CARE HOMES FOR OLDER PEOPLE
Coton Care Ltd Coton House 55 Coton Road Penn Wolverhampton West Midlands WV4 5AT Lead Inspector
Mr Ian Harris Key Unannounced Inspection 22nd June 2006 08:00
22/06/06 08:00
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 Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 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 Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Coton Care Ltd Address Coton House 55 Coton Road Penn Wolverhampton West Midlands WV4 5AT 01902 339391 01902 339391 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) Mr Balbir Singh Kular Mrs Inderjit Kular Mrs Kalwant Chahal Care Home 27 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (21) of places Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home should only accommodate service users with mild dementia. Date of last inspection 26th September 2005 Brief Description of the Service: Coton House is situated in a very quiet area of Penn, some 400 yards from Goldthorn Hill. The property was built in the 1930s and has been a residential home for the elderly for many years. In 2001 the Home had major development and refurbishment with a new purpose built wing of 10 en-suite bedrooms being added. Coton House is registered for 21 service users aged over 65 years. The home is well maintained and has a homely, friendly atmosphere. The staff are experienced and committed to meeting the care needs of the service users. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 5. hours. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 4 members of staff 6 residents were spoken to. It was noted that the fees range from £323 to £390 depending on size and ensuite facilities. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable with contented residents. All the residents spoken who could express themselves in a meaning full way expressed their satisfaction with the care they received and there were comments as follows “ the food is good here” “We are well looked after here” “ I’m very settled now, This is a very nice home.” “The staff are good”. What the service does well: What has improved since the last inspection?
A considerable amount of work has taken place to improve the internal and external environment, 2 bedrooms and the dining room have been redecorated. The rolling programme of replacement double glazed windows has now been completed. A new mobile hoist has been provided for the benefit of both residents and staff.
Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 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 Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 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 Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 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): 3 and 6 There is a good assessment procedure of residents needs in place and there is evidence that they are being followed. The home does not provide intermediate care but offer a very good respite service. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: There is evidence on the files that all the residents who are funded by the Local Authority undergo a full multi-disciplinary assessment prior to admission. The residents, who are self funding are assessed by the Care Manager, using the homes assessment forms. Two residents confirmed that they had been involved in the assessment process The home does not provide intermediate care but has a respite unit. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 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, and 10 Each resident has a very good comprehensive, individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are well met. The systems for the administration of medication are good with clear and comprehensive recording arrangements being in place to ensure resident’s medication needs are well met. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis.
Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 10 The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that, these services are provided by local practitioners. The records indicate that resident’s medical needs are being met. Medication is administered by means of a monitored dosage system. The system appears to be working very well. The home receives good support from the local pharmacist who does a three monthly audit of the homes medication. All Senior Care Staff have been trained to use the system before they are allowed to administer medication. The home has good policies and procedures, which have recently been updated and are used as an integral part of the care staff induction programme. All the residents have single rooms and all but two rooms have en-suite. No personal care interventions take place in communal areas. Observed practice on the day of inspection was appropriate and showed respect for the residents. Six of the residents who could express themselves in a meaning full way said that the staff were very helpful and kind. Consultation with health care and social care professionals is carried out within treatment room or the resident’s bedrooms. Visitors are able to meet residents in their bedrooms or the visitors’ room. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 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): 12, 13, 15 The home provides a Very good programme of social activities within and outside of the home, which are designed to meet the resident’s capabilities, which the staff encourage the residents to pursue. The Care Manager and staff encourage family and friends to maintain good contact with their relatives at the home. The meals in the home are good offering both choice and variety and also catering for special dietary needs. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The residents and staff stated that the residents are consulted regarding the day-to-day running of the home through residents meetings, reviews and by feedback from their care worker. The Key-workers also identify interests that the residents wish to pursue. The minutes of the residents meetings indicate that residents are able to express their views, which are acted upon particularly regarding menus and outings. Many resident have good contact with their relatives and a small number of residents go out with their family on a regular basis. Family and friends are welcomed at the home and are invited to attend parties, jumble sales, fetes, and other celebrations, which are well attended.
Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 12 There is a very good programme of activities both within and outside of the home and there are trips arrange to go to West Park, Local garden centre, Bantok Park and the Holly Bush Pub. The observations made, examination of menus and the comments received from the residents and their relatives confirmed that particular attention is given to the residents’ individual preferences. All of the comments made by residents regarding the quality, quantity of food provided are complimentary Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 13 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 and 18 The observations made and the comments received from the residents and their relatives confirmed that particular attention is given to the resident’s individual preferences regard the meals provided. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home has a very good comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence, the service users guide and, which a copy is issued on admission to the home. Also a copy is placed in the reception hall. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in internal and N.V.Q. and Prevention of Elder Abuse training, which all care Staff is undergoing. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 14 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 and 26 The standard of the environment is very good providing service users with a safe well-maintained environment to live in. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home is long established and has undergone alterations over the years in order to provide appropriate accommodation for 27 older people. The home is maintained to a good standard, as are the gardens and grounds and provides a very comfortable homely and safe atmosphere. The home has just competed a rolling programme of replacement of the windows with double glazed units. The dining room and two bedrooms have been redecorated and re-carpeted and a new mobile hoist has been provided. Also one bedroom has been fitted with an en-suite. It was noted that the security alarms on the fire doors were not working and need to be repaired.
Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 15 The home was found to be clean and tidy and free from odour. The home has good policies and procedures regarding infection control and the staff have received training in food hygiene and Infection Control. All staff appeared to be conscious of the dangers of cross infection by the observation of their practice. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 16 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, and 30 The home is well staffed with adequate numbers and skill mix of staff. The staff have a very good understanding of the resident’s support needs. The home has good policies and procedures regarding the recruitment of staff, which is being followed. There is a excellent training programme in place that ensures staff are competent to do their job. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The inspection of staff rotas and discussions with residents indicated that the home is well staffed. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career. The home has a good record of retention of staff. The home operates a very efficient recruitment procedure and has registered with the West Midlands Homes Association in order to complete the appropriate checks on staff. There was evidence within the home that all the checks are being carried out. The home has an excellent training programme and all staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a programme of N.V.Q. training and has exceeded the minimum standard required. The staff have also the attended courses on Safe handling of medication, Risk assessment, Moving and Handling, First Aid, Protection
Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 17 From Abuse, Infection Control, Dementia Care, Health and safety at work and Fire prevention. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 18 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, and 38 The manager has very good leadership skills and has a clear development plan and vision for the home, which he has effectively communicated to the residents’, staff and relatives. The Residents’ finances, are being handled appropriately by a designated senior staff member The home is very well managed, where service users interests and welfare are well promoted and protected. The home has good heath and safety polices and all staff are aware of their responsibilities regarding these issues. The quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home is well managed by the Care Manager who is qualified in both practice and management and has considerable experience in caring for older
Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 19 people in residential homes. Also the proprietor is very involved in the day-today running of the home. There are clear lines of accountability within the home and the manager is very supportive of both staff and residents as is the proprietor. Observations made and discussions with residents’ and staff indcated that the Care Manager is very approachable and operates an open door policy. The staff and service users who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. All the Financial records and administrative procedures within the home that were, inspected were found to be well ordered and maintained. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training on these issues. All safety equipment is check and well maintained. Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 20 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 3 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 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X X Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 21 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 OP 19 Regulation 23 Requirement The registered person must ensure that the security alarms on the fire exit doors are repaired. Timescale for action 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Coton Care Ltd DS0000020885.V296405.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Wolverhampton Area Office 2nd Floor St. Davids Court Union Street Wolverhampton WV1 3JE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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