CARE HOMES FOR OLDER PEOPLE
Cornerways Church Lane Kings Worthy Winchester Hampshire SO23 7QS Lead Inspector
Tracey Box Unannounced Inspection 16th January 2006 10:00 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 Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cornerways Address Church Lane Kings Worthy Winchester Hampshire SO23 7QS 01962 882060 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) Hampshire County Council Mrs Hazel F Hiskett Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40) of places Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: Cornerways is a registered care home providing personal support and accommodation for up to forty older people. Hampshire County Council owns the home, the manager is Mrs Hazel Hiskett. The home is divided into four units, which comprise of ten single bedrooms, a communal lounge, dining room and kitchenette. Two units on the ground floor accommodate residents with dementia type needs, the two remaining units on the first floor accommodate physically frail older people. The home surrounds a courtyard garden. Attached to the home is a purpose built day centre which residents attend if they wish, this is not registered or inspected by the Commission. The home is situated in the quiet village of Kingsworthy, three miles away from Winchester. A small local shop is within walking distance from the home. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over five hours. The people living at Cornerways prefer to be referred to as residents, therefore will be referred to as this throughout the report. The environment surrounding the home was good, providing the residents with an attractive and homely place to live, however the carpets in the corridors were worn and stained, the inspector was assured the carpets are being replaced. The inspector witnessed good interacting between residents and staff, looked at records and asked residents, one visitor and staff for their views and experiences of living and working at Cornerways. What the service does well:
Six residents were taking part in a chair exercise class which is run by a man who visits the home once a fortnight to conduct gently exercises, all residents seemed to enjoy the exercises they were participating, the inspector spoke with three residents after the class had finished, they all commented on how beneficial and fun they find it, one resident said “It is important to keep active, and this is a fun, gently way to achieve it, I really enjoy the exercises, we have a lot of fun doing them.” One resident said “Staff are always doing training of some sort or another, moving and handling trains them to help keep me safe when I have a bath.” Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Two staff told the inspector “I receive more than adequate training to enable me to carry out my role” “I am encouraged to do training, I really enjoy doing it, and working here”. The manager says there is great demand for the respite care service the home provides. Staff were observed knocking bedroom doors and waiting for a reply before entering, three residents said that they felt staff respected their privacy and dignity. Two staff confirmed they have received comprehensive training since the started to work at Cornerways, a few staff are working towards achieving a National Vocational Qualification (NVQ) award, level 2 and 3, the majority of staff have completed the level 2 and 3 awards. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 6 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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 Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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 the following standard(s): 6 (Standard 3 was assessed at the previous inspection.) The home provides short term respite care to residents who have been assessed. EVIDENCE: The manager explained the process she follows if someone wishes to stay at Cornerways for respite care, if the manager is not available, an assistant unit manager will complete an assessment prior to the resident visiting. The inspector saw the homes policy on intermediate care, two bedrooms (one on each floor) are available to accommodate these stays. Residents confirmed they are consulted prior to a resident staying for short term care. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,10. Residents health, personal and social needs are set out in individual’s care plans ensuring the individual’s needs are fully met. Residents are protected by appropriately trained staff, who follow the homes policies and procedures for dealing with medicines. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: The home will complete risk assessments with all residents who require a bath chair whilst bathing. The inspector looked at two care plans, both included pre assessment paperwork, the information in these assessments is used to compile to individuals care plans and risk assessments. The care plans are comprehensive and include information about the individuals health, abilities, strengths, needs and wishes, any special requirements, mobility, religion and family details The manager reviews each care plan monthly, signed documentation showed this practice occurred. One resident said “staff care for me as I wish, all I have to do is ask”.
Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 10 Staff confirmed the care plans provide them with the information they need to satisfactorily meet the resident’s needs. Care plans included records of visits to the individual by their doctor, chiropodist, district nurse and other entries such as flu jab and admittance to hospital. At the time of the inspection, staff administer all of the residents medication. Staff told the inspector that residents prefer them to store and administer resident’s medication for them, one resident told the inspector this was their wish. The inspector saw medication being correctly administered, staff followed the homes medication policy and procedure, (the home uses the monitoring dosage system and monitoring administration record sheets) the records kept in conjunction with medication received and returned to the pharmacist were found to be correct. Records of all staff trained to administer medication were found to be in order. The inspector witnessed staff address individuals in their preferred manner, as stated in individuals care plans. Staff were observed knocking bedroom doors and waiting for a reply before entering. One member of staff recalled privacy and dignity being part of her induction and foundation training. Five residents and one relative commented on how polite, helpful and friendly the staff are, and how they feel staff respect their privacy and dignity. Staff receive Dementia care training, one member of staff said the training helped them to understand peoples behaviour better, it made her more aware of why some people seem forgetful at times, and how she can help the resident. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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 the following standard(s): 13 (Standards 12, 14 & 15 were assessed at the previous inspection.) Contact with family/friends/representatives and local community is encouraged as the individual wishes. EVIDENCE: Individuals care plans explore contact with family, friends, representatives and social workers, so to are individuals wishes to attend activities outside the home, one resident attends a local church, this was recorded in her care plan. A record of visitors to the home was seen, which showed family visits, the inspector talked to one visitor who expressed their happiness with the care and support their relative receives, they also stated that they are welcome at the home at any time, “I visit my relative every other day, sometimes at weekends. The staff are very caring, I cannot speak highly enough of them. The manager is readily available to see me if I want, I was made aware of the complaints procedure through the ‘service users guide’ my relative received, I haven’t had to use it yet though. I am very happy with the, she has settled in very well, I am sure this is due to the high level of care and support my relative gets. The home is clean and very homely, it has a nice atmosphere as soon as I walk into the home.” Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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 the following standard(s): These standards were assessed at the previous inspection. EVIDENCE: These standards were assessed at the previous inspection. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 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 the following standard(s): 19 (Standard 26 was assessed at the previous inspection.) Residents live in a safe environment, some areas require attention in order to keep them well maintained. EVIDENCE: The provider must ensure there is a ratio of one assisted bath to eight residents. At the time of the inspection there were three bathrooms to accommodate up to forty residents. Despite the carpets in the corridors being cleaned on a regular basis, they are stained and worn, therefore the provider is required to replace all carpets on the corridors. The manager showed the inspector around the home, which appeared well maintained, however the lighting in the small lounge on the ground floor was dim, two out of the ten bulbs had blown. The inspector saw records within the homes maintenance file, details included the fault and the action taken, all records are signed and dated to monitor progress.
Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 14 One resident said their room was very pleasant, clean and warm, they were encouraged to bring their own personal belongings, furniture and pictures to make it feel like home. “if I want anything fixing or putting up on my wall, all I have to do is ask and it’s as good as done.” A random selection of bedrooms were seen, all were found to be clean, warm and furnished with personal items. One resident said “I feel safe here, as well as being free to come and go as I please”. The home’s radiators and pipe work are safe ensuring that all potential hot surfaces are kept to low temperature. The garden is well maintained and residents enjoy using it, to walk around, sit in or look at from inside the home. The inspector witnessed the homes procedures to ensure hygiene is maintained, staff were seen to use protective clothing whilst completing their duties of personal care and cleaning. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 (Standards 27,28 & 30 were assessed at the previous inspection.) The home has developed staff as individuals and this is reflected in the residents feeling safe and comfortable at the home. EVIDENCE: The residents spoken with described the staff as “caring, friendly, helpful and are there when I need them.” All the residents spoken with said there was sufficient staff around and that the staff appear to know what they are doing. One relative also said she felt there were sufficient staff on duty who are professional. At the time of the inspection, appropriate numbers of skilled staff were on duty, ensuring the residents safety. The rotas showed that there were ample staff on duty over a four week period to meet the residents needs. The manager explained the recruitment process and showed the inspector the homes written procedure. Three staff files were sampled, two of which belonged to the two staff who were employed recently. The files contained photographs of the individual, along with other evidence of the individual’s identification. The inspector saw evidence of the CRB and POVA first disclosure being completed. The files contained certificates of all mandatory training and records of induction and foundation training. Staff explained the variety of training they had received enables them to carry out their role effectively. One staff member explained they had recently
Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 16 attended Dementia training, which they found to be “a real eye opener, as it explains why some people behave the way they do, I found it very interesting” One member of staff said the skill mix of staff is good, as there is always someone to go to for advice or guidance of needed, and there are enough staff on duty to meet the residents needs” The manager is positive and supportive of staff development and training, the inspector saw records which show staff receive regular supervisions, annual appraisals and various staff meetings that are minuted. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33 & 35 (Standard 38 was assessed at the previous inspection.) The home has a registered manager who runs the home in the best interests of the service users. The home ensures resident’s financial interests are safeguarded. EVIDENCE: The registered manager is registered with The Commission for Social Care Inspection (CSCI) to run the home and has completed her registered managers award (RMA) and NVQ level 4 in management. One visitor said “” I often see the manager on a regular basis, she informs me of how my relative is. I let her know how very happy I am with the care and support my relative receives.” The manager confirmed she gets feedback on the running of the home on a daily basis by talking to residents, their families and staff.
Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 18 At the time of the inspection a regulation 26 visit was being carried out, this occurs un announced on a monthly basis, the CSCI receive copies of their findings. One resident said “I like going to meetings which are held every two or three months, especially at the moment with the food, I get to say what I think of it.” One unit manager is currently devising a quality management auditing tool, which if agreed will be used in the future to monitor the quality of the home. The home follows policies regarding service users finances. The inspector sampled four residents money which was held in a locked safe in the office which is locked when not in use. Receipts were in order for all moneys received and spent, all four balances tallied up with the balances stated in the records. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 19 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 X X X X X 3 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 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO 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. 2. Standard OP19 OP19 Regulation 23(2)(j) 23(2)(d) Requirement The provider must ensure there is a ratio of one assisted bath to eight residents. The provider must replace all carpets on the corridors. Timescale for action 16/03/06 16/03/06 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 OP07 Good Practice Recommendations The home will complete risk assessments with all residents who require a bath chair whilst bathing. Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cornerways DS0000040361.V277191.R01.S.doc Version 5.1 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
