CARE HOMES FOR OLDER PEOPLE
Eden Cottage Residential Home 37 Cobden Street Darlington County Durham DL1 4JF Lead Inspector
Tanya Newton Unannounced 2 August 2005
nd The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Eden Cottage Residential Home Address 37 Cobden Street Darlington County Durham DL1 4JF 01325 281 061 01325 281 077 maureenhorton@edencottage.fsnet.co.uk Mr Ralph Horton Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Ralph Horton Care Home 20 Category(ies) of OP - Old Age - 20 places registration, with number of places Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th November 2004 Brief Description of the Service: Eden Cottage is a care home which is registered to provide personal care and accommodation for up to twenty older people. The home is privately owned and run by Mr and Mrs Horton. The home is a single storey building which has been extended, ten of the bedrooms have en-suite facilities. Additional toilet and bathing facilities are available throughout the home. There are two shared lounges and a dining area. The home is surrounded by beautiful gardens and there is an allotment to the rear from which fresh produce is grown. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was announced and carried out by the lead inspector. The inspector was able to speak to the majority of the people at the home to ask them about their experiences and views of living at Eden Cottage. The staff on duty were interviewed as part of the inspection. The relevant policies, procedures and information about people at the home was also looked at. A tour of the home was carried out and the inspector had lunch with a resident living at the home. The inspector would like to thank everyone they met on the day for their hospitality, help and assistance with the inspection process. People living and staff working at the home both considered that a very good quality service was being delivered. The inspection process also found that the home is providing a high level of care and support to those using the service. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. Issues raised in the last inspection were also examined. What the service does well:
The level of care provided to residents is said to be high, there is a loyal staff team and a good relationship between the owners, staff and residents. The food is attractively served, tasty and is made from fresh produce, some of which is grown within the grounds of the home. People at the home said that staff were very helpful and “the staff were marvellous”. There were no odours present during the inspection and a general tour of the premises demonstrates that the home is well maintained; all residents’ rooms were individually decorated and furnished, many with items of their own furniture to personalise and make their rooms feel more homely. Training is provided for staff and the staff spoken to confirm that they felt valued. Activities are provided for residents and there is a minibus, which is used for outings. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3,4,5,6 The manager and staff make sure that all residents who are considering living at the home and those significant to them are provided with all necessary information so that they can make an informed choice. The manager and staff of the home make sure that a comprehensive written assessment process is carried out so that they and the individual/s concerned can make a realistic decision about living at the home. EVIDENCE: The home has a statement of purpose and service users guide, which provide residents and their relatives with information about the home. All residents are given a copy of the service users guide. Both documents require minor updating as they make reference to NCSC not CSCI. Each person living at the home has a contract, which contains information about the terms and conditions of residence. The home is going to pilot the single assessment scheme which is an assessment used by Social services. This will be used in conjunction with the homes own assessment. Care plans and assessment information record how
Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 9 the needs of people are to be met. A resident who had quite recently moved into the home said, “I looked around prior to moving in, I’m well cared for, there’s plenty of staff” another commented “I found it difficult to settle at firstbut they are all very kind and want to help you”. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 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 standard(s) 7,8,10 Each service user has a care plan, which provides staff with the information they need to satisfactorily meet service users needs. Health needs are met and privacy and dignity is maintained. EVIDENCE: All service users living within Eden Cottage have a care plan which details how the home will meet their individual needs. Two care plans were viewed during the inspection; the home is continuing to develop the care plans. Care plans include risk assessments which detail how the home can minimise risks to service users. Eden Cottage continues to provide a good standard of care and support to service users. Service users views are sought in all aspects of daily living. Residents meetings are held regularly. Support from other professionals is accessed where this is required. Comments from relatives included “you can visit at anytime” and “its very good, couldn’t be better, my relative is very happy here”. Residents made the following comments regarding their care, “my health needs are well met”, “I enjoy staying here, I am well cared for and it feels like my home”. “My healthcare needs are well
Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 11 met”, “staff always knock, you are treated privately” and “staff are very good you mention something and its there”. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14,15 The social, cultural and religious needs of people living in the home are thoughtfully identified and people receive the necessary support so that they exercise their individual lifestyle choices. Contacts with the local community are maintained. Food is appetising, attractively presented and a good choice is available. EVIDENCE: A recreational activities co-ordinator is employed at the home and this member of staff is responsible for organising and supporting people with activities. Activities include singing, reminiscence, bingo, music and quizzes. Transport is available at the home in the form of a minibus and everyone who is able, is given an opportunity to be taken out; the owner arranges outings and drives the minibus. Contact with relatives is encouraged by the home and relatives spoken to confirm that they were kept up to date and made welcome by the home. Mealtimes were noted to be unhurried, food was freshly prepared, tasty, well presented and obviously promoted as a social occasion. The inspector took a sample of the daily menu; the food was tasty and attractively presented. Fresh produce is grown and used and meals are homemade. The staff that provide support and assistance to residents during mealtimes should always be seated. One resident is blind and commented that although his food was
Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 13 lovely he often did not know what he was eating, staff should be mindful of this. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 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 standard(s) 16, 18 Systems are in place to protect people from abuse. EVIDENCE: There are policies in place for adult protection and complaints. Adult protection training has been included within the induction and foundation training and NVQ training for staff, the home has accessed a presentation on adult protection, which will commence soon. Staff spoken to confirmed that they would feel confident in whistle blowing (reporting any allegations of abuse). The manager confirmed that there had been no complaints and that any minor concerns, which were raised, were dealt with immediately. Relatives confirmed that they would have no hesitation in raising concerns with staff or management. Residents confirmed that they would feel confident in raising any areas of concern. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: None of these outcomes/standards were assessed on this occasion. They will be examined during the next inspection of the home. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 Further training must be provided to ensure that staff are competent in doing their jobs. EVIDENCE: There is a core staff team who have been working at the home for a long time. Training for staff is required in the following areas: fire training for night staff, infection control and further training in adult protection. All staff who have any input in the administration of medication must receive training prior to being involved and manual-handling training must be provided for new staff, one staff member made reference to carrying out a “drag lift” which is an inappropriate practice which may cause injury to service users. Discussion with staff did highlight that there were many training opportunities for staff; these include mandatory courses, NVQ’s and training in specific conditions such as dementia. Staff were very positive about working in the home and their comments included; “The owners run the home for the residents, they look after staff as well as the residents”. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: None of these outcomes/standards were assessed on this occasion. They will be examined during the next inspection of the home. Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x x Eden Cottage Residential Home B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 19 YES 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 OP7 Regulation 12 &15 Requirement Timescale for action 30/12/05 2. OP30 18(1)a As highlighted in previous inspection reports care plans require further development, it is aknowledged that the home has made some improvements to these documents, however this does need to continue to ensure that all aspects of social emotional, physical and psychologicol needs are being met. Training is required in the 01/11/05 following areas; Adult protection, Fire, Medication training for all staff involved in the administration of medication and manual handling for new staff. 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 OP1 Good Practice Recommendations The statement of purpose and service users guide need minor amendment to reflect the change from NCSC to CSCI.
B54 S819 Eden Cottage V232285 020805 Stage 4.doc Version 1.40 Page 20 Eden Cottage Residential Home Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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