Inspection on 06/09/05 for Coombes Wood House

This inspection was carried out on 6th September 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

Coombes Wood House 27/04/06

Coombes Wood House 16/05/05

Coombes Wood House 03/02/05

Coombes Wood House 19/08/04

Coombes Wood House 08/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Coombes Wood House Coombesend Road East Kingsteignton Newton Abbot Devon, TQ12 3DZ Lead Inspector Mark Sharman Announced 06 September 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 V237731 060905 Stage 4.doc Version 1.40 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 Louis Cook/Marjorie Cook Care Home 19 Category(ies) of Old age - not falling within any other category registration, with number (19), Dementia (19), Physical Disability - over of places 65 years of age (19), Mental Disorder - over 65 years of age (19) Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 16/5/05 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 car parking areas. A substantial purpose-built extension to the home is now nearing completion. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and about six and a half hours were spent at the home. A pre-inspection questionnaire was completed by the home owner before the inspection, and some comment cards were also received (three from residents and one from a relative). Nine of the residents and four staff were consulted, and one visitor was also spoken to (several residents were too confused to clearly express an opinion). A sample of the home’s records was inspected. A tour of the premises included the communal areas and most of the bedrooms. What the service does well: What has improved since the last inspection? One minor recommendation was made at the last inspection that the medicines refrigerator should be lockable, to ensure that only authorised staff would have Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 6 access to any medicines stored in it. The solution tried by the home was to keep the refrigerator in a locked cupboard, but this has proved impracticable. The recommendation is therefore repeated. 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 V237731 060905 Stage 4.doc Version 1.40 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 V237731 060905 Stage 4.doc Version 1.40 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. Standard 6 is inapplicable. No resident is admitted to the home unless her/his needs have been assessed first to ascertain if the home is suitable, which is done consistently. EVIDENCE: Four of the residents’ individual files were inspected. All of them contained a written assessment carried out by a local authority care manager prior to admission, and in two cases a referral had also been written by hospital staff. Whenever practicable a prospective new resident is seen by two of the home’s senior staff at home or in hospital. Mr Cook said that the last resident admitted had come directly from another care home, and had spent some hours at Coombes Wood House on a visit before a decision was made. Mr Cook was clear that the home is not suitable to cater for all needs, and examples were given of people who had been declined. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 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 residents’ health care and social care needs are set out in individual care plans, and these needs are being well met. There is a safe system for handling residents’ medication. EVIDENCE: Four of the residents’ individual files were inspected, all of which contained a care plan. These set out the resident’s perceived health care needs and social care needs, and included a (brief) action plan. Each also included a personal risk assessment and a falls risk assessment, and there was evidence of regular reviews. The approach to the residents’ health care is regarded as commendable. All are registered with a general practitioner, and visits by general practitioners are recorded in the care plans (a general practitioner visited one of the residents during this inspection). These included a pressure sore assessment and a nutrition screening form. Equipment which is needed is obtained, and currently the home has a specialist air mattress and a specialist bed on loan in order to provide appropriate care. A dentist and optician will attend residents at the home, and a dentist saw two residents on the afternoon of the inspection. The Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 10 home has contact with members of the local mental team for older people, and several of the residents have been seen by the psychogeriatrician. Mrs Cook has qualified as a massage therapist and is able to offer this service to residents. She is also training in reflexology and will be able to offer this service as well (at a cost). Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 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) 12. A range of activities and entertainment is provided which is suited to the residents’ preferences and abilities. EVIDENCE: The residents who were consulted felt that suitable activities are offered to them. Regularly occurring activities are listed on a programme which was displayed on a notice board. These include bus trips out, indoor games, exercise sessions, Fellowship meetings, reminiscence sessions, professional musical entertainment, nail painting etc. Several residents said they enjoy the fortnightly bus trip out, and three of them said they have started to attend monthly music therapy sessions in the community. Singing is popular and the home has karaoke equipment, which was in use on the afternoon of the inspection. A summer fete was held recently which raised money for the residents’ comforts fund. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 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 and 18. Residents are confident that any complaint would be taken seriously by the home’s management, and there are satisfactory arrangements in place to ensure that they are protected from abuse. EVIDENCE: The complaints procedure is satisfactory in all respects, and a copy was displayed in the home. The residents who were consulted all said that they were sure if they expressed a complaint it would be taken seriously by the home owners. Experience has shown that the owners regard complaints in a positive way, as an opportunity to rectify anything which may be unsatisfactory. There is an adult protection policy in place and other appropriate policies, and the home has a training video on abuse matters. The staff consulted were aware of the home’s policy on abuse. Recent experience has shown that an allegation of abuse would be taken seriously. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 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. The building is kept in a safe, comfortable condition and was clean and tidy. EVIDENCE: The home is in an attractive rural location and there are good views from many of the windows. There is a large garden, with level access from the building. All current residents have single bedrooms, most of which were inspected. Many of them have been made quite homely by their occupants with items of their own furniture and ornaments. Disruption from the building of the extension has been kept to a minimum. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 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 29. The staffing arrangements are adequate and staff morale is high, resulting in a good standard of care for the residents. EVIDENCE: Staffing levels remain as at the last inspection and are regarded as adequate. The more capable residents said that their call bells are usually answered promptly. Most of the staff have worked at the home for a number of years, which ensures a consistent standard of care for the residents. Over half of the care staff have attained NVQ level 2 and/or 3. The care manager and one senior carer are working towards the registered manager award and NVQ level 4. The recruitment procedure for new staff is generally satisfactory, and Criminal Records Bureau disclosures and references were seen for three of the newer staff. However, a Criminal Records Bureau disclosure should also be applied for in respect of staff employed who are foreign nationals. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 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) 33, 35 and 38. Regular monitoring of the quality of the service takes place, and there are satisfactory arrangements for ensuring the health and safety of the residents. EVIDENCE: Mr Cook spends much of the week at the home and has substantial contact with the residents and their relatives, and it was clear from comments made that residents have confidence in him. A quality assurance questionnaire for residents and their relatives is now in use regularly. Residents’ meetings and staff meetings are held, and the home’s current annual development plan was available. The administration of residents’ personal money is satisfactory, and a sample of these records was inspected (including receipts). With regard to health and safety, the core training for all care staff includes manual handling, fire safety, first aid, food hygiene and infection control. Mr Cook said there is normally a first aider on duty. All but three of the radiators accessible to residents are covered, to prevent residents from sustaining a Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 16 burn injury. The three radiators were to have been removed as part of building alterations, but this will not now happen. Accordingly Mr Cook said they will now be covered in the next six weeks. He confirmed that the upstairs windows have restricted openings to prevent residents from falling from them, and several of these were checked during the inspection. Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 17 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 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 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 3 x x 3 x 3 x x 3 Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 18 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 29 Regulation 19 Requirement A Criminal Records Bureau disclosure (of an appropriate level) must be obtained in respect of any foreign national employed at the home. Timescale for action 30/9/05 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 V237731 060905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP 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 Coombes Wood House D54-D07 S3676 Coombes Wood House V237731 060905 Stage 4.doc Version 1.40 Page 20 - 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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