14 Staff were observed encouraging people to make choices and were on hand to help at all times. When people move into the home they and their families are asked about what the resident likes to eat. Residents, although not always able to say what they enjoy, are very able to make their preferences clear. Menus are based both around the known likes and dislikes of the residents and on providing a good wholesome diet. On the day of inspection lunch was steak pie, roast potatoes and fresh swede and broccoli, with soft meringue, fruit and cream for dessert. The home had plenty of fresh and frozen food and the store cupboard was well stocked. Comprehensive records are kept of meals, further demonstrating the variety and choice available. Residents can have their meals where it suits them. The home has a pleasant dining area that most residents eat in. Some residents choose to eat in the lounge and when the weather is good others prefer to take meals outside in the garden. Meals are relaxed and unhurried. Drinks, including fruit juices, are available throughout the day. Staff working in the kitchen had appropriate food hygiene certification. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 17. A system is in place to deal with any complaints that might be made about the home to ensure that concerns will be listened to and investigated. The legal rights of residents are protected and they are encouraged to participate in the civic process. EVIDENCE: The home has a complaints policy / procedure that is included in the information given to residents and their supporters and it is also on display in the hallway. No complaints have been received by the home since the last inspection or by the Commission. Residents are supported by people outside the home e.g. their families, solicitors and friends in managing their affairs and protecting their rights. At the last general election no residents exercised their right to vote, although all were registered and could have voted if they had wanted. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and26. Ongoing investment in the upkeep of the home maintains the comfortable and safe environment for the residents living there and anyone visiting. Bedrooms are well decorated, well furnished and personalised to suit the residents. Adequate facilities are available to meet the number and needs of the people living there. The home is kept clean and smells pleasant thereby making daily life for all in the home more pleasurable. EVIDENCE: Since the last inspection the major works to the home have been completed and the home has had its registration increased to 14. Bedrooms are now available on the lower ground, ground, 1st and 2nd floors. The new rooms have en suite facilities and are decorated and furnished to a high standard. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 17 Work is nearly complete to the new shower on the first floor and the there are plans to refurbish the kitchen. Colindale has a warm and homely atmosphere. The home is well decorated throughout. The lounge and dining areas are well and comfortably furnished. A quiet room is available on the first floor. The garden is well maintained and accessible with garden furniture available for those wishing to sit outside. Residents are mostly mobile and can choose where they spend their days. Some need a little assistance to get about and occasional reminders to help them to get where they want to go. Signs are available around the home to assist with this. There are sufficient communal baths and toilets in the home and a number of rooms have en suite facilities. Some aids and adaptations are available in the home and some residents with particular needs have their own personal equipment to assist with their independence. Other useful aids and adaptations are around the home for use by all e.g. raised toilet seats. Residents and their supporters are able to personalise their rooms with general belongings as they wish. There are emergency alarm bells throughout the home. Suitable laundry equipment is in place at the home. The home was clean and there were no unpleasant odours. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30. Sufficient care staff are employed and deployed to ensure that the care needs of residents can be met. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. However the home is still waiting for the return of the POVA first check and Criminal Record Bureau certificate for a new member of staff. EVIDENCE: Clear staffing rosters are in place that show who is on duty, when and what jobs they do. 3 care assistants are on duty between 8am and 2pm, with one person working in the kitchen for part of this time and 4 care staff are on duty between 2pm and 8pm. Two care assistants are on duty at night. Evidence of what was actually worked was seen. Ms Hart and Mr Gray are additional to the care staff and a cleaner works at the home on weekdays between 9 and 2. It is always clear who is in charge. Well ordered staff records/ personnel files demonstrated the homes’ recruitment procedure in action. The files of the latest members of staff to join the home were inspected. These were exemplary. However the CRB disclosure and POVA 1st check had been applied for but had not yet been returned for one member of staff who was working at the home. The Inspector was reassured to find that the member of staff was being well supervised and would not be delivering care to residents until the checks were complete.
Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 19 The home employs some workers from abroad. It was clear from the files that the home gathers the right sort of information about people’s rights to work in the country and any restrictions on that work. Records are kept of training that staff undertake. These records showed that staff have access to a good range of basic training and receive their regular mandatory updates e.g. manual handling and first aid. Training needs are discussed at supervision sessions and staff always complete evaluation forms for training they have had. Inductions are thorough and well structured. Recent training subjects for all staff have included dementia, problem behaviours, communication, anger management and manual handling. One member of staff described the recent manual handling training as ‘brilliant’. Another spoke very highly of the recent fire training that the local fire officers had carried out. Staff have expressed an interest in training in oral hygiene, general care and death and dying – all subjects that are pertinent and relevant to their work and this training will take place in the coming months. The way that staff were conducting themselves in the home and working with the residents on the day of inspection demonstrated that the training that they had had, had been understood and was being applied in practice. 10 of the 16 care staff have the NVQ level 2 in care qualification which is in excess of the target set by the Department of Health of having 50 of care staff trained to this level. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 An excellent supervision system is now in place that supports the staff in delivering care to the residents. Good management practice, systems in place and records kept confirm the health and safety of all in the home. EVIDENCE: Ms Hart has given considerable thought to the supervision system now in place at the home. This incorporates training and observation and gives staff the opportunity to really reflect on their practice and performance. Fire records were in place and internal checks are being carried out. An external company carries out quarterly checks of the fire equipment. Fire training records for staff showed that all staff had had fire training at the required intervals. Accident records and accident analyses were looked at. Most accident records were well completed in that they were clear about how staff came across
Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 21 accidents or if they had witnessed them. Analysis of such records provides the home with important information as to the effectiveness of the emergency systems in operation and of any further measures that could be put in place to minimise risks to residents. The data product sheets files – for any hazardous substances in the home e.g. cleaning materials, were being checked at the time of the visit to ensure that they were up to date with the products currently in use. These are readily accessible to the staff using the products. First aiders are always on duty and a refresher course is planned for staff in the autumn. Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x x x x x x 4 3 Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Colindale Care Home D55 S3941 Colindale Care Home V239315 270705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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