Inspection on 28/04/05 for Coombe Dingle

This inspection was carried out on 28th April 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Coombe Dingle 17/12/07

Coombe Dingle 15/01/07

Coombe Dingle 30/08/05

Coombe Dingle 28/07/04

Coombe Dingle 06/04/04

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

CARE HOMES FOR OLDER PEOPLE Coombe Dingle 14 Queens Park Road Caterham Surrey CR3 5RB Lead Inspector Kathy Martin Unannounced 28 April 2005 10:00 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. Coombe Dingle Version 1.10 Page 3 SERVICE INFORMATION Name of service Coombe Dingle Address 14 Queens Park Road Caterham Surrey CR3 5RB 01883 345993 01883 341869 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) Alpha Care (Caterham) Ltd Nirmala Read CRH (N) 42 Category(ies) of Dementia (DE) 1 registration, with number Dementia - over 65 (DE(E)) 42 of places Learning Disability - over 65 (LE(E)) 1 Coombe Dingle Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1) Up to 1 bed may be used for people with a Learning Disability (LD(E)) 65 years and over. 2) Up to 5 beds may be used for respite care. Up to 1 resident may be cared for on Day Care basis between the hours of 0800-2000 hrs. 3) The one (1) place for (DE) Dementia under 65 years of age may be for the named service user only. Date of last inspection 16 June 2004 Brief Description of the Service: Coombe Dingle is a registered care home providing nursing care for up to 42 residents with Dementia. The home is situated in a quiet residential road in Caterham facing a large park. The property is detached and has a large garden to the rear and also offers car parking for several vehicles. Additional parking is on the road. Accommodation is provided over three floors. There are a few (9) en suite single bedrooms and 2 double bedrooms with ensuite facillities. The home is owned by Alpha Care (Caterham) who are the registered providers. Coombe Dingle Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection that has taken place this year. The home will receive another inspection before the end of March 2006. The inspection was unannounced and therefore the residents and staff were not aware that the inspector was visiting. The inspection took place at 10:00 am. The manager was present throughout the inspection and the inspector was given plenty of opportunity to speak to several residents, 3 relatives who were visiting and staff who were on duty. Records were also seen. The atmosphere in the home was relaxed. Residents were freely accessing many different areas of the home especially the ground floor. The weather was not warm enough on the day for the residents to be out in the garden. The home was clean and tidy and there were adequate staff on duty. The home has now employed an activities organiser. The manager is newly registered with the CSCI and has settled in well. She has worked hard with the support of the provider and her staff in implementing changes to ensure the home meets the required standards of care. The previous requirements made at the inspection in July 2004 were now met. The requirements made in the CSCI pharmacist inspector’s visit in November 2004 were also all met. The inspector wishes to thank all those involved in providing the information in this report and in particular the residents, the relatives, the manager, the provider and the staff present. What the service does well: The home has established very good rapport with residents’ families who are encouraged to participate in the care of the residents. Some comments made to the inspector included: “…has everything he needs” “The care staff are very good”. The relatives felt that they were able to take any issue to the manager and the other staff anytime. “everyone is lovely”. One resident enjoyed listening to the inspector’s conversation with her husband whilst also encouraging her to participate in French, which was in her Coombe Dingle Version 1.10 Page 6 own mother tongue although her verbal communication was not very good that day. Many comments were received in favour of the home cooked meals prepared in the home’s kitchen. The comments included: “the food is lovely”. There was choice offered and one relative stated that “the cook is my friend” and he was always offered a meal. The staff spoken with commented on “good communication between staff”. There has been a lot of effort made by the provider in obtaining training for all levels of staff employed. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Coombe Dingle Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Coombe Dingle Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home has procedures that work well when introducing new residents. Residents’ relatives and care managers are always encouraged to participate in their care, as are the health care professionals. EVIDENCE: Residents are given plenty of opportunity to visit the home with their relatives and care managers although some decline this dependent on their situation and location at the time of application. There is a period for deciding if the placement is suitable. This information was provided in the notes inspected. The assessment of needs is obtained before a placement is offered and the manager will visit the resident at home or in the hospital when conducting the assessments. Coombe Dingle Version 1.10 Page 9 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 and 8 The care plans inspected contained many relevant areas of needs with realistic goals and were reviewed regularly. Each resident has a key worker. Residents can see a number of relevant health care professionals when they need to. EVIDENCE: Care plans inspected were written very clearly and in very good details. The areas of needs included: personal care, bedtime routine, relevant nursing needs for nutritional intake and physical needs. Not all care plans contained emotional and social needs, which is recommended. Residents are able to access a doctor, chiropodist, hairdressers and dentists. This was evidenced in conversations with the residents and relatives during the inspection and the manager and provider stated that the visiting doctors had an excellent rapport with the staff of the home. Coombe Dingle Version 1.10 Page 10 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 and 13 The arrangements for providing activities are good. The home encourages community involvement and visitors to come to the home and add to the stimulation of the residents on a daily basis. EVIDENCE: A new activities organiser is in post and she has the relevant experience of working with older persons with Dementia. An activities list is planned beforehand and the home also provides entertainers to come in. One resident and his relatives told the inspector about the recent lady who came to sing wartime songs, which was really enjoyed by all. The home very obviously encouraged participation and regular visiting from relatives and friends. Residents have access to their doctors and visiting health professionals. Parties are planned for the summertime. Birthdays are always celebrated. Residents are also encouraged to mingle with each other and sit together at table for meals. There is a large secluded garden for those who enjoy some fresh air. A large conservatory is also available for the residents who want to look at the garden and birds from inside. Coombe Dingle Version 1.10 Page 11 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 18 The home has a procedure for making complaints, which is in writing and not always used by residents themselves due to their condition. Staff received training in the protection of vulnerable adults and procedures for protection from abuse is in place. EVIDENCE: The complaints procedure is in writing but not always understood and used by the current residents especially those who are in advanced stages of Dementia. The staff respond to any comment made seriously and act on these, similarly to the comments that are sometimes made during social workers reviews and key workers meetings or inspections. The home has policies and procedures to ensure the protection of vulnerable people in their care. Issues relating to the employment of new staff have been picked up with the provider and requirements have been made for the home to have a contract with the introductory agencies to clearly say who is responsible for checking what. This is discussed under Standard 29 of this report. Coombe Dingle Version 1.10 Page 12 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 and 26 The home is kept in a homely and pleasant manner. There are no health and safety issues relating to the property. The home and gardens are well maintained. EVIDENCE: The home is maintained in a good standard. The bedrooms are decorated regularly and there is a homely atmosphere experienced by residents. The décor is not clinical despite being a nursing home having been refurbished a few years ago. The home employs dedicated staff to take care of the cleanliness and it was noted that the home was very clean and tidy with no unpleasant odours. This is commendable. Coombe Dingle Version 1.10 Page 13 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) 29 The recruitment policies were not used properly at all times. The home needs to take measures to ensure the new staff they employ have been through rigorous checks. EVIDENCE: The inspector looked at 3 newly employed staff records and had a long discussion with the manager and the provider. The records missed relevant details as specified by regulations such as a recent photograph, a clear police check done by the Criminal Records Bureau (although it is acknowledged they had obtained clear police checks from the country of origin). The home uses the services of an introductory agency that provides new staff on occasion to the home. A requirement was made for the provider to write a contract between them and the agency, which stipulates the checks to be undertaken by the agency before the staff are employed by the home. This will ensure the regulations have been followed in terms of appropriate checking and interviewing of new staff. Coombe Dingle Version 1.10 Page 14 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, 38 The preparation to receive new staff in the home was not always good and needs to be more consistent. There were no health and safety issues relating to the home. Relevant checks were done and the home was maintained safe. EVIDENCE: The preparation to receive new members of staff in the home was not very good recently. On one occasion the induction pack was not even completed by the staff member or their mentor. This is not considered good practice. A requirement has been made for the manager to ensure that the staff are supported better when they come to the home and that their induction checklist is completed in due course. However, a registered nurse had a long discussion with the inspector and stated that every effort is made to support new staff in the home. The staff group is friendly and everyone helps each other. That was actually observed during the inspection. There was regular handing over sessions between each shift for staff to communicate the events in their shifts to the next. There was ample time given to staff to talk to each other and also see the manager who Coombe Dingle Version 1.10 Page 15 is reported as friendly and approachable. The staff also confirmed that new staff were given induction on a supernumerary basis (meaning that they would not work on their own) for their first few shifts. The home holds fire drills and provides training in all aspects of health and safety. Policies and procedures for health and safety were seen in the office and the manager stated that these were used although not checked in details. Coombe Dingle Version 1.10 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x x x 2 x 3 Coombe Dingle Version 1.10 Page 17 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 18, 29 Regulation 19 (1) Requirement Ensure fitness checks are undertaken by the introductory agency for staff referred to the home; draw a contract stipulating the responsibilities of each party to ensure fitness. All newly employed must apply for CRB clearance and POVA check prior to commencement of employment Staff need regular supervision especially those who are recent employees. Timescale for action 5/6/5 2. 18, 29 19 5/6/5 3. 36 18 (2) 5/6/5 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 7 Good Practice Recommendations Include social and emotional needs on all care plans Coombe Dingle Version 1.10 Page 18 Commission for Social Care Inspection The Wharf Abbey Mills Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 Coombe Dingle Version 1.10 Page 19 - 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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