CARE HOMES FOR OLDER PEOPLE
Coombes Wood House Coombes Wood House Coombesend Road East Kingsteignton TQ12 3DZ Lead Inspector
Mark Sharman Unannounced 16th May 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. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Coombes Wood House Address Coombesend Road East, Kingsteignton, Newton Abbot, Devon, TQ12 3DZ 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) 01626 365101 01626 365101 Mr Louis CookMrs Marjorie Cook Care Home 19 Category(ies) of Dementia (19), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (19), Old age, not falling within any other category (19), Physical disability over 65 years of age (19) Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None. Date of last inspection 3/2/05 Brief Description of the Service: Coombes Wood House is registered to provide personal care for up to nineteen people aged 65 or over, who may also have a degree of physical or mental disability including dementia. The home owners are both registered nurses (general and psychiatric nursing) and have substantial experience of working with elderly people, including those suffering from dementia or functional illness such as depression. The home is situated in a rural position a little more than a mile from the centre of Kingsteignton, and there are attractive views from many of the windows. All but one of the bedrooms are single rooms, and nearly all have en suite facilities. The home has a shaft passenger lift. There is a comfortable lounge and a separate dining room with an adjoining sun lounge. There is easy access on to a terrace and lawn, and there is a large garden and extensive grounds (with a car parking area). A substantial purpose-built extension to the home is now in the course of construction. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection lasting four hours, and for some of this time Mr Cook (home owner) was present. Seven residents and three of the staff were interviewed. A partial tour of the premises took place, including a look at the new extension which is being built. What the service does well: What has improved since the last inspection?
The one requirement and the recommendation made at the last inspection have both been complied with. The requirement related to the replacing of a damaged bath panel in a communal bathroom. The recommendation related to improving the accuracy of record keeping in respect of residents’ personal money. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 6 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. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 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 Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 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) None of these Standards was considered at this inspection. EVIDENCE: Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 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) 9 and 10. The medication system was being well managed, thus helping to promote residents’ health. There is a strong emphasis on treating residents with respect. EVIDENCE: The medication cupboard was inspected and a sample of medication administration recording sheets was seen. Controlled drugs were stored and administered correctly in accordance with the Standard. There is now a small fridge for medication, although this should be made lockable. All staff who administer medication have received training, including Boots training in some cases and distance learning courses in others, and this was confirmed by the staff on duty. Residents spoken to said they were happy for the staff to give them their medication. Residents were especially complimentary about the attitude of the staff towards them, one describing them as “wonderful”. They confirmed that their dignity is maintained as far as possible and that, for example, staff always knock on bedroom doors. The staff treated the residents in a kind and caring way. None of the bedrooms was shared. A cordless telephone is available for residents who do not have their own telephone, thus allowing for privacy.
Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 10 Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 11 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) 13, 14 and 15. It is part of the home’s ethos that residents should be as independent as possible, and they are helped to make decisions for themselves. Their dietary needs are well catered for with a varied selection of food which suits their preferences. EVIDENCE: The residents spoken to said that they are able to please themselves as to routine, for example getting up and going to bed, and whether or not to join in with activities. They are able to personalise their bedrooms, and some have made their rooms very cosy. A few manage their personal money and others have their own representatives to handle their financial affairs. Some voted at the recent parliamentary election. The cook has changed recently, but the residents said that the meals remain excellent. One said that “the food’s the best 1’ve had in one of these places”. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 12 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. The management takes a positive approach to complaints, regarding them as an opportunity to improve services. The residents were confident that any complaint would be dealt with. EVIDENCE: The two residents who were asked said they were sure that any complaint they had would be listened to and taken seriously by the home owners. No complaint has been received by the Commission for Social Care Inspection since the last inspection. One resident said that she was very satisfied with the services provided, with the exception of the laundry service. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 13 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, 24 and 26. The home is well located and provides suitable and comfortable accommodation for the residents. It was warm, clean and hygienic. EVIDENCE: This was an unannounced inspection and the building was warm and clean. One of the residents said that his room is always kept clean. There was no unpleasant odour in the building, with the exception of one bedroom (which was discussed with the owner). The residents said that they liked their own rooms, and all rooms are occupied singly. Most have en suite facilities. The laundry room is cramped and poorly sited, and it is necessary to use bags to carry laundry through the kitchen. There is no sluicing facility. Once the extension is completed the owners plan to re-site the laundry room to the first floor and install a new washing machine with a sluicing function. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 14 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 and 30. The staffing arrangements are satisfactory and staff morale is high, resulting in a good standard of care for the residents. The staff are well trained for the work they do. EVIDENCE: This was an unannounced inspection, and the residents’ needs were being met by the staff on duty. The residents themselves said that there are enough staff deployed and that, for example, call bells are answered promptly. The staff on duty said that the staffing levels which are maintained are sufficient. All of the residents said that the staff are excellent, and one said that “the staff will do anything for you”. All but two of the care staff have attained NVQ level 2 and/or 3. The care manager and one senior carer are now doing the registered manager award and NVQ level 4. The staff felt that they have good training opportunities. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 15 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) None of these Standards was assessed. EVIDENCE: Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 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. 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 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 4
COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x x Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 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 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 9 Good Practice Recommendations A lock should be fitted to the refrigerator used for storing medicines. Coombes Wood House D54-D07 S3676 Coombes Wood House V227282 160505 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ11 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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