Inspection on 16/10/08 for Epworth Care Home

This inspection was carried out on 16th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Epworth Care Home 24/10/06

Epworth Care Home 17/01/06

Epworth Care Home 18/07/05

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 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Epworth Care Home Front Street Tanfield Lea Stanley Durham DH9 9LX     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: Lee Bennett     Date: 2 4 1 0 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 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 26 Information about the care home Name of care home: Address: Epworth Care Home Front Street Tanfield Lea Stanley Durham DH9 9LX 01207236379 01207290853 Epworth.health@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs P Hardy Type of registration: Number of places registered: X9 Healthcare Epworth Limited care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Epworth Care Home is an establishment for 31 older people in need of residential care, who do not need nursing care. The home is owned by a private company, X9 Health Care Epworth Ltd. It is situated in the Derwentside District of North West County Durham, at Tanfield Lea, one of the villages near the town of Stanley. There is a shop and other local village amenities close by. Accommodation is on 2 floors, connected by stairs and a passenger shaft lift. Bedrooms are generously sized, the majority having en suite toilets. Outdoor space is very limited at this home, although there is a grassed area and woodland nearby. There is a plan to develop some outside amenity space and off road parking for the home. The home?s charges range from #364.50 per week to #398.50, depending on the type of care required. These charges are in line with the Care Homes for Older People Page 4 of 26 Over 65 31 31 0 0 Brief description of the care home local authority?s set rates. Residents have no fixed additional charges for extra services apart from a #15 charge if a resident needs to be accompanied to hospital and a relative is not available to escort them. The home can be contacted by fax on 01207 290853, by e-mail on Epworth.health@btconnect.com, and via the website at www.x9healthcare.com. Care Homes for Older People Page 5 of 26 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: The visit; Before the visit: We looked at: - Information we have received since the last visit in August 2006. - How the service dealt with any complaints & concerns since the last visit. - Any changes to how the home is run. - The providers view of how well they care for people. - The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on the 16th October 2008. An announced visit was made on 24th October 2008. Care Homes for Older People Page 6 of 26 During the visit we: - Talked with people who use the service, staff and the manager. Observed life in the home. - Looked at information about the people who use the service & how well their needs are met. - Looked at other records, which must be kept. - Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. - Looked around parts of the building to make sure it was clean, safe & comfortable. - Checked what improvements had been made since the last visit. After the visit: We told the manager what we had found. Previous Requirements: 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 the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Overall the home operates at a good standard however, some areas need attention. Care Homes for Older People Page 8 of 26 These include: - The manager needs to make sure Social Workers are ask for and supply clear assessments for people who plan to move here. This is so she can be confident their needs can be met here. - Finger foods should be introduced for people who find it hard to use standard cutlery. - Amendments should be made to medicine and financial recording procedures. This is to make these areas more easy to audit and account for. - Fire door must not be wedged open. This is to make sure that people are protected in the event of a fire. 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. 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 26 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 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed to a varying level before moving here. Obtaining information about a persons needs is important in ensuring that everyone concerned is confident that this is a suitable place to live, and that everything is in place to make people comfortable. Evidence: Before a person moves to a care home they are entitled to have an assessment of their needs carried out, either by social services or a health care worker, such as a nurse assessor. Even when a person pays for their own care, they are still entitled to such an assessment. Most people moving here have their care arranged by Social Services, but some have come here by private arrangement. The manager of a care home must also obtain information about those people who would like to come here. This will include a copy of the assessment, and a summary Care Homes for Older People Page 11 of 26 Evidence: care plan, which explains how each persons needs are to be addressed. This is to make sure their needs are looked at and then can be properly met. The manager has obtained a care needs assessment and a care plan for one of the people whose files we looked at. Another person had only a summary care plan provided by Social Services. Another privately placed person was assessed by the homes manager. Based on the information gathered a plan of care is then developed by either the manager or senior staff. Risk assessments, for areas such as falls and pressure care, are also written up if needed. These assessments look at each persons needs in a way that would highlight any cultural or religious preferences, or how the service could ensure any barriers facing a person with a disability could be overcome. Care Homes for Older People Page 12 of 26 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. The people living here receive the right level of care and support to meet their health and personal care in a well-planned way. Evidence: To help guide the practice of staff, after a person has been admitted here a plan of care is written up. This is so that important areas of need, such as those around personal care, diet and social interests, can be clearly identified, and the support that staff are to provide is clearly explained. Everyone living here has a care plan file in place, and for the people whose files we looked at, the care plans themselves are relevant to the needs observed and that have been assessed by the social worker. Staff keep regular notes about each persons welfare and any care that they have provided. These records are clear, factual and relate to each persons health and personal care needs. Where people do have medical needs, evidence is kept of appointments attended and other visits by healthcare professionals is kept. This can help ensure peoples health needs are regularly monitored and met, and proper advice and intervention sought. Furthermore, where personal care is needed this is written Care Homes for Older People Page 13 of 26 Evidence: down in a care plan. During the inspection, there were no instances where personal care was carried out in the public areas of the home, which shows that staff are conscious of peoples privacy and dignity. The support offered by staff was carried out in a friendly, and pleasant manner. Two people were observed to have been supported in wheelchairs without footrests. This can put people at risk of injury, and once pointed out to the manager she spoke to staff to ensure this practice no longer happens. The people we spoke to told us that they are cared for in a good manner. Comments included: - We get looked after. - They re excellent girls. A common area where staff help people with their health care is in the way medicines are administered. The majority of people here have all of their medicines looked after for them. To keep them safe, medicines are stored in a secure way and the room where they are kept is at a safe storage temperature. Staff check the temperature of the medicine room and the medicine fridge to make sure that these are correct for the medication being stored. This will make sure the medicines concerned remain safe and effective. When staff administer medication they tell the person concerned what medication they are receiving, and also follow good hygiene practices. There are clear records kept of the medicines administered by staff. The stocks held for all medicines we checked corresponded to the stock records. Medicine records are accurate, and the reasons for medicines being missed is clearly recorded. To help ensure staff are aware of the importance of good record keeping, along with other aspects of medication management, they have attended accredited training on this topic. Where there is loose medicine held there is currently no record of the balance remaining at the end of each four week administrative period. There is also no evidence of any quality check carried out, to check that medicines are well managed. Care Homes for Older People Page 14 of 26 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. The people living here are offered regular opportunities to participate in a range of activities, maintain friendships and family contacts, express choice and control in their lives and receive varied, wholesome and well-presented meals. Evidence: Epworth House benefits from the work of an Activities Worker. This person is employed specifically to help arrange and deliver a range of activities. This includes in house activities, trips out, and visiting entertainers. A record of activities is kept. On the morning of the visit some people were relaxing in the various sitting areas or in their own rooms. In the afternoon there was a quiz session run by an outside agency. This was well attended and appeared to be enjoyed by those people present. Activities offered include, religious visits, entertainers, baking sessions and crafts. There are events that reflect cultural events and celebrations, such as Christmas, Easter, and so on. Visits from relatives form an important part of many peoples day. Visitors can come and go freely. People commented positively to us about the food on offer, and we heard many compliments about this. The comments you get choice and you get Care Homes for Older People Page 15 of 26 Evidence: loads to eat were similar to many we heard. A cooked breakfast can be provided and a choice of main meal and pudding is always offered. Staff were noted to be helpful at meal times, but one person who had difficulty using cutlery would have benefited from having finger foods to help promote her dignity. Routines are flexible here, and if someone wants to have a lie-in they can have their breakfast later in the day, to suit them. The dining tables here are nicely presented, and condiments are provided so that people can help themselves. A lunchtime meal was shared with several of the people living here. Staff were courteous, encouraging people to be independent. A choice of dilute juice or water was offered followed by tea or coffee. Care Homes for Older People Page 16 of 26 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. There are suitable arrangements in place here to protect people form abuse, and this enables people to make their views heard, and to raise any concerns or complaints they have. Evidence: A complaints procedure is available within the home with a copy placed on display. This informs the people here that they can contact the Commission if they wish regarding complaints. A record book for complaints and suggestions is maintained, although none have been received. No complaints have been referred to the Commission since the last inspection. Staff have received training on Adult Protection from an independent trainer, but not from the local Social Services Department. This training was to help explain the role of adult protection, and to offer guidance to staff. The care provider has adult protection procedures, which are available in the home, should staff need guidance in this area. These have been read and signed by staff. Care Homes for Older People Page 17 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The accommodation here generally suits peoples physical and personal care needs, is clean throughout, well maintained and personalised to suite individual tastes. Evidence: Epworth House is an adapted care home. It is kept clean throughout and re-decoration and refurbishment has taken place to Keep the home clean and fresh looking. There are some en-suite bedrooms here, and bathrooms and toilets have been located throughout the home to be near all of the living areas and bedrooms. There were no physical hazards observed during the inspection, but the practice of wedging open bedroom doors that are designed to contain the spread of fire can put people at risk if a fire occurs. Care Homes for Older People Page 18 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff working here are safely recruited, regularly trained, qualified and competent. This can help make sure the people living here are protected and receive the care they need. Evidence: Before staff start working here they have to undergo a series of checks. This is to ensure they have the right skills, experience and approach for the job. There are also checks carried out to help make sure they are physically fit for the work they have to do, and do not have a criminal history that would make them unsuitable to work here. Since the last inspection was carried out here, of the current staff team one member of staff has been employed. Suitable pre-employment checks, including the receipt of a Criminal Record Bureau Disclosure and two references have been obtained before they started duty. Once employed, staff receive a detailed induction and regular training. This includes training relevant to peoples needs in the home. This is to make sure they remain up to date with the requirements of their job, and with current good practice. The staff here initially attend induction training if they are new to care work. Following this they will also be offered periodic training opportunities. Furthermore, those not already qualified will be supported to attain a vocational qualification in care. All of the staff here have Care Homes for Older People Page 19 of 26 Evidence: achieved such an award, at NVQ level 2 or higher. Care Homes for Older People Page 20 of 26 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. The people here benefit from living in a well managed home. This can help make sure their views are sought and acknowledged, and that their health and safety is promoted. Requirements and Recommendations: Falls prevention strategy. Evidence: The manager has many years experience at a senior level within social care. She is a has attained a number of care and management qualifications including the NVQ level 4 qualification in Management (the Registered Managers Award), and an NVQ level 3 in care. Furthermore she undertakes periodic training on topics such health and safety, dementia and epilepsy awareness. This is to ensure that her knowledge is kept up-todate. The people living here and the staff all commented positively about her. Care Homes for Older People Page 21 of 26 Evidence: The manager is supervised by an area manager, and supported by a senior carers. There are clear lines of accountability within the organisation. The area manager regularly visits the home and also completes a monthly audit of the service. To complement this several quality checks are carried out in areas such as equipment and the building. There is a record kept of service users views. Satisfaction questionnaires have been introduced to gain the views of the people living here and their relatives. The records kept at the home, were up to date, detailed, and held in a safe and secure manner. Financial records are subject to the scrutiny of the area manager. Staff in the home do not usually hold or manage service users finances, but where these are left with staff for safe keeping they are securely stored, with clear records in place. Some minor errors were noted, and records are not made on consecutively numbered pages, which would aid auditing and accountability. The home was free of hazards to the safety of service users and staff. Care Homes for Older People Page 22 of 26 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 23 of 26 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 3 14 Care managers assessments 16/02/2009 must be obtained for all prospective service users. This is so the manager can be confident their needs can be met here. 2 26 13 The practice of wedging open fire doors must cease. This is to ensure that people are protected from fire risks. 09/02/2009 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 9 Medication recording procedures should be amended to include a carried forward balance on the Medication Administration Records. This is to help keep a track of what medicines are held here. Finger food, to uphold the dignity of people who cannot use cutlery, should be incorporated into the menu. Staff should receive adult safeguarding training from the local Council, to supplement the training they have already received. This is so they are fully aware of the local adult safeguarding procedures. Page 24 of 26 2 3 15 18 Care Homes for Older People 4 35 The manager should revised financial procedures to include periodic audits, and to ensure that financial transactions are detailed on consecutively numbered pages, and that individual entries are not tippexed out. The manager should develop a falls prevention strategy, in liaison with the local NHS fall prevention adviser. 5 38 Care Homes for Older People Page 25 of 26 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). 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. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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