Inspection on 07/06/07 for Collingwood

This inspection was carried out on 7th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Collingwood 24/10/06

Collingwood 17/02/06

Collingwood 05/11/05

Collingwood 15/09/04

Collingwood 28/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Collingwood 78a Bath Road Longwell Green South Glos BS30 9DG Lead Inspector Jon Clarke Key Unannounced Inspection 7th June 2007 09:45 X10015.doc Version 1.40 Page 1 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 DS0000003320.V337882.R01.S.doc Version 5.2 Page 2 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. DS0000003320.V337882.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Collingwood Address 78a Bath Road Longwell Green South Glos BS30 9DG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0117 9324527 NONE Mrs Frances Stephanie Bailey Mrs Wendy Ann Pullin Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places DS0000003320.V337882.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 21 persons aged 65 years and over requiring personal care only 24th October 2006 Date of last inspection Brief Description of the Service: Collingwood is a privately owned care home registered to provide accommodation and personal care for up to 21 older people. The home is situated in a cul-de-sac in the residential area of Longwell Green. It is within walking distance of nearby shops and other amenities including medical services. The area is well served by public transport. There is easy access to Bristol and Bath. The M4 and M5 motorways are within easy reach. The property is stone built on two levels with an additional extension to the side. There is a passenger lift. There are attractive, well maintained gardens which are fully accessible to the residents. Accommodation is provided on two floors comprising of 21 single rooms. All rooms have en suite toilet facilities and wash hand basins. There are two lounges and a dining room on the ground floor. Assisted bathrooms and toilet facilities are situated on both floors. Collingwood aims to provide high quality care in a homely and safe environment and maintain individual service-user care, respecting resident’s rights, choice, privacy, individuality, autonomy, independence and confidentiality. (from home’s Statement of Purpose) Fee £400-410 DS0000003320.V337882.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of an inspection to look at the home’s performance and quality of care provided. As part of this visit a number of documents were looked at including the home’s Statement of Purpose, care plans, staffing arrangements, recruitment and training of staff. There was also an opportunity to discuss with people who live in the home their experience and views about the quality of the care they receive in the home. “Have Your Say” questionnaires were sent to the home for distribution to residents, relatives and professionals. We received 12 of 15 sent from residents, 6 of 15 from relatives and 5 responses from professionals such as GPs who visit the home. These responses have been used to inform the judgements made about the service. What the service does well: What has improved since the last inspection? DS0000003320.V337882.R01.S.doc Version 5.2 Page 6 A number of requirements were made at the last inspection relating to care planning and information about individual care needs. These have now been addressed and care plans provide a good outline of individual health and social care needs. The home has also address gaps in training of staff specifically moving and handling and infection control. 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. The summary of this inspection report can be made available in other formats on request. DS0000003320.V337882.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000003320.V337882.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose provides the required information about Collingwood, the facilities, staffing arrangements, admission procedure and aims and objectives of the home so that individuals can make an informed choice about the suitability of the home. The home’s agreement/contract generally provides all the terms and conditions of living at Collingwood. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs of the individual. Individuals are given the opportunity through the admission assessment, preadmission visit and trail period to make an informed decision that the home is suitable and can meet their needs. DS0000003320.V337882.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home’s Statement of Purpose was looked at and gave full and detailed information about the facilities including environment, how the home meets social needs through activities, staffing structure, complaints procedure. It would be helpful to provide information about staff training and qualifications particularly number of staff that have NVQ 2 or 3. Importantly it set out clearly the criteria for admission and the admissions procedure specifically the introductory visit wherever possible and trial period of four weeks. How perspective residents must be self-caring in some respects such as able to wash dress with minimal assistance, independent when toileting, independently mobile though the home can support individuals who need assistance with mobility or are wheelchair independent. It also states how the home is unable to provide “Dementia care” though will support individuals who have some memory difficulties. Copies of home’s agreement (contract) were looked at and gave information about fee and additional costs also arrangements for giving notice. It fails to state individual room or that 4 weeks notice of increase in fee will be given. A number of pre-admission assessments were looked at and showed that information about individual health and social care needs had been obtained. Also included were social and personal circumstances of the individual. The home obtains a copy of the local authority care assessment where this is available. DS0000003320.V337882.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents are met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were examined and showed detailed information about care tasks associated with daily routines of the individual. There were separate entries for health needs, mobility (with moving and handling assessments being completed) and mental health. Risk assessments were completed generally relating to risk of falls and in one instance relating to an individuals behaviour and mental health. These had all been reviewed on regular basis. Waterlow scoring is undertaking to identify risk of skin breakdown and the home has identified individuals who need support in maintaining healthy skin DS0000003320.V337882.R01.S.doc Version 5.2 Page 11 and referred to community nurse for support. All care plans looked at had been reviewed. There are now monthly care plan meeting held by senior staff to discuss any changes in individuals care needs. As part of care plans Advanced Directives are completed by the individual or their representative which provides information about next of kin and importantly their wishes on death. Health arrangements make sure that people who live in the home receive community health services such as chiropody, dental and optician. All respondents (residents) to Have Your Say questionnaire said they receive the medical support they need. Questionnaire returned by 3 G.P.s all stated that they were satisfied with the overall care provided, staff demonstrated a clear understanding of care needs and that management take appropriate decisions about health needs of people who live in the home. One G.P. commented “this is an excellent home and one, if not the, best in our area. I recommend it to patients and families”. A comment of a district nurse “pleasant atmosphere, staff very caring and helpful. Residents always appear happy and content. Very high level of care”. I also spoke to a district nurse and she was very positive about the care provided and staff. I asked her if she felt that the home always refers people when they need health support and whether they seek advice and her response was “always”. Medication arrangements in the home were looked at and were as required with secure storage, return of medication and accurate recording of administering of medication. Staff have completed training in supporting individuals with their medication. I also discussed with the manager the home’s home remedy policy and clarified issues around recording of their use. I spoke with a number of people who live in the home about how they felt they were treated by staff specifically whether they felt staff treated them with respect. Comments from individual included “I have no complaints about how staff talk to me you can’t fault them at all” “they speak to me as I would want them to”. I also observed staff assisting and talking with individuals and this was always respectfully and with sensitivity. DS0000003320.V337882.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: Individuals I spoke to about social opportunities in the home said that they felt there was enough going on for them. They told me about the exercise sessions “which we all enjoy”, bingo, outside entertainer and on occasion trips out particularly during the summer months. The manger said that she takes residents out whenever possible and staff will accompany individuals out of the home to local shops. There are good links with the local church with some individuals attending events as well as a monthly service in the home. A relative commented “they do have things of interest for the residents”. DS0000003320.V337882.R01.S.doc Version 5.2 Page 13 I asked about how visitors are received in the home and one individual said how she felt staff always make people who come to the home welcome and I also observed this during my visit to the home. One relative commented in their questionnaire response on what the home does well “the friendliness of staff and a very warm welcome”. I spoke to a number of individuals about the routines and flexibility of the home and how they felt in the choices available to them about their daily lives. The overall response of people was that they felt able to choose for themselves what did during the day and that staff were flexible ie one individual said how she always felt able to choose when she went to bed yet needed staff to assist her. Another spoke of how staff didn’t try to make her do anything it was always said and felt like it was up to her ie she hadn’t felt like a bath one day and it had been arranged for another time “and it wasn’t a problem”. However two individuals spoke to me about one aspect of the homes routine, which they believed was not flexible and this was about how they “had” “it’s the rule” to be in the lounge when morning and afternoon drinks were served. “If not we don’t get one and it would be nice to have afternoon tea in my room if I’m there”. I spoke to the manager about this and she agreed that this was the practice however she recognised the lack of flexibility though I understood some of the reasoning behind this arrangement in that it encouraged people to socialise. I joined the residents for lunch which was very well presented and certainly looked appetising in the way the food was placed on the plates. Importantly the size of the meal suited the individuals it was given too and one said how she was never given too much “that it puts me off”. There was a relaxed and unhurried atmosphere with staff assisting where this was required but doing so in a quiet and unassuming way. Individuals I spoke too were all very positive about the meals and food provided in the home “its always looks nice and I enjoy my food here” “they take a lot of effort in giving us what we like”. I asked about choice and all said how they could have something else if they wanted or didn’t like the main meal. I noted that all meals are served plated (warm plates) however the cook came round and poured gravy and served sauce if this was wanted rather then being available on the tables for individuals to serve themselves. Tea was also served as part the meal however no-one was asked if they wanted coffee or tea rather an assumption was made (in my view) that they always had tea and never wanted anything different. DS0000003320.V337882.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: The home’s complaints procedure forms part of information given to people who move to live in the home and individuals I spoke to said they were aware of how to make a complaint. When asked about if they had been unhappy about anything or if they were what they do all the individuals said how they would “tell one of the staff” “go to the manager”. Importantly people said they felt they “would be listened too”. The responses from people who live in the home to the Have Your Say questionnaire all said they knew how to make a complaint and all said yes to the question “Do staff listen and act on what you say”. The home has an Adult Protection policy and staff have received Adult Protection training however the manager and deputy have not completed the local authority training. DS0000003320.V337882.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and hygienic environment for the residents and staff. People who live and work in the home benefit from a warm, welcoming and well-maintained environment. EVIDENCE: The home is very well maintained and attention paid to making the home a pleasant place to live improvements have been made since the last inspection by the decorating of bathrooms. In looking around the home it was evident that a high standard of cleanliness and one individual said this was what made the home for her the fact it was “always so clean”. All respondents to the questionnaire said that the home was “always” fresh and clean. Relative comments the “home is kept spotlessly clean”, “the rooms are always spotlessly clean”. DS0000003320.V337882.R01.S.doc Version 5.2 Page 16 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are satisfactory so that the needs of residents can be met in an efficient way with care being provided by skilled and competent staff. The recruitment and selection of staff is undertaken to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing rotas were looked at and showed that there is good arrangements for staffing of the home with 4/5 staff on duty am, 2 1-5:30 and 2 5:30 –9:30 with waking night staff and sleep-in member of staff. In addition to care staff the manager and deputy are on duty. Over 50 of staff have completed NVQ 2/3 with 2 staff currently undertaking level 2. Staff are advised at interview that NVQ training is mandatory. Staff recruitment records were looked at and showed the necessary checks had taken place with 2 references being obtained and Criminal Record Checks undertaken. Application forms showed full employment history. All staff complete an induction programme. DS0000003320.V337882.R01.S.doc Version 5.2 Page 17 Training records showed staff had completed “mandatory” areas of training: moving and handling, first aid, fire and health and safety. Fire training is undertaken yearly. Infection Control training is undertaken monthly and this is an area of improvement. Other training is available to staff including Managing Continence, Dementia and Skin Care. DS0000003320.V337882.R01.S.doc Version 5.2 Page 18 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for residents and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff is protected. EVIDENCE: The manager Mrs Pullin has extensive experience of working with older people having worked at Collinwood for over 18 years originally coming to the home as a care assistant. She has completed NVQ 4 Registered Manager’s Award and is a qualified NVQ assessor. Individuals I spoke too said they found her “approachable” “can always go and talk to her” “manager is wonderfully supportive as is her staff team”. DS0000003320.V337882.R01.S.doc Version 5.2 Page 19 In talking with a number of people who live in the home there was a real sense that they felt they could express their views. Resident’s meeting are held which provide an opportunity for individuals to comment on the service they receive people I spoke to said they often talk about the food provided in the home, they are told about any changes. There is a quality Assurance questionnaire sent to residents of the home however they were not available for inspection. A limited number of questionnaires returned by relatives were seen and were all very positive about the home and care provided. It the home’s policy not to manage individuals financial affairs. Where the home purchases items or services such as chiropody records were seen which showed that individuals or two members of staff sign and witness any money given or used for such services. The home completes the necessary fire and health and safety checks with staff undertaking fire drill as required. Fire risk assessments in relation to the environment have been completed. Arrangements are in place to maintain infection control. DS0000003320.V337882.R01.S.doc Version 5.2 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 DS0000003320.V337882.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 OP33 Regulation 24(2) Requirement Supply to the CSCI copy of resident’s Quality Assurance questionnaire and report giving results and any actions taken. (Previous inspection requirement not met) Timescale for action 31/07/07 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 OP2 Good Practice Recommendations The home’s agreement/contract to show room to be occupied by the individual. DS0000003320.V337882.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 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 © 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 DS0000003320.V337882.R01.S.doc Version 5.2 Page 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. 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