CARE HOMES FOR OLDER PEOPLE
Eskdale House Swan Street Longtown Carlisle Cumbria CA6 5UZ Lead Inspector
Paula Banham Unannounced Inspection 12th December 2005 11:05 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 Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Eskdale House Address Swan Street Longtown Carlisle Cumbria CA6 5UZ 01228 791366 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) www.cumbriacare.org.uk Cumbria Care Ms Geraldine Ann Watt Care Home 27 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (27) of places Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Two service users may share a bedroom of at least 16 sqm usable floor space only when they have made a positive choice to do so, and when a shared space becomes vacant the remaining service user has the opportujity to choose not to share, by moving into a different room if necessary. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. When single rooms of less than 12 sqm usable floor space become available, they must not be used by wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. The home is registered for a maximum of 27 service users to include: up to 27 service users in the category of OP (Old age not falling within any other category) up to 5 service users in the category of DE(E) (Dementia over 65 years of age) One named service user in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the overall number of registered places. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 22nd June 2005 2. 3. 4. 5. 6. Date of last inspection Brief Description of the Service: Eskdale House is a residential care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for up to twenty-seven residents. The home is owned by Cumbria County Council and carried on by Cumbria Care which is a County Council business unit. Mrs Ann Watt is employed as the registered manager of the home. The home is located near to the centre of Longtown and is close to local shops, GPs surgeries and local churches. The property consists of a purpose built two storey building and is equipped with a passenger lift to assist residents to access accommodation on the first floor. Accommodation is provided in twenty-five single bedrooms and one double room which two people can choose to share. Three bedrooms have ensuite toilet facilities and there are accessible toilet and bathing facilities close to all the accommodation provided for residents. Shared space is provided in the form of two lounges with dining areas and a separate
Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 5 sitting room which residents can use to meet their visitors in private. Outdoor space is provided by an enclosed courtyard with flowerbeds and seating for residents and a garden area which is accessible to the people living in Eskdale House. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out on Monday 12th December 2005. The inspection focussed on how well the services provided meet the needs of the residents living in the home. This was assessed by speaking to residents, visitors and staff, observing activity in the home and examining the records which care homes are required to keep. What the service does well:
Eskdale House provides a high standard of care which meets the needs of the people living there. Residents spoke very highly of the support provided in the home and said, “It’s grand here”. Residents know that their views are listened to and they can affect how the home is run. Residents are provided with a range of activities which take account of individuals’ interests and preferences. Activities are discussed at residents’ meetings and they are included in planning celebrations and trips away from the home. Entertainment evenings are held to which older people living in the local community are invited. Many residents said they enjoy the opportunity to socialise with their former neighbours. Residents make choices about their lives and the decisions they make are respected. Care staff and residents have developed positive relationships and the atmosphere in the home is friendly and relaxed. Residents receive health care from their own GPs, local District Nursing teams and appropriate specialist services as they need. Care staff take appropriate advice and actions if they are concerned about the health or well-being of a resident. Eskdale House provides safe and well-maintained accommodation for residents to live in. Residents choose where to spend their time in the home and where to see the visitors they receive. The home is well managed and residents’ safety and welfare are protected. Appropriate procedures are followed when employing new staff to ensure they are suitable to work with residents. Staff receive a range of training to give them the skills and knowledge to provide a high standard of care and to carry out their duties safely. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 8 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 Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4. Residents receive a high standard of care which meets their assessed needs. EVIDENCE: Eskdale House provides a high standard of care which meets the needs of the people living there. Residents’ needs are assessed before they move into the home. The needs assessments are used to ensure that the services provided are appropriate to provide the support individuals require. Residents spoke very highly of the support provided in the home and said, “It’s grand here”. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8 and 10. Residents’ health and well-being are maintained by the support provided in the home. Care staff treat residents with respect and protect their privacy. EVIDENCE: Residents are registered with local GPs’ surgeries and receive health care from their own GP and local District Nursing teams. Appropriate specialist health care services are provided, as individuals need. Residents are supported to attend routine health appointments with their dentists, chiropodists and opticians. Care staff take appropriate advice and actions if they are concerned about the health or well-being of a resident. Residents are treated in a respectful manner. Care staff and residents have developed positive relationships and the atmosphere in the home is friendly and relaxed. Staff ensure that residents’ privacy and dignity are maintained. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14. Activities are well managed and provide residents with opportunities for leisure and recreation. Residents make choices and maintain control over their lives. EVIDENCE: Residents are provided with a range of activities in and away from Eskdale House. Activities are discussed at residents’ meetings and they are included in planning celebrations and trips away from the home. Residents benefit from having a variety of leisure and recreation opportunities which take into account their views and preferences. Monthly outings are arranged to local areas of interest, concerts and shopping areas. Residents choose whether to take part in the activities provided. Entertainment evenings are held to which older people living in the local community are invited. Many residents said they enjoy the opportunity to socialise with their former neighbours. Residents make choices about their lives and care staff respect the decisions they make. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Residents are protected from harm by staff knowledge and the procedures in the home. EVIDENCE: Care staff are aware of the actions to take if they are concerned about a resident’s safety or welfare. Procedures are followed to ensure that residents are safe living in Eskdale House. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26. Eskdale House provides clean, safe and comfortable accommodation, which is suitable to meet the needs of the residents living in the home. EVIDENCE: Eskdale House provides a safe and well-maintained environment for residents to live in. The standard of decoration and furnishing is high and the accommodation is comfortable and homely. There are two large lounges and a smaller room for residents who want to spend time away from other people or to see visitors in private. Residents choose where to spend their time and where to see the visitors they receive. The home is clean and hygienic and provides a pleasant environment for residents to live in. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 and 29. The training and recruitment practices in the home protect residents and ensure they receive a high standard of care. EVIDENCE: Cumbria Care operates Eskdale House and their recruitment procedures are followed when employing new staff. The procedures include checks on applicants to ensure they are suitable to work with residents. Staff receive a range of training to give them the skills and knowledge to provide a high standard of care and to carry out their duties safely. Residents’ safety and welfare are protected by the recruitment and training practices used in the home. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Residents benefit from living in a well managed home where their interests, welfare and safety are protected. Residents know that their views are listened to and they can affect how the home is run. EVIDENCE: Eskdale House is well managed and residents’ safety and well-being are maintained. Procedures are in place to ensure that valuables held on behalf of residents are stored securely and their financial interests are protected. Staff in the home receive training and support to provide a high standard of care and to carry out their duties safely. Regular meetings are held with residents. Residents know their views are taken into account and that they can affect how the home is run. Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? Not Applicable 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Eskdale House DS0000036493.V273520.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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