CARE HOMES FOR OLDER PEOPLE
Eskdale House Swan Street Longtown Carlisle Cumbria CA6 5UZ Lead Inspector
Paula Malaney Unannounced Inspection 20th June 2006 11:30 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 Eskdale House DS0000036493.V291301.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. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 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.V291301.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 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 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. 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 opportunity to choose not to share, by moving into a different room if necessary. The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Older Adults. 12th December 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.V291301.R01.S.doc Version 5.2 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 the home. Fees charged to residents include all care, accommodation, meals and laundry. Fees are charged weekly and for the financial year 2006 to 2007 range from £385.00 - £422.00 per week, depending on the level of care a resident requires. Residents pay separately for their own toiletries, newspapers and hairdressing. Information about the services provided and fees charged is included in the information given to residents and their families. Copies of recent Commission for Social Care Inspection inspection reports are displayed in the home and provided to prospective residents on request. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and included a visit to the home on 20th June 2006. The inspection focussed on how well the services provided in the home meet the needs of the people living there. This was assessed by speaking to residents and their families, speaking to care staff and the manager, observing activity in the home and examining the records which care homes are required to keep. The views of residents, their families, social workers and health care professional were also obtained by a postal survey. What the service does well: What has improved since the last inspection?
Eskdale House continues to provide a high standard of care to the residents living in the home. A new lounge has been provided to improve the facilities for residents who smoke. A fixed canopy has been installed in the courtyard garden to provide shade for residents who wish to sit outside.
Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 7 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.V291301.R01.S.doc Version 5.2 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.V291301.R01.S.doc Version 5.2 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, 4 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed and are met by the services provided in the home. EVIDENCE: Residents’ needs are assessed before they are offered accommodation in the home. The assessments are used to ensure that the services provided are suitable to meet the needs of the individual. The home’s admissions procedure includes a review period during which time residents and their families can decide whether they wish to stay at Eskdale House. The home provides short term respite care which give individuals the opportunity to become acquainted with the home and staff. This can assist people to settle in the home if they decide to move into permanent residential care. Eskdale House DS0000036493.V291301.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are identified, clearly recorded and are met by the services provided in the home. Residents are treated with respect and their privacy and dignity are protected. EVIDENCE: Residents’ health and personal care needs are identified in their individual plan of care and care staff provide the support that individuals require. Residents benefit from receiving health care from local and specialist health services. Medication is handled safely and residents are able to maintain responsibility for their own medication. Care staff treat residents with respect and take appropriate actions to protect their privacy and dignity. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 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, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Activities are well managed and residents’ benefit from having a choice of activities which take into account their preferences and abilities. Residents make choices about their lives and the decisions they make are respected. Meals are of a high standard and residents receive a varied and nutritious diet EVIDENCE: The home provides a very good range of activities including group and individual activities. Residents are provided with recreational interests which offer variety and meet individual needs. The management team and staff put a lot of effort into raising money to pay for activities and into providing activities which suit individuals’ abilities and preferences. Visitors are made welcome and residents know they can maintain contact with their friends and families as they choose. The home is well supported by local churches and services are arranged for residents to attend in the home. Residents have a choice of nutritious and appealing meals and have drinks and snacks as they want them. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know how to complain and that their complaints will be looked into and appropriate actions taken to resolve them. Residents are protected from abuse by staff awareness and procedures in Eskdale House. EVIDENCE: Residents are aware of how they can make complaints about the care provided. Residents said they have “no complaints at all” about the service and said, “You couldn’t complain about anything about this place”. Care staff are aware of the procedures to follow to protect residents’ safety and welfare. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 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, 21, 22, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The accommodation provided in Eskdale House is clean and comfortable and is suitable to meet the needs of the people living in the home. EVIDENCE: Eskdale House provides safe and well-maintained accommodation for residents to live in. The standard of decoration and furnishing is high and the environment is comfortable, pleasant and hygienic. The home has two main lounges and residents choose where to spend their time, in their own rooms or with other people. There is also a separate sitting room where residents can receive visitors in private. Residents are able to bring their own possessions into their rooms and have personalised their rooms as they wish. The home has a range of equipment to assist residents to maintain their independence including specialist equipment provided for individual residents. All areas of the home are cleaned thoroughly and the environment is clean and hygienic.
Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home’s recruitment, training and supervision practices ensure that residents are safe and receive a high standard of care. EVIDENCE: The home’s recruitment procedures ensure that staff are suitable to work with residents. The procedure ensures residents’ safety by taking up of references and making checks against the Criminal Record Bureau and Protection of Vulnerable Adults list. Care staff receive training and support to give them the skills to provide a high standard of care and to carry out their duties safely. Residents made many positive comments about the care staff and said, “All the staff here are lovely”. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 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, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home is well managed and residents know that their views are listened to and they can effect how the home is run. Residents’ health, safety and financial interests are protected in the home. EVIDENCE: The atmosphere in the home is inclusive and residents’ are given choices and encouraged to maintain control of their lives. Meetings are held with residents to obtain their views on the services provided. Residents’ views are listened to and changes have been made in the home in response to their comments. Systems are in place to maintain residents’ safety including those people who may be at risk if they leave the home alone. Care staff receive training to enable them to carry out their duties safely and to protect residents’ safety
Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 16 and welfare. Residents have secure storage areas for their possessions and their financial interests are protected. Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 17 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 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Eskdale House DS0000036493.V291301.R01.S.doc Version 5.2 Page 18 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.V291301.R01.S.doc Version 5.2 Page 19 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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