Inspection on 23/08/06 for Ecton Brook House

This inspection was carried out on 23rd August 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

Ecton Brook House 07/07/08

Ecton Brook House 13/10/05

Ecton Brook House 14/04/05

Ecton Brook House 22/09/04

Ecton Brook House 27/07/04

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Ecton Brook House Ecton Brook Road Ecton Brook Northampton Northants NN3 5EN Lead Inspector Mrs Pat Harte Unannounced Inspection 23rd August 2006 09:30 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 DS0000035693.V306578.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. DS0000035693.V306578.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ecton Brook House Address Ecton Brook Road Ecton Brook Northampton Northants NN3 5EN 01604 402455 01604 410890 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) www.northamptonshire.gov.uk Northamptonshire County Council Emily Jane Dunkley Care Home 46 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (7), Old age, not falling within any other category (46), Physical disability over 65 years of age (5) DS0000035693.V306578.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No person falling within the OP category can be admitted where there are already 46 people of OP category already in the home No person falling within the DE (E) category can be admitted where there are already 24 people of DE (E) category in the home No person falling within the PD (E) category can be admitted where there are already 5 people of PD (E) category already in the home No Person falling within the MD (E) category can be admitted where there are already 7 people of MD (E) category already in the home. Total number of service users in the home must not exceed 46 Date of last inspection 13th October 2005 Brief Description of the Service: Ecton Brook House is a purpose built home for Older People that is owned by Northamptonshire County Council and managed by Mrs. E. Dunkley. The Home is registered to provide personal care for up to 46 Older People on a long stay basis. There are up to 24 places for People with Dementia, 5 places for People with a Physical Disabilities and 7 places for People who suffer from a Mental Disorder. The premises consist of 6 self-contained ground floor units with lounge/dining/kitchenette, toilet, bathing and bedroom facilities. Main meals are provided from a central kitchen however Residents who are able may make drinks and snacks in their units. The Home has a central lounge area with bar and shop. There are garden areas for each unit and a central courtyard garden. The Home is situated in the Ecton Brook area, a suburb of Northampton. Ample parking is nearby and the Home is easily accessible by public transport. There are nearby shops including a post office and newsagents and a minisupermarket, there is also a public house, Chemist, and Health Centre close by. The charges for the Home are up to £366 per week. The Northamptonshire County Councils carries through a financial assessment to determine individual weekly fees the lowest amounts were not available at the time of inspection. The Home’s charges do not include services such as Hairdressing and Chiropody and Residents are also responsible for paying for toiletries and DS0000035693.V306578.R01.S.doc Version 5.2 Page 5 newspapers. DS0000035693.V306578.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took half a day and consisted of a full review of the inspection record, the Home’s service history record including notifications of complaints, accidents, events and incidents, the pre inspection information submitted by the Home and correspondence and contacts between the Commission and the Home. At the time of the Inspection Residents and Relatives questionnaires had not been received back by the Commission. However positive comments were received from four Doctors and included a comment by one Doctor that Ecton Brook was “An excellent Home with very high standards – Staff caring.” Two responses to the questionnaires were received from Community Psychiatric Nurses; one expressed a concern about the possible move of a Resident with Dementia. She felt that staff should be able to meet this Residents needs and that a move was not in his best interests. She also commented that staff numbers were low and that the exit doors from the Home were not alarmed. All the information was collated and analysed to form the plan of inspection focusing on the outcomes for Residents. The primary method of inspection used was “case tracking” which involved selecting three Residents and tracking the care they receive through review of their records, talking with them and the care staff and observing practice. The concerns of the Community Psychiatric Nurse were discussed with the Manager and the particular Resident, to whom the concerns related, was one of those “case tracked” to establish the care given. The findings of the Inspection were that the Manager and staff had acted entirely appropriately, staffing levels had been increased to monitor the Resident’s safety, the doors were alarmed and the proposed move was in his best interests and in keeping with the Family’s wishes. The Community Psychiatric Nurse was given information on the findings following the inspection and was satisfied with the outcome. In addition to the case tracking four Residents, five staff and three Relatives were spoken with to gain their opinions. Observations were made on routines and care practices. Selected areas of the premises were viewed and a selection of records was inspected. Discussions were held with the Registered Manager. DS0000035693.V306578.R01.S.doc Version 5.2 Page 7 The Inspection took place during the morning and afternoon over a period of six hours. What the service does well: Ecton Brook House continues to have a stable staff group who demonstrated their commitment to the well being of their Residents. Staff turnover was low and this means that familiar staff are on hand to provide care for the Residents. Residents spoke very highly of the staff group commenting that they were very caring, helpful and on hand to quickly respond to their needs. Residents commented and observations confirmed that relationships between themselves and the staff group were very good. Comments included “the staff are so kind,” “They can’t do enough for you,” “These kind people help me to find my way about,” “If I need help I only have to ring the bell and they come,” “Staff help me to keep up appearances, they paint my nails for me which always cheers me up.” Written information on the Home’s facilities and services is given to all prospective Residents to help them make decisions on their placements. The information had recently been updated and Residents felt it gave them good descriptions and accurate information on the Home. Discussions with senior staff and the review of records confirmed that all prospective Residents are visited prior to admission and a thorough assessment is carried through to establish individual’s needs and to ensure that those needs could be met. Residents and/or their Families and Friends have opportunities to visit the Home, meet the staff and other Residents, see the accommodation and discuss further their care needs. Staff demonstrated that they involved all their Residents in the planning of their care, including those Residents with Dementia. Residents’ commented that staff treated them as individuals and respected their wishes and preferences on how the care was to be provided. The care planning process took account of any cultural or religious needs paying respect to Peoples’ differing backgrounds and lifestyles. Arrangements were made to support the Residents, uphold their wishes and enable them to pursue their religious observances. Residents’ needs were carefully documented in their care plans and clear instruction and guidance was given to staff on how the care was to be carried through. Health care needs were carefully monitored and Residents confirmed they were enabled to see their relevant medical professionals promptly and in private. Records showed that specialist professionals such as the Continence and Falls Advisers and Occupational Therapists were called in to give staff advice on how best to support Residents. DS0000035693.V306578.R01.S.doc Version 5.2 Page 8 Residents confirmed that they were aware of the home’s complaints procedure and felt confident to raise any issues or concerns with staff or the Manager. There have been no complaints since the last inspection. Routines were relaxed and flexible and Residents had choice in how and where they wished to spend their time. Residents’ comments included “I can get up and go to bed when I want to,” “ I can chose whether I wish to join in activities,” “Staff offered me the choice of a bath or a shower” and “I can spend my time in my room if I wish.” Observations confirmed that staff took care to protect Residents’ dignity and privacy by ensuring personal care tasks were carried out in private. Residents commented that staff took care to ease any embarrassment and make them comfortable when intimate tasks such as bathing were carried out. Residents’ comments and the review of records showed that they were encouraged to remain as independent as possible and do things for themselves. The Activity programme was viewed as excellent. Residents were encouraged to pursue their interests and hobbies and to develop new ones. There were opportunities for individual as well as group activities, cookery being a favourite group activity. Meaningful activities were provided for Residents with Dementia and including them being taken for walks and to do shopping. Residents’ comments on the food provision were very positive. They felt that they were provided with a good range of meals, choices were available and staff went out of their way to “tempt” their appetites. They felt that the catering staff were fully aware of their dietary needs and that their likes, dislikes and preferences were respected. The serving of the midday meal was efficient, the food was nicely presented and Residents were given help by staff to eat their meals. Records showed that Residents’ weight is monitored and staff noted daily nutritional intake to ensure any problems were quickly identified. Residents were provided with a comfortable and homely environment. The seating provided in the corridor area by the Home’s Bar and Shop acts as a focal point where Residents can gather together, socialise and entertain their visitors. Both Residents and visiting Relatives spoke of the Home’s “Family atmosphere” and Relatives said they were always made very welcome. The Manager ensures that the Home is run in the best interests of her Residents. She demonstrated that Residents were involved in the running of their Home and that their opinions and suggestions were constantly sought, valued and acted upon. DS0000035693.V306578.R01.S.doc Version 5.2 Page 9 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. DS0000035693.V306578.R01.S.doc Version 5.2 Page 10 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 DS0000035693.V306578.R01.S.doc Version 5.2 Page 11 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 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Excellent information is made available to prospective Residents on the Home’s services and facilities, the assessment process is thorough and effective ensuring that the needs of Residents admitted to the Home can be met. EVIDENCE: The Home’s Statement of Purpose, which describes the aims and objectives and gives details of the range of services, had been reviewed and updated. Residents confirmed that they had received information, prior to their admissions, on the Home’s facilities and services in the form of the Service User Guide. They felt this contained accurate and excellent information and told them how to raise any issues or concerns. Copies of both the Guide and Statement are available in the main foyer so that anyone visiting the Home may access these together with other information DS0000035693.V306578.R01.S.doc Version 5.2 Page 12 such as Independent Advocacy, the last Inspection report and the results of satisfaction surveys undertaken with Residents, their Relatives and visiting professionals. The assessment process was discussed with the Manager and three assessment records were viewed. The process ensured that the Manager or senior staff visit all prospective Residents, to carry through a needs assessment. Where at all possible prospective Residents and their Relatives are encouraged to visit the Home to view the facilities, meet with staff and other Residents and discuss further their care needs before coming to a decision on admission. The Manager showed, through discussions, that she considered the needs of each prospective Resident carefully and balanced these with the dependency levels of People already living in the Home. Care is taken to monitor the settling in of Residents particularly those with Dementia care needs. The assessment records were thorough and holistic and took account of all areas of need including Residents’ emotional, health and psychological care needs. Historical information had been gathered from Residents, Families and relevant professionals to broaden the understanding of the needs. Care had been taken to establish the Residents’ wishes in relation to routines, food likes and dislikes, their hobbies and interests and their preferences for their support. Care had also been taken to identify any cultural or religious needs. The Manager showed that arrangements could be made to provide cultural diets and to enable Residents to pursue their different religious observations, although currently there are no specific needs other than arrangements made for visits from local Christian Clergy. Records showed a thorough approach to identifying any areas of risk that may make Residents vulnerable. Recognised assessment tools were used to assess any risk areas such as skin and nutritional needs. Where Residents were suffering from Dementia or Mental Disorders an additional assessment of their mental abilities, awareness and understanding had been carried through. Assessments of physical care needs identify any aids or equipment that may be needed to assist individuals or to provide for their comfort and health care. Resident’s records showed that they had been given contracts detailing the terms and conditions of their placement, details of the fees to be charged are provided direct from the County Council following a financial assessment. The Service User Guide gave information on services not covered by the fees. For DS0000035693.V306578.R01.S.doc Version 5.2 Page 13 example Residents pay for their toiletries, newspapers and services provided by external professionals, such as Chiropody and Hairdressing. DS0000035693.V306578.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are supported to take acceptable risks, make decisions about their lives and are assured that the staff group know their needs, aspirations and goals. EVIDENCE: Residents felt that staff knew their care needs very well and provided them with good support and encouragement. Several Residents spoke of staff helping them to find their way about as they were forgetful and easily got lost. Other Residents commented that staff allowed them to do things for themselves and only supported where necessary, they saw this as being very important in encouraging them to maintain their independence. Residents’ comments and observations confirmed that staff responded quickly to the alarm call system or requests for help. Three Residents care plans were inspected. The records showed a holistic approach to recording the Residents’ needs and providing staff with very good DS0000035693.V306578.R01.S.doc Version 5.2 Page 15 levels of instruction and guidance on how the care was to be carried through. It was clear that Residents were involved in the development of their plans and agreement reached on their preferences. Care was taken to involve Residents with Dementia in the development of their plans. The plans showed Residents were enabled to continue to maintain their individual lifestyle routines, for example preferred rising and going to bed times were clearly stated. The care plans gave step-by-step guidance to staff on the areas where they needed assistance. For example personal care routines such as bathing were thoroughly documented, showing Residents preferences, giving detailed instructions to staff on the equipment needed and how the task was to be carried through. The plans detailed the areas that the Residents could safely undertake for themselves showing they were encouraged to maintain as much control over their lives and be as independence as possible. Reminders were incorporated into the plans for staff to routinely monitor skin and nail conditions, which meant that any changes were quickly picked up and the necessary action taken. Risk assessments were carefully undertaken and plans were in place to eliminate the risks as much as possible. For example the plans gave instructions to staff on monitoring or escorting Residents as they moved about the Home to help them find their way or ensure their safety. Night routines were clearly detailed and instructions were given to staff where checks were needed. Residents confirmed that they were consulted on night checks and had agreed the frequency. They spoke of being reassured that help was at hand throughout the night and had peace of mind that that staff popped in to check that they were all right. Records showed that good use if made of historical information to help staff understand and provide support for Resident’s with Dementia. For example information on past interests, events and people of importance to individual Residents are documented to help staff understand and respond to their Residents in their confusion. Strategies were in place to support Residents who were confused or who suffered from memory loss. The plans showed detailed instructions for the management of behaviours that could lead to a Resident being vulnerable. Observations confirmed that staff responded sensitively to Residents who were confused and spent time with them dealing with any concerns and establishing what they wanted to do. Residents wanting to leave the building were supported to safely go out to the local shops or for walks. DS0000035693.V306578.R01.S.doc Version 5.2 Page 16 Discussions with the Manager and staff and observations of practice showed that attention has been paid to developing effective communication methods. Care plans detailed the need to speak clearly, explain carefully and give time for Residents respond. Staff showed that they were sensitive and took care and time to work at their Residents pace encouraging and enabling them to express choice and make their wishes and opinions known. Health care records were very detailed. They showed that health care professionals were routinely involved with Resident’s health care and that staff were quick to respond to any changes and request visits from the relevant medical practitioners. Residents’ felt that staff kept a close eye on their health care needs, quickly arranged Doctors visits and ensured they met with medical professionals in private. In one instance concerns were expressed by a visiting Professional on the prospective move of a Resident with Dementia care needs to another Home. Discussions with the Manager and staff and the review of the Resident’s records showed that there were difficulties in meeting needs and there were safety concerns as the Resident constantly tried to leave the building. Whilst all the exit doors were alarmed to alert staff the risk factors were carefully examined, not all the garden areas are secured and there remained a potential that the busy road could be accessed. The risk factors had been discussed with the Resident’s family who had expressed a wish that the Resident be moved nearer to his wife. The Manager demonstrated that she had carefully weighed the risk factors together with the wishes of the family. Whilst it was acknowledged that the move would be confusing for the Resident concerned it was agreed that this was his best interests to provide a more suitable environment with fully enclosed gardens to give him complete freedom of movement. Until the move could be arranged additional staffing had been deployed on a one to one basis. The care plans showed that Residents’ needs were constantly monitored and when changes were identified new instructions were provided for staff. Where no changes have occurred there is a system for reviewing the plans on a monthly basis. Procedures were in place for the management of medication. Storage was safe and appropriate. The required records for incoming, administration and disposal of medication were in good order and regular audits were carried out. Observations confirmed that Medication was safely and appropriately administered. Assessments are carried out to determine whether Residents can DS0000035693.V306578.R01.S.doc Version 5.2 Page 17 safely continue to manage or part manage their own medication if at all possible. Where Residents can undertake this they are provided with safe storage arrangements and staff monitor for any change in abilities. There have been two medication errors since the last inspection. Action was taken to alert the Doctor concerned and no harm came to either Resident. Both incidents were fully investigated by the Manager and action was taken to provide refresher training for staff. Observations confirmed that Staff ensured the protection of Residents privacy and dignity by carrying through personal care tasks in private. DS0000035693.V306578.R01.S.doc Version 5.2 Page 18 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 Residents are enabled to exercise control and choice in the way they wish to lead their lives and are provided with good activity programmes in keeping with their interests. EVIDENCE: Residents stated that routines were relaxed and flexible. They commented, and observations confirmed, that they were free to decide on how and where they wished to spend their time. They said that timings for routines such as getting up and going to bed were wholly in accordance with their wishes. Residents spoke of being provided with early morning cups of tea, being able to lay in and take a late breakfast. Residents were very satisfied with the activity programme and confirmed they could chose whether they wished to join in or not. Those with specific hobbies or interests are encouraged and supported by staff to pursue them. There is an DS0000035693.V306578.R01.S.doc Version 5.2 Page 19 activities programme for each of the Units that includes quizzes, games, craftwork, cookery and external entertainers visit the Home to provide musical events. Staff take care to gather historical information on the past hobbies and interests of Residents with Dementia and provide equipment or books that will help stimulate their memories and encourage interest. Quizzes are designed with reminiscence in mind so that Residents can get the full benefit of joining in and recalling past events and ways of life. One to one time provides Residents with opportunities to go for walks or to go shopping and regular nail care sessions are thoroughly enjoyed by the Ladies who felt that they were assisted to maintain their appearance. There is an open visiting policy. Residents confirmed that they were enabled to receive their visitors in private if they wished. Visiting Relatives spoke of the real family feel of the home. They said that they were always made welcome and were extended hospitality. They stated that staff made time to discuss their Resident’s care needs and commented that they were kept well informed of any changes or concerns. Residents were fully satisfied with the food provision. They felt that staff respected their individual likes and dislikes and catered for their dietary needs. They stated that they were provided with a good range of choice and alternatives were always available to tempt their appetites. Records showed that care is taken to identify any nutritional needs or cultural preferences. A Resident preferred rice in place of potatoes and she confirmed that her preference was upheld. Residents commented and observations of the mid day meal confirmed that the food was nicely presented and efficiently served. Staff were on hand to provide assistance to their Residents. Records showed that care is taken to routinely monitor Residents weight and appetites. This ensured that any nutritional concerns are quickly identified so that action can be taken. For example food and fluid charts are used to ensure sufficient intake and the advice of the Dietician or Doctors is sought to determine any need for additional supplements. DS0000035693.V306578.R01.S.doc Version 5.2 Page 20 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, 17 &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 effective systems in place to ensure complaints or concerns are listened to, investigated and acted upon and to ensure that Residents are protected from abuse. EVIDENCE: Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the foyer of the Home. Those spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. No complaints have been made to the Commission since the last inspection. Residents are registered on the Electoral roll and are given assistance to exercise their voting rights by the use of postal votes or alternatively arrangements can be made for them to go to the polling station. Robust procedures for the Protection of Vulnerable Adults are in place. Staff receive training in recognising abuse and discussions with two carers and a domestic worker showed that they were fully aware of their duty to report to DS0000035693.V306578.R01.S.doc Version 5.2 Page 21 report any allegations or suspicions to the relevant Authorities. There have been no incidents since the last inspection. DS0000035693.V306578.R01.S.doc Version 5.2 Page 22 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, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a warm, safe, clean, comfortable and wellmaintained environment suitable for their needs. EVIDENCE: The premises were in good order, clean, warm, safe, comfortable and well maintained. There is an on going programme of maintenance and redecoration. Standards of domestic and hygiene maintenance were viewed as very good. Residents stated that cleaning routines were carefully organised to ensure no disruption to their preferred routines. A Handyman is employed to carry out minor repairs. DS0000035693.V306578.R01.S.doc Version 5.2 Page 23 Selected areas of the premises were viewed. Residents’ bedrooms viewed were comfortable and safely maintained. Residents commented that they were able to have their furniture and belongings around them and personalise their rooms as they wished. Bathrooms and toilet areas were hygienically maintained. The communal lounges and dining rooms were comfortable and suitable for the Residents’ needs. There is additional communal space in the main corridor area next to the Home’s bar and shop. Residents felt that this was a very homely place where they could gather together and meet up with friends from the different units as well as using the space to entertain their visitors. They stated that it was nice to be able to gather at the bar for a drink and they commented that they shop provided them with essential toiletries at very good prices. The main corridor carpet in this area is beginning to deteriorate and is becoming very worn however mental strips have been securely fixed over joins to prevent any risk of tripping. The Manager constantly monitors the area for safety and the carpet is down for replacement on the refurbishment programme. Residents have the use of a pleasant courtyard garden at the centre of the Home. There are garden spaces leading off the Units, some are fully enclosed for use by Residents with Dementia needs and there is an alarm system to alert staff to anyone leaving the Home unnoticed. Track hoists are fitted in two of the Units to ensure the safe movement and handling and ease of access to bathing and toileting facilities for Residents who have physical disabilities. Specialist equipment is provided to help Residents with their mobility and equipment such as pressure relieving mattresses and cushions are also obtained, where needed, to maintain skin care. DS0000035693.V306578.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust and sufficient numbers of competent care staff are deployed to meet the Residents needs. EVIDENCE: Residents spoken with said that the all the staff, including ancillary staff, were very kind, committed and caring. They felt that staff did everything possible to ensure their well being. Observations showed that staff constantly monitored their Residents and responded promptly to their needs. Relationships and interaction between the Residents and staff were viewed as excellent. The rotas showed that 7 care staff are deployed on daytime shifts between the hours of 8am and 2pm and again from 5pm to 10 pm. 5 care staff are deployed in the afternoons, currently one of the six units is unoccupied. 3 carers provide overnight care. In addition a Residential Care Supervisor is on duty on all daytime shifts and provides guidance and support for staff. The Manager mainly works office weekdays hours. Staff stated that they were always able to contact her or other County Council representatives in an emergency out of office hours. DS0000035693.V306578.R01.S.doc Version 5.2 Page 25 Daytime care staff are deployed to and have responsibility for specific areas of the home. On the busier morning and evening shifts two carers are available to act as “floaters” giving assistance to Unit staff where required. The deployment of regular staff to specific areas provides consistency and continuity of care and enables Residents with Dementia to become familiar with and recognise their staff group. The Manager demonstrated that the overall needs of the Residents were kept under review. Recently an additional care staff member has been deployed to the High Dependency Dementia Care Unit where dependency levels are currently high and a Resident is in need of one to one staffing. In addition to the care staff, domestic and catering staff are employed together with a Handyman. The ancillary staff provision ensures that care staff are not diverted from their care duties. Two staff members’ records were viewed and showed that the recruitment practice was good and afforded protection to the Residents. The necessary Criminal Records Bureau Checks had been undertaken and references obtained. Records showed that new staff were provided with an recently reviewed induction programme, which is linked to the Sector Skill Council’s recommended guidelines and timeframes. Staff commented that they are supported to work alongside experienced staff during the induction process. Care is taken to introduce them to all the Residents and time is dedicated to familiarise them with the policies and procedures. The Manager showed that she kept the annual staff-training plan under constant review and that she accesses core and specific training on an on going basis. Training records were in excellent order and confirmed that appropriate training is secured, for example Mental Health and Dementia care training had already been secured for staff who have recently been employed. Staff spoken with expressed positive comments on the training provided. They stated that they were given good access to training courses and were encouraged to undertake National Vocational Qualifications. Currently about 50 of the staff group have obtained an NVQ; the percentage meets the minimum expected standard but has dropped since last year due to a minimum staff turnover. All new staff agree to undertake this training as part of their contractual arrangements. DS0000035693.V306578.R01.S.doc Version 5.2 Page 26 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, 35, 36, 37 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Management of the Home is effective and in the best interests of the Residents. Safe systems are in place for the management of Residents monies and items held for safekeeping. EVIDENCE: The Manager demonstrated her ongoing commitment to maintaining the required Regulations and Standards and ensuring the Home is run in the best interests of her Residents. This is shown by the fact that no requirements have been made in this report. DS0000035693.V306578.R01.S.doc Version 5.2 Page 27 She closely involves her Residents in the running of their home. Residents said that she was readily available to them and was in contact with them on a daily basis. They confirmed and records showed that regular Residents meetings are held. The Manager showed that Residents with Dementia care needs are involved and consulted and are encouraged to have a voice and offer their opinions and suggestions. It was clear from the records and Residents comments that their opinions and wishes are listened to, valued and acted upon. The Manager has undertaken surveys with the Residents, Relatives and stakeholders, such as Doctors, Nurses, Chiropodists, Hairdressers and other visiting professionals, to gain their opinions of the services. The results have been collated and published and have been made available to all in the information area at the entrance to the Home. Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. Records showed that formal staff supervision and appraisal is undertaken and staff meetings are held with specific groups of staff such as domestic staff, night or day carers, catering and maintenance staff. The Home’s policies and procedures were all revised last year by the County Council and are now in place to guide and instruct staff. Visit reports made by the County Council’s representatives show that the Home is visited regularly with quality areas reviewed and Residents comments sought. The systems for the safekeeping, where necessary, of Residents moneys were in good order. One record reviewed showed that a Resident’s Personal Allowance, received from the County Council Finance section on a fortnightly basis, was immediately passed to her for her use. Another record showed money deposited by a Resident’s Family was held for safekeeping, receipts were carefully maintained for any purchases made by staff on a Resident’s behalf or charges incurred for services such as Hairdressing and Chiropody. The Administrator carries through weekly reconciliation of the books and the Manager and the Administrator audit the entire system once per month to ensure the accuracy of the individual accounts and balances. The approach to general health and safety was assessed as excellent. Fire records were well maintained indicating that the fire systems were carefully DS0000035693.V306578.R01.S.doc Version 5.2 Page 28 and regularly checked in accordance with the guidance given by the Fire Officer. Accident/Incident records were well maintained and showed that every accident or incident was analysed and action was taken to prevent similar occurrences. Staff comments and the review of staff records confirmed training is provided in the required areas relating to Health and Safety. The Home was safe and no hazards were observed. DS0000035693.V306578.R01.S.doc Version 5.2 Page 29 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 3 4 DS0000035693.V306578.R01.S.doc Version 5.2 Page 30 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. 1 Refer to Standard OP19 Good Practice Recommendations That the hall carpet is replaced as it is becoming badly worn. DS0000035693.V306578.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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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