Inspection on 05/02/09 for Ella McCambridge Residential Home

This inspection was carried out on 5th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ella McCambridge Residential Home 07/02/07

Ella McCambridge Residential Home 27/01/06

Ella McCambridge Residential Home 21/09/05

Ella McCambridge Residential Home 28/06/04

Ella McCambridge Residential Home 17/01/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ella McCambridge Residential Home Mitchell Street Walker Newcastle Upon Tyne NE6 3PR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Allan Helmrich     Date: 0 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ella McCambridge Residential Home Mitchell Street Walker Newcastle Upon Tyne NE6 3PR 01912341881 01912343327 noemail Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robert Pattinson t/a Manor Care Home Group Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 67 Number of places (if applicable): Under 65 Over 65 0 55 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 67 0 Ella McCambridge is a modern purpose built care home providing accommodation with personal care for up to 67 older people. The home is owned by Manor Care Home Group who have another homes in the vicinity. The home is in a residential area of Walker, close to shops, pubs and other local amenities. The home was opened in 1999 and was purpose built over two storeys. In 2008 it merged with the adjacent Harrison Wing to form the current home. There is level access from the car park into the home and into the enclosed garden and there is a passenger lift between floors. Two bedrooms are registered to accept double occupancy and all but two bedrooms have en-suite toilet and wash hand basins. There are lounges and dining rooms on both floors and a separate lounge that is used by smokers. Inspection reports and Care Homes for Older People Page 4 of 28 Brief description of the care home information about the home are readily available. The weekly fees are in the range 427-441 pounds. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is an overview of what the inspector found during the inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Care Homes for Older People Page 6 of 28 The Visit: The inspection was unannounced and was undertaken by the link inspector for the service over two days and lasted 8.5hrs. During the visit we: Talked with people who use the service. Talked with the home manager and staff on duty. Looked at information about the people who use the service and how well their needs are met, Looked at case records for three residents and other records that must be kept, including medication. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to assess if it was clean, safe and comfortable. Checked what improvements had been made since the last visit. Also surveys were sent to residents and staff and professional visitors. Responses were received from twenty four residents supported by relatives, five staff members and three professional visitors. Information from these sources is used in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Comprehensive pre admission assessments are done to ensure the home can meet the needs of people before they move in. Information that should be available to inform people about the service was not immediately available. Evidence: When requested the manager could not provide an up to date copy of a Service User Guide that would normally be given to people visiting the home to inform them about the service provided. This guide is currently being revised following recent management changes. Of the 24 residents who reponded to a survey 21 stated they had enough information provided before they moved in. Comments include; I visited a few times. I had a look around beforehand. I had a few visits before I moved in. Yes I was looking forward to moving in. The home receives an assessment from the persons care manager prior to admission. Care Homes for Older People Page 11 of 28 Evidence: This information is looked at by the manager and a pre admission visit is made by management when other information is collected to ensure the home can meet the persons needs. Each of the case records reviewed contained an assessment of the persons needs and other appropriate supporting information. The case file of one person admitted two weeks before did not contain their photograph to identify them to new staff on shift and other health visitors. This is also useful should the resident go missing. Within a short time of admission each resident has a plan of care constructed by senior staff in the home. These plans identify any special needs the individual may have such as religious or cultural requirements as well as personal care needs. The manager stated the home does not provide a rehabilitation service but short-term respite beds are available. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health & personal care needs are well supported by good care planning, regular involvement from other professionals and clear recording. The medication system ensures people in the home are safely supported. Evidence: Shortly after admission a range of assessments to determine the physical and mental needs of the resident are carried out and any identified needs are included in the persons plan of care. The care plans reviewed included information needed to provide a person centred approach. Social assessments are done, risks in daily living are produced with information to staff as to how independence is promoted. The health care records included reference to hospital visits and contact with GPs and other health professionals. Each person is weighed regularly as a health indicator and the home has a set of sit-on scales to aid this process. Each of the plans was reviewed recently by care staff. This ensures that staff are Care Homes for Older People Page 13 of 28 Evidence: considering the individuals needs are wishes on a regular basis. The files are also reviewed by the manager for quality. The manager stated all files are currently being reviewed following the merger to ensure each plan meets individual needs. Three residents spoken to all stated the home provides a good standard of support and staff were observed throughout the inspection talking to residents and involving them in ad-hoc activities. An activities organiser works with groups of residents and on the day of inspection was baking with some people. The manager is concerned that all residents are treated individually. She has recently completed equality and diversity training which she promotes in the staff team to ensure residents are well supported to live a life of their choosing. Each resident has also had a mental capacity assessment. Everyone who commented stated they Always or Usually receive the care and support they need. Comments included; Staff are very helpful. Very happy with the care I receive. The staff are very helpful. Sometimes they can be busy but they come when they can. If they dont come straight away they are busy with others but they always let me know. They are here in a jiff. The home has a system in place to manage peoples medication safely. All senior staff that dispense medicines have had training in the safe handling of medication and the manager also judges their competence. The medication records for three people were checked. These records were free from errors, no signature gaps were found on the MAR (medical administration record) charts. A controlled drug check was in order and a suitable medication reference book was available to staff. The temperature at which medicines are stored is recorded daily but a max-min thermometer is not used for accurate measurement. The manager attends local medical group meetings to promote good practice. Everyone who responded to a survey stated they Always receive the medical support they need. Visiting professionals commented; Staff do an excellent job of caring for residents, taking into account individual needs. The staff team have skills and experience. Residents always appear well cared for. Residents are well looked after and respected. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents take part in regular activities of their choice. Visitors are made welcome. A good standard of healthy food is provided. Evidence: Nineteen people who responded to a survey stated there are Always or Usually activities arranged by the home to take part in. People commented; I enjoy all the activities and like to join in when I can. I enjoy the singing. I like sing-a-longs, carols and dominoes. There are a range of activities that I like and some I dont. I like all activities. Two people stated they Never like the activities and commented; I dont like to join in. I only like horse racing and TV. I would rather just sleep or watch TV. An activities organiser is employed and during the inspection some people were baking with her and other were seen doing a jigsaw with care staff. Bingo is popular with residents and is a regular weekly event organised by the homes dedicated activities person. The manager is aware of those residents who are not interested in activities provided by the home and respects their opinions. Some residents go out independently and others are supported to use local shops and other community services. A record is kept of the activities people are involved in Care Homes for Older People Page 15 of 28 Evidence: where appropriate a social care plan is promoted to ensure people are not isolated in the home. Although care plans are reviewed regularly a monthly summary is not produced covering general health and social involvement. This would identify any changes in peoples behaviour that may need attention. Residents stated they could choose when to get up in the morning and what to do during the day. Visitors also said the home routines are flexible to meet individual needs. One visitor came at lunchtime to take their relative out and staff stated his lunch would be available when they returned. When they returned a lunchtime meal was provided. Another visitor stated their relative prefers to be in her room all of the time and this choice is respected by staff. Other visitors were seen during the day talking to residents. Those spoken to stated that visiting was not restricted. The home has a visitors policy to ensure residents rights are respected. People survey were asked if they enjoy the meals provided; 12 stated Always, 7 Usually and 4 Sometimes. Comments included; The meals are always lovely. The meals are always very good. I enjoy breakfast, dinner and supper but I dont like tea. The meals are good I enjoy them alot. I dont like corned beef hotpot otherwise everything is lovely. A sample of the menus seen showed that each day residents were provided with a range of vegetables and fruit. One resident was seen eating grapes from a bowl in a lounge. The lunchtime meal was observed. It was unhurried with adequate staff numbers supporting residents in a quiet dignified way. The kitchen is well equipped and a range of foodstuffs to enable the cook to meet individual choice was available. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home takes complaints seriously and staff are well trained to ensure everyone is protected from abuse. Evidence: The home has a complaints procedure and this is given to each new resident. A copy of the complaints procedure is also displayed in the home for the benefit of visitors. Everyone who reponded to a survey was aware of the complaints procedure and who to complain to. The home has received two complaints since the last inspection. Both were recorded in a log together with the actions taken to resolve them. Also several letters and cards of compliment were seen on a home notice board. The manager stated that later these will be filed away as a measure of quality. Staff are provided with training related to protecting vulnerable adults and procedures are in place regarding this. Staff spoken to understand how to protect vulnerable people. The home have previously involved professional people to provide training and support for staff in dealing with challenging behaviours. Currently ten care staff are undertaking a twelve week course on safeguarding people to better promote the welfare of people in the home. Care Homes for Older People Page 17 of 28 Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe, clean and well maintained. Evidence: The home was merged in 2008 with the adjacent Harrison Wing to provide one home registered to provide care for older people and people with a dementia. The home is clean and well maintained. A programme of maintenance is in place. When bedrooms are empty the opportunity is taken, if needed, to replace carpets and any other items of furniture. Residents and their visitors spoken to during the inspection are happy with the standard of appointment. A programme of cleaning is in place, the home is clean and no odours were detected. Ten staff are currently involved in a twelve week course for infection control. During the inspection, domestic staff were seen in appropriate numbers to ensure the home is well maintained. At lunchtime the cleaners group together to freshen the communal areas so that residents are not disturbed during the day. Everyone surveyed, said the home is Always or Usually fresh and clean. Comments included; Lovely and clean. Domestics are always here. Always clean, they are good cleaners. Always clean and tidy. Care Homes for Older People Page 19 of 28 Evidence: The kitchen is well equipped with new sinks recently fitted. A good standard of hygiene was observed. The laundry contains appropriate equipment to meet disinfection standards and dedicated laundry staff are provided with information and instruction regarding laundry. As with many large homes, there are issues regarding lost and damaged clothing, however, management are aware of these issues and try to limit these with the systems they have in place. Individual washing baskets are provided to identify where the laundry is from. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff to meet the needs of each resident, however recruitment procedures do not always ensure people who live in the home are safe. Staff get regular supervision and training is being provided to provide staff with the necessary skills to promote the wellbeing of people who live at the home. Evidence: The staff team is consistent; only two new staff have been employed since the last inspection in February 2007. Staff left in charge of the home are over 21 years of age and no one under 18 years of age is employed. Appropriate care staffing levels are provided to meet residents needs. The rota showed that there are eight care staff during the day until 8:00pm and six care staff from then and through the night until 8:00am. In addition the manager is available in the home each weekday. The home employs an activities person, an administrator and a maintenance person. The home has suitable domestic, laundry and catering staff hours. There are no staff vacancies and existing staff provide cover for absences. Everyone spoken to praised the quality of the staff team and professional visitors Care Homes for Older People Page 21 of 28 Evidence: commented; The staff team have skills and experience. Staff do an exceptional job. The home employs 35 care staff, 28 staff have achieved National Vocational Qualifications (NVQ) Level 2, 3 are working towards this qualification and 14 are working on to level 3. This exceeds the standard expected of 50 . The staff recruitment files for the latest two staff employed were examined. One file included appropriate information to demonstrate good employment techniques were used. The file was audited, an application was completed, references were obtained and Criminal Records Bureau (CRB) checks were carried out. The second file did not contain an appropriate CRB check or an induction to demonstrate the person is competent. This information is needed to confirm people living in the home are safe. The manager has recently assessed the training needs of staff and is using a training company to bring all training requirements up to date. Training has been organised to provide the following training to the staff team to ensure appropriate skills are available within the staff team: Safeguarding, manual handling, health and safety, fire safety and nutrition. The manager must also ensure that a copy of the national induction standards are available in the home for new staff employed without a care background. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ella McCambridge is a home that is well run for the benefit of the people who live there. Evidence: The manager who has been the deputy since 1999 was recently promoted. She does not have the Registered Managers Award and has not as yet applied for registration with The Commission. She has a National Vocational Qualification (NVQ) level 3 and has recently attended equality and diversity and mental capacity training to improve her awareness of issues that may affect the resident group. Professional visitors to the home commented; the home is excellently managed with a blend of caring, efficiency and common sense. The home is managed very well. In conversation she demonstrated a good awareness of management and is currently working with the staff teams from from what was two separate homes and bringing Care Homes for Older People Page 23 of 28 Evidence: their best practices together. Staff are receiving regular 1-1 supervision sessions to promote good practice but the notes from these meetings are not stored securely to ensure privacy. A quality monitoring system is in place and this has been used to assess the quality of care provided in the home. As part of this process questionnaires were sent to relatives. Twelve responses were received and any issues identified were addressed. Since then a suggestion box has been provided at the ground floor entrance for visitors and residents. Resident meetings are held regularly to ensure everyone is aware of home issues and to give people the opportunity to have a say. The last minuted meeting was two weeks before the inspection and was attended by nine residents. Comments from residents were included in the minutes seen. Other meetings are held with different staff groups; senior staff, kitchen staff and domestics. Residents and their families are encouraged to handle their own finances. However a system is in place to hold monies should this be requested. Records reviewed included a current balance sheet with two signatures for each transaction, receipts for purchases and details of spending. This system is audited to ensure residents monies are accurately accounted. Systems are in place to ensure the home is safe for residents. Certificates were seen to demonstrate that maintenance tasks carried out by external contractors were done. The company also carries out a health and safety audit each year and this was last done in August 2008. Accidents in the home are recorded and the manager reviews these monthly for any emerging patterns. A fire risk assessment has been produced and regular fire checks are recorded and staff training provided to ensure residents are safe. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 All staff employed must 31/03/2009 have a valid Criminal Records Bureau assessment. This is to ensure people living in the home are safeguarded. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 1 3 Copies of the homes Service User Guide should always be available to enquirers about the service. A recent photograph of new residents should be placed on file at the earliest opportunity to identify the person should they go missing and to staff and other health care visitors. Obtain a max-min thermometer to ensure accurate recording of medicine temperatures. Senior staff should produce a monthly assessment of individuals, health and welfare in addition to the evaluation of care plans. This will identify any changes in lifestyle and ability. An induction equivalent to that specified by the national training organisation should be available in the home for use by new care staff without appropriate qualifications in Page 26 of 28 3 4 9 12 5 30 Care Homes for Older People care. 6 31 The manager should work towards achieving management qualification to demonstrate ability to manage a home for vulnerable people. The manager should also submit an application for registration with The Commission. 7 36 The manager should secure information provided in confidence by staff. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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