Inspection on 04/05/06 for Coton Hill House

This inspection was carried out on 4th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Coton Hill House 03/10/05

Coton Hill House 03/06/05

Coton Hill House 23/02/05

Coton Hill House 13/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Coton Hill House Berwick Road Shrewsbury Shropshire SY1 2PG Lead Inspector Pat Scott Unannounced Inspection 4th May 2006 09:15 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 Coton Hill House DS0000020665.V293631.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. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Coton Hill House Address Berwick Road Shrewsbury Shropshire SY1 2PG 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) 01743 235788 01743 240002 enquiry@coveragecareservices.co.uk. www.coveragecareservices.co.uk Coverage Care Services Ltd Mrs Lilian Mary Langdown Care Home 45 Category(ies) of Dementia (15), Old age, not falling within any registration, with number other category (30) of places Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home may accommodate a maximum of 45 service users. The home may accommodate a maximum of 15 persons with dementia requiring personal care. The remainder being persons who are over 65 years of age who do not fall within any other category. 3rd October 2005 Date of last inspection Brief Description of the Service: Coton Hill House provides care for 30 elderly service users and 15 service users with dementia in single bedrooms with communal sitting, recreational and dining space in five separate units. The care home has large, well-maintained gardens that provide safe and accessible areas for all service users. The home is situated close to Shrewsbury town centre with views across the River Severn. The local transport system has regular bus services for those who do not have their own transport. The home provides visitors with car parking facilities. Coverage Care Services Ltd make their services known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and summarised in the service user guide. It is also on display in all homes’ entrance halls with a note stating the document can be made available to copy and take away. Coverage Care Services rates are reviewed annually on 1st April each year and service users are notified one month in advance. The only additional charges to service users are for toiletries, hairdressing, newspapers and escorting to hospital for routine appointments. This is clearly laid out in the terms and conditions. Fees for Coton Hill as of 1st April 2006 are: £316.73-£394. All service users pay monthly by standing order or by cheque usually on the 15th of the month. This is two weeks in advance and two weeks in arrears. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, staff records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, quality assurance process, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service, What the service does well: What has improved since the last inspection? The range of topics covered by training has improved. When training is attended it is cascaded down to all levels of staff. Research by the manager identifies areas of care that can be improved upon to meet national practice and guidance. An example of this is how the staff have implemented a specific care plan for end of life care with associated training. The manager spoke of many areas in which the home aims to improve one of which is the promotion of healthy eating by screening service users on admission, monitoring their nutritional intake and providing meals in line with the healthy eating award. The manager has implemented systems, prompts and reminders to improve the safety of medication administration to service users. The system for dealing with poor staff practice in this area are robust. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 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. Coton Hill House DS0000020665.V293631.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 Coton Hill House DS0000020665.V293631.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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes statement of purpose and service user guide provides service users and prospective users with details of the services the home provides, enabling an informed decision about admission to the home. Assessment of need is conducted in a respectful and plain speaking way so that service users understand their needs will be met during their stay. EVIDENCE: The statement of purpose and service user guide have been reviewed for 2006/7 and were on display in the home. Evidence from previous inspections show that the organisation of Coverage Care regularly reviews its information for service users and their families/supporters/advocates. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 9 A service user staying in the home for a period of respite confirmed that he had been given a lot of information about the home and that he had made the decision to stay at Coton Hill together with his family after visiting three places. Information is provided to service users before and during their stay at the home. Photographs of key staff are on display on the foyer notice board. Admission assessments on the care files that were read during this visit were comprehensive, clearly written and staff were aware of their content. Service users spoken with said that a member of staff from Coton Hill had asked ‘a lot of questions’ and that they had been ‘able to understand what they were asking and why they were asking it’. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is excellent . This judgement has been made using available evidence including a visit to this service. The medication at this home is well managed promoting good health. There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. The attitude of staff is excellent and service users are treated with dignity and respect. Personal and healthcare support in this home is offered in such a way as to promote and protect service users’ dignity and privacy in their daily life and at the end of life. EVIDENCE: The care plans that were read were very clearly written. Information from the initial assessments had been written into the plan of care. Care plans are Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 11 reviewed monthly and annually with signed input from the keyworker, service user and family. A service user spoken with was aware of her care plan and went through her medication chart stating that she receives her medication on time and a review of those tablets she wasn’t ‘keen on taking’ had occurred with the General Practitioner. The medication administration chart recorded these changes. Medication charts in general were well organised and fully completed. Prompts for staff to be vigilant were seen within the charts to prevent any human errors during administration. Medication that has to be crushed and placed in food because it is in the service users best interests for this to happen is clearly recorded. The reason for doing so was written in the care plan and a risk assessment for the process recorded. Written evidence of consultation and agreement with the General Practitioner was also recorded within the risk assessment. A staff member went through a care plan of one service user. She was conversant with its content, of how it is used during daily care and of how information is shared out between staff. Training has been provided for staff which is recorded in the staff training profiles. The manager and staff at Coton Hill have been working towards providing good end-of-life care for service users. An example of a care plan was seen of a recently deceased service user which showed that the elements of the national framework for this aspect of care has been taken on board with good outcomes for the service user and her family in the last days of life. During the visit staff were seen and heard to treat service users with dignity and respect. They had patience with those who, for health reasons, were confused or agitated and staff allowed them to go at their own pace in all aspects of care. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff have an excellent understanding of the service users support and leisure needs and use this to assist them to exercise choice and control in their lives. Service users have many opportunities for community/family contact which enables them to make a choice about who they see and when and where they see them. Dietary needs of service users are very well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Service users were very complimentary about the food provided. They were able to relate what they had chosen for lunch and that staff come round and ask them their preference from the menu each day. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 13 The catering staff are going for the healthy eating award. A recent infection control audit by the Primary Care Trust had judged them to have achieved 100 in the main kitchen and the satellite kitchens on the units. The manager has attended an activity training day covering therapeutic activity awareness, communication, physical activity etc. This information has been shared with all staff. Service users were looking forward to the extend class during the visit. Some had also been for a 5 day break to Blackpool and shared their experience with me. Activity preferences are discussed at the resident meetings. Service users confirmed that they can participate in anything and can go down to the day centre as and when they wished. Or, they could sit quietly in their lounge “without the blast of TV to annoy us” A service user had recently had a birthday and had enjoyed a party out with his family. Service users can also speak privately to friends and family in their rooms. They can use the private pay phone or have one in their room. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. 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 a satisfactory complaints system with evidence that service users feel that their views are listened to and acted upon. Staff are provided with induction and on-going training regarding adult protection. This provides staff with the relevant knowledge to safeguard service users from many types of abuse. EVIDENCE: The CSCI has not received any complaints about the home. Nor have their been any adult protection issues. Service users spoke of their ability to talk to any staff. They didn’t have any complaints but would feel very comfortable to speak with the manager or staff at any time. A service user stated “ you see, we don’t need to use the complaints system because staff are always around talking about how we like things and we can go to meetings if we want to. They always listen. It’s a friendly place”. The reviews that take place give a forum for concerns to be aired. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is excellent providing service users with an attractive, homely and hygienic place to live. EVIDENCE: The home has a programme for the review of décor and equipment. Works carried out are recorded. All bedrooms and communal areas were in excellent order with clear signage to assist service users to find their way around. The organisation has provided an improvement plan for the home. The premises are regularly reviewed during the monthly visits to the home by the Head of Operations who supplies a report to the CSCI and during the health and safety audits. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 16 Service users were proud to show their rooms which were personalised and were aware of the changes that take place to improve the appearance of the premises i.e new tablecloths, napkins, table mats etc. The gardens are very well maintained, accessible and with an improved area outside one of the dementia units. A garden competition takes place between the homes of Coverage Care. The recent infection control audit has provided the home with an overview of current best practice and the home has implemented some of the relevant points for the type of service Coton Hill aims to provide. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 17 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): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of vetting and recruitment practices is excellent with appropriate checks being carried out. This ensures that suitable staff are employed to care for service users. The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: The file of a new recruit was seen which showed that robust recruitment practices are carried out. Staff files were seen regarding induction and training. The induction standards have been amended to meet those for ‘Skills for Care’. Staff confirmed that training is provided and there are many equal opportunities to improve themselves for the benefit of service user care. The home uses the services of a volunteer and also has people for work experience. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 18 The home is working towards 75 of staff having NVQ qualifications with 68.2 of staff already having this. A service user stated “ staff are very nice and helpful but they also know what they are doing”. Information sent to CSCI demonstrates that if staff make mistakes in any area of practice then management are quick to resolve any issues and put plans in place to prevent re-occurrence. The organisation benefits from having the post of a personnel and training officer. A compliment card from a family of a deceased service user was extremely positive about the experience of the service and staff at Coton Hill. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 19 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): 31,32,33,34,35,37,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The systems for resident consultation are excellent with evidence suggesting that their views are sought and acted upon The home is managed by an experienced, suitably qualified individual who carries out her responsibilities fully. The manager has sound leadership skills and promotes a professional ethos within the home The management team are developing and maintaining a wellsupported staff group in the home’s quest to constantly improve the service to meet residents’ aspirations The organisation continues to improve and make progress towards raising the standards in all areas for the benefit of its service users. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 20 Health, safety and welfare of service users and staff are promoted fully by safe working systems in place EVIDENCE: The manager has attended many training events and updates to complement her role within the home. Many of these are shared with the staff and with service users at the staff/resident meetings. Through discussions she demonstrated that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the service users living at Coton Hill. She seeks to continually improve her performance through research into best practice in elderly and dementia care. She is fully conversant with the Coverage Care business and improvement plan. The deputy and care managers are participating in an NVQ 4 programme. Equality and diversity for service users were seen to be promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. Senior management of Coverage Care review the conduct of the home on a regular basis through the visits under Regulation 26, management meetings, board meetings etc. Quality assurance takes place throughout the service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that service user satisfaction is at the heart of the service. The home keeps records to show that the health and safety of service users is promoted and protected. Complaints, incidents/accidents are all monitored to identify trends and failings and the need for reassessments. Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 21 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 4 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 X 4 4 Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 22 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. 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. Refer to Standard Good Practice Recommendations Coton Hill House DS0000020665.V293631.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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. 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