Inspection on 30/04/08 for Englewood Care Home

This inspection was carried out on 30th April 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Englewood Care Home 25/01/10

Englewood Care Home 06/04/09

Englewood Care Home 24/01/08

Englewood Care Home 14/08/07

Englewood Care Home 21/11/06

Englewood Care Home 25/05/06

Englewood Care Home 26/01/06

Englewood Care Home 04/05/05

Englewood Care Home 20/12/04

Englewood Care Home 18/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Englewood Care Home 42-44 Egerton Park Rock Ferry Birkenhead Wirral CH42 4QZ Lead Inspector Peter Cresswell Unannounced Inspection 30th April 2008 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 Englewood Care Home DS0000054702.V362953.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. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Englewood Care Home Address 42-44 Egerton Park Rock Ferry Birkenhead Wirral CH42 4QZ 0151 645 5064 0151 6455069 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) Englewood Care Limited Manager post vacant Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 24 service users to include:*Up to 24 service users in the category of DE (E) (Dementia over the age of 65 years). 24th January 2008 Date of last inspection Brief Description of the Service: Englewood provides personal care and support for up to 24 older people who have dementia. The home is situated in a quiet residential area of Rock Ferry in Wirral. Accommodation is on three floors, which are served by a passenger lift. The bedrooms are single and most of them have en-suite facilities. There is one double bedroom. On the ground floor there is a lounge and a large dining room/lounge to the rear of the building overlooking the garden. The home has a call system and mobility aids. There is a large car park at the front. At the time of this inspection, the weekly fees for the home were £406.84. Additional charges are made for hairdressing, newspapers, clothing, medical requisites (other than prescribed medications) items of a luxury nature and chiropody. A service user guide and a statement of purpose, which describe the services offered is available to new residents, their relatives and professionals before a resident comes to live at the home. A copy of the most recent inspection report can be obtained from the owner. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This inspection included an unannounced site visit during which we spoke to the owner, most of the staff on duty, a visiting relative as well as several residents. We toured the home, visiting all of the bedrooms, and examined care plans, medication, fire safety records, and the menu. Some survey forms were distributed but none had been returned by the time we wrote this report. What the service does well: What has improved since the last inspection? The halls, stairs and corridors have been recarpeted. Medication was accurately recorded and properly administered. The new care plans were being maintained and the deputy manager was planning to continue with the staff supervision programme. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Quality in this outcome area is good. The assessment of new residents ensures that a service is only offered to people whose needs can be met. Residents and their relatives benefit from being able to visit the home to see if it is right for them before moving in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the manager has resigned and the home is being managed by Mr Bukhari, the owner. We looked at several files which showed that an assessment is undertaken before anyone moves to the home. The deputy manager told us how she had visited one of the people in her own home to carry out the assessment. The assessments provided the basis from which a care plan can be developed. Standard assessment tools are used for nutrition and skin care but it was not always apparent that this had been transferred to the care plan. Prospective residents and their relatives are able to visit the home before moving in. During these visits they can meet staff and current residents and view the home. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 9 The owner told us that residents and their families are given a ‘Welcome guide’ when they are admitted but that a contract is not necessarily signed immediately. A contract should be issued ‘at the point of moving into the home’. Intermediate care is not provided at the home so Standard 6 does not apply. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is adequate. The health and social care needs of residents would be better met if the care plans and risk assessments contained more detailed information for staff to refer to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the care plans for two of the eleven residents plus one who had recently left the home. The plans included a social history and information to help staff provide appropriate care. Assessments from local authorities were on file. There is an ‘overview’ (a summary) which contains basic details for staff. However, even though skin care and continence assessments are carried out when residents are admitted there were no care plan elements dealing specifically with skin care and continence, building on the initial assessments. The deputy manager said that staff familiarised themselves with the details of the care plan and were able to provide a high level of care. There was no evidence of any residents not being cared for, and staff appear to be very conscientious, but the absence of detailed care plans for vital areas of care leaves open the possibility of the correct care not being given. The care plans would be improved by separate elements for skin care and continence being developed and a summary being kept by the daily reports so that those reports Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 11 detailed how the care plan is being delivered. At the moment the daily write ups tend to be bland and rather uninformative. Records are kept of visits by medical professionals. We checked the medication for three residents and found that it was well organised and in order. The deputy manager confirmed that staff do not leave medication for residents to take on their own (as observed at the last ‘key’ inspection). Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is adequate. People’s recreational needs are not met adequately. Dietary needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not have an activities organiser and the owner said that he was trying to recruit one. In fact he spoke to a candidate on the telephone during the site visit. There is no programme of activities or trips out, though staff do talk to the residents when they have the time. Residents are free to get up and go to bed when they choose and can stay in their room if they want to, though none were doing so when we visited. Two hairdressers visited whilst we were at Englewood and most of those residents who had their hair done enjoyed it and appeared to value the activity. The hairdressers visit once a fortnight. Otherwise residents tend to sit in the main lounge or the lounge/diner, watching television. Though the main lounge is not really ideally suited to allow everyone to watch the television. The owner felt that this was not a problem as few of the residents were able to concentrate on a programme. Visitors are welcome in the home and one called in whilst we were there to deliver a newspaper to his father. He told us that the staff were ‘first class - no complaints at all.’ He felt that his father was safe in the home. There is a four week menu in place, with the main cooked meal at lunch time. The Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 13 evening meal is lighter but usually includes a cooked option. There is no formal choice on the menu for the main meal of the day but the cook said that she would cook anything that a particular resident requested. The meals are largely traditional English meals; apparently slightly more cosmopolitan meals such as curry have been tried but were not a great success. The cook said hat she would cook a curry as a special option if requested. Meals are cooked form fresh ingredients and the cook makes her own pies and puddings. On the day we visited the residents enjoyed their lunch and most ate healthy portions. Nobody needed assistance with the meal, though one or two had bowls and spoons instead of knives and forks. The present cook is quite new to the job, though she has worked at the home in other capacities. She had not received training around meeting the dietary needs of people (as recommended in previous reports) with dementia and this would still be a good idea. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. Quality in this outcome area is good. The wellbeing of residents is safeguarded by the procedures and practices for responding to complaints and safeguarding of adults issues. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure is displayed in the reception area. No complaints had been recorded in the home’s records since the last inspection. One complaint has been made to the Commission and was investigated during this key inspection. The requirement concerning activities in the previous section relates to this complaint. The manager and staff interviewed were aware of the action to be taken should a complaint be made to them. The home has a copy of Wirral Borough Council’s adult protection procedures. No allegations of abuse have been made at the home over the past twelve months. Staff have received training around safeguarding older people from abuse. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 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. 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. Residents are able to live in a safe, clean, well maintained environment. They may benefit from the home environment being assessed to identify further ways of helping them to find their way around the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean with no unpleasant smells. The owner has a programme of refurbishments and since the last ‘key’ inspection many of the corridors and stairs have been recarpeted. As reported on the last two inspections, some of the furniture and furnishings in the communal rooms and bedrooms are showing signs of wear and tear. For instance, the dining room tables are sturdy but appear a little worn. Some of the carpets in a sample of bedrooms seen showed staining due to wear. We looked at all bedrooms, most of which have en suite facilities. Many of them were personalised with the resident’s own belongings and pictures. There are sufficient toilets, showers and bathrooms to meet residents’ needs and there were aids such as hoists in the bathrooms to assist residents to get in and out of the bath. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 16 There is a spacious dining room/conservatory with a separate lounge/TV area a and a separate lounge, also with a television. If the home was full the communal space may be rather crowded but this was not an issue at the time of the site visit. The kitchen was spotlessly clean and well organised. Tests of hot water temperature are recorded and show that water is being delivered at a safe temperature. Radiators have a low surface temperature and window restrictors are in place. It would be helpful if an assessment of the environment was undertaken by an individual with experience in dementia care with a view to making the environment more accessible for people with dementia. Photographs of residents have been placed next to their bedroom doors. Further aids such as this may help to make the home easier for people with dementia to navigate. Residents currently have to go outside to smoke. This is not ideal for people with dementia but the owner said that the change had been accepted by residents and their families and no complaints have been received about this issue. There is a private enclosed garden with seating areas for the residents and their visitors to use in the warmer weather. The garden has a variety of plants and bushes and a bird table as well as a paved path around the grass. It is secured by gates and lit by security lights. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is adequate. Staff are competent, qualified and experienced but need to have training updated. There are not sufficient staff on duty at all times given the size of the building and the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota shows that there are two care staff on duty at all times, including at night, when both care staff are on waking duty. There is a cook on duty each day from 10.45 to 16.45, a laundry assistant/domestic assistant for five hours on weekdays and a maintenance worker for 20 hours a week. Since the manager left the owner, Mr Bukhari, is carrying on the home himself and said that he is in the home most afternoons, though he is not on the printed rota. The last report stated that ‘Given the needs of the residents and that the home is a large building and has three floors two care staff are not sufficient. Sufficient staff need to be available at all times to meet the needs of the residents. There were only eleven residents in the home at the time of this inspection but the staffing levels are still not sufficient in the opinion of the Commission and should be reviewed. The absence of a member of staff to organise activities puts an extra burden on the care staff as does the lack of domestic staff at weekends. Nine of the eleven care staff have NVQ2 or above, well in excess of the National Minimum Standard, but there is no up to date training plan and staff had not received any training since the last key inspection earlier in the year. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37, 38. Quality in this outcome area is adequate. The home needs a clear sense of direction from a suitable manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager left in April, after having her hours reduced as a result of the falling number of residents. The last report stated that ‘There now needs to be consistency in the management arrangements at the home for these issues to be effectively addressed’. In surveys, relatives expressed the view that managers did not stay long and the hope that the new manager would stay to see through the improvements that she had started. That consistency has not yet been achieved and there have now been a number of managers in recent years. The owner, Mr Bukhari, is currently managing the home on a day to day basis. He does not have any qualifications or prior experience in social care and should therefore appoint a suitably qualified and experienced person to manage the home. Until there is clear, consistent leadership from a suitably experienced person the home and its staff team are unlikely to achieve a clear Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 19 sense of direction. Although the home does not use an accepted external quality assurance system it does consult relatives through questionnaires with a view to reviewing and improving the service it provides. The last round of questionnaires was sent out in October/December but there has been no feedback on this occasion. Since the manager left the home at the beginning of April the staff supervision programme has been in abeyance but the deputy manager was planning to continue it as from May when the next round of one to one meetings is scheduled. The home has up to date safety certificates but the most recent electrical safety certificate was issued on 17 November 2006 and the certificate states hat it should be assessed again ‘after a period of not more than one year’. It is therefore essential that a new check of the electrical systems is done as soon as possible. The food safety programme safer Food, Better Business is used in the kitchen and was properly recorded. The most recent Environmental Health report states the home had ‘a good, well run kitchen’ with ‘good record keeping’. Fire safety records were properly maintained and fire drills were properly recorded. Accidents are recorded properly but need to be filed in accordance with the Data Protection Act. Relevant incidents, such as accidents which require medical intervention must be notified to the CSCI. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 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 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 3 3 x 3 3 2 2 Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 14 Requirement The registered person must ensure that the residents care plans contain clear information as to how staff are to support residents who have pressure sores. (Originally required by 24/02/08). The registered person must consult residents about the programme of activities at the home and provide facilities for recreation having regard to the needs of the residents, activities in relation to recreation, fitness and training. This would be facilitated by the employment of a dedicated activities organiser. (Originally required by 24/02/08). The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of residents, ensure that at all times suitably qualified, competent and experienced staff are working at the care home in DS0000054702.V362953.R01.S.doc Timescale for action 24/06/08 2. OP12 16 24/06/08 3. OP27 18 24/06/08 Englewood Care Home Version 5.2 Page 22 such numbers as are appropriate for the health and welfare of the residents. (Originally required by 24/01/08). 4. OP27 18 The registered persons must ensure that all staff are provided with appropriate training for the work they perform and should therefore put in place a staff training programme. The registered person must appoint an experienced, competent, qualified person to manage the care home. The registered person must maintain a system for reviewing and improving the quality of care at the home. The registered person must notify the Commission of any circumstances adversely affecting the well being or safety of any resident. The registered persons must provide evidence that the electrical wiring of the home is safe. (Originally required by 24/02/08). 24/06/08 5. OP31 8 24/06/08 6. OP33 24 24/09/08 7. OP37 37 24/06/08 8. OP38 23 01/06/08 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 OP2 OP38 Good Practice Recommendations Residents should have a written, signed contract issued when they move into the home. Accident reports should be filed in accordance with the DS0000054702.V362953.R01.S.doc Version 5.2 Page 23 Englewood Care Home 3. OP33 requirements of the data Protection Act. Further work should take place around ways of obtaining the views of the residents and their relatives. Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG National Enquiry Line: 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 © 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 Englewood Care Home DS0000054702.V362953.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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