CARE HOMES FOR OLDER PEOPLE
Eden Cottage Residential Home 37 Cobden Street Darlington Durham DL1 4JF Lead Inspector
Mrs Tanya Newton Unannounced Inspection 28th November 2005 10.00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 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. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Eden Cottage Residential Home Address 37 Cobden Street Darlington Durham DL1 4JF 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) 01325 281061 01325 281077 maureenhorton@edencottage.fsnet.co.uk Mr Ralph Horton Mrs Maureen Doris Horton Mr Ralph Horton Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2nd August 2005 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 DS0000000819.V253974.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced 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 asked for their views and opinions of the service being provided. The relevant policies, procedures and information about people at the home were also looked at. 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. Issues raised in the last inspection were also examined. What the service does well:
One of the relatives spoken with during the inspection made the following comments; “The home is first class, I can’t speak highly enough, the attention to detail is exceptional. The social stimulation is excellent and my mother in law has discovered a new lease of life since moving in here”. Another relative commented “I am completely satisfied with the overall care my mother is receiving, I have no complaints at all, all aspects of her care are excellent”. 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 home has safe systems to administer medication. The food is attractively served, tasty and is made from fresh produce, some of which is grown within the grounds of the home. 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 DS0000000819.V253974.R01.S.doc Version 5.0 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 DS0000000819.V253974.R01.S.doc Version 5.0 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 Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 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 The manager and staff carry out a comprehensive assessment to ensure that only those residents whose needs can be met will be admitted to the home. EVIDENCE: The home has begun 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 the needs of people are to be met. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 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&9 Each resident has a care plan, which provides staff with the information they need to satisfactorily meet resident’s needs. The systems for the administration of medication are good with clear and comprehensive arrangements in place to ensure resident’s medication needs are met. EVIDENCE: All residents 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 residents. Resident’s views are sought in all aspects of daily living. It was obvious from direct observation that staff members relate well to the residents of the home as well as their visitors and family members.
Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 10 The home has comprehensive procedures for the administration and management of medication. All medication is supplied by a local pharmacy using the “Monitored Dosage System” (MDS). Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 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): None of these standard/outcomes were assessed; they were looked at during the previous inspection, which took place in August 2005. EVIDENCE: Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has clear policies and systems in place to protect residents. EVIDENCE: There have been no complaints to the home since the last inspection. Adult protection training has commenced for staff. The home is also hoping to attend some adult protection training via Social Services. These standard outcomes were assessed in greater detail in the previous inspection, which took place in August 2005. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Residents live in a safe, homely and comfortable environment. EVIDENCE: The environment is well maintained, decorated and individually furnished to suit resident’s taste. The home has a large communal lounge, a smaller quiet lounge/dining area and a large dining room. The rooms are domestic in style and homely. Although there were no odours within the home staff and residents felt that standards of cleanliness were not as high as they had been previously, the manager confirmed that this would be addressed. There are plans in place to further develop the environment fitting additional en-suite toilets. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 14 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, 29 & 30 Residents are supported by an effective and stable staff team who provide consistency of care to those who live at the home. The arrangements for the recruitment and induction of staff are good with staff demonstrating a clear understanding of their roles. Staff, are trained and competent to do their jobs maintaining the safety and well being of residents. EVIDENCE: It was obvious from direct observation that staff members relate well to the residents of the home as well as their visitors and family members. Staff members spoken to had a good knowledge of the needs of the residents living within Eden Cottage. The residents themselves determine the waking day within the home; there are either 2 or 3 staff members on duty at key times during the day for fifteen residents. During the night 1 staff members is on waking night duty. The owners (who live on the adjacent property) are on call on an evening. The home also has its own support staff that carry out domestic, laundry and cooking tasks.
Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 15 Staff recruitment files were viewed as part of the inspection, all staff have had a Criminal Record Bureau (CRB) check. All staff employed over recent years had files, which contain all of the required information, and new staff do not commence employment without the home accessing references and police checks, this helps to protect residents. The staff’s training files were not up to date; the home confirmed that these would be updated. All staff members follow a thorough induction process and have the opportunity to participate in on-going training. Staff members spoken to during the inspection confirmed that training is given a high priority. Out of the fifteen staff currently employed as carers seven have NVQ level 2 and two have NVQ level 3, staff confirmed that they were well-supported n attending training courses. Some of the staff felt that staffing numbers should be improved particularly on a morning. The home must continue to monitor the staffing numbers. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 16 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): 33, 34, 35 & 38 Residents’ views are sought through regular meetings and where possible their views are borne in mind by the manager when considering how to improve the running of the home. Financial systems are in place to protect residents. Records in general including Health and Safety were up to date. The Health and Safety of visitors, residents and staff are maintained. EVIDENCE: Residents spoken to confirmed that residents meetings do take place within the home and a record of the minutes is held. Quality feedback questionnaires have been given to service users, the information within these has been
Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 17 collated and the home has an action plan in place to address any areas of improvement. The home does not act as an appointee for any resident, in the main residents look after their own money with support from their relatives where this is required. The home maintains records of expenditure for items such as hairdressing and relatives are then billed. The care plan should contain a section on resident’s monies as part of the risk management. Health and safety records were examined; the home carries out regular checks on the building and these are recorded. The home should record which fire point is being checked each week, portable appliance testing (PAT) is due, the owner confirmed that this was booked. The home must hold an electrical wiring certificate this was not available during the inspection, the owner confirmed that a copy would be sent to CSCI. The home has a vista point schedule of risk assessments, which is broken down into four modules covering; premises, locations in the home, environmental safety and equipment. This is an in depth tool covering all aspects of health and safety. There are lots of areas within this which need updating for this to be effective. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 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 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 3 3 X X 2 Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP30 OP38 Regulation 19 schedule 2b(4) 13(4) c Requirement Staff training records must be maintained to evidence any training undertaken. The home must have an electrical wiring certificate. The vista point risk assessment file needs to be completed. Timescale for action 31/03/05 31/03/05 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. 2. Refer to Standard OP26 OP35 Good Practice Recommendations Standards of cleanliness throughout the environment must be maintained at a high standard. The care plan should contain a section on resident’s finances. Eden Cottage Residential Home DS0000000819.V253974.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Darlington Area Office 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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