CARE HOMES FOR OLDER PEOPLE
Good Companions 113 Roe Lane Southport Merseyside PR9 7PG Lead Inspector
Mrs Elaine Stoddart Key Unannounced Inspection 30th October 2006 09:00 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 Good Companions DS0000005324.V308715.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. Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Good Companions Address 113 Roe Lane Southport Merseyside PR9 7PG 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) 01704 220450 Mrs Jennifer Moffatt Mr David Michael Moffatt Mrs Jennifer Moffatt Mr David Michael Moffatt Care Home 23 Category(ies) of Old age, not falling within any other category registration, with number (23) of places Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include up to 23 OP One named service user, under pensionable age with a physical disability may be accommodated at the home for a period of 4 to 6 weeks. Once the named Service user leaves the home, the variation will cease to apply. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 1st March 2006 3. Date of last inspection Brief Description of the Service: Good Companions is a Registered Care Home providing personal care and accommodation for up to 23 older people. At the time of the inspection there were 18 service users in residence. The home is owned and managed by Mr and Mrs Moffatt. The two deputy managers Ruth Watson and Mhairi Cairns are also actively involved with the day-to-day running of the home. The home is a large, converted Victorian property with an added extension to the rear and side of the building. The home is serviced by a passenger lift and access is available to all floors. All but one of the bedrooms has en-suite facilities. Communal facilities include two lounges, a large pleasant dining area and a hairdressing room. There are two bathrooms that provide assisted baths and one shower unit. There is a large well-maintained rear garden, which the home uses for garden parties and activities. The garden also provides a pleasant area for the service users to sit in the summer months. The front entrance provides an attractive approach to the home and parking for visitors. The home has a minibus, which is used frequently for day trips. The cost for the service is £360.50 per week Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The site visit took place over one day duration of eight hours. It was an unannounced visit and conducted as part of the regulatory requirement for care homes to be inspected at least twice a year. A tour of the building was conducted. A selection of care staff and home records were also viewed. During the inspection three residents were case tracked (their care files were examined and their views of the home were obtained). This process was not carried out to the detriment of other residents who also took part in the inspection process. The Manager/Owners were on holiday at the time of the site visit. Discussion took place with the two deputy managers, four staff members, four of the residents, a relative and a visitor to obtain their views of the home. Survey forms ‘Have your say about….’ were also given to residents to complete. Comments received from the surveys and discussions, which took place, are incorporated within this inspection report. What the service does well: What has improved since the last inspection?
Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 6 Since the last inspection the home has continued its ongoing maintenance programme and a number of private rooms have been decorated, the outside has been painted, chairs replaced and a new cooker purchased. A new medication storage facility is in place. 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. Good Companions DS0000005324.V308715.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 Good Companions DS0000005324.V308715.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): Standards 1,2,3,6. (Standard 6 Intermediate care is not provided at the home). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessments carried out by the manager ensure that the home can meet the needs of the residents. EVIDENCE: Surveys received from residents confirmed that they had received sufficient information on the home prior to their admission and had a contract outlining their terms and conditions of occupancy. Residents commented: “My daughter and son found the home for me and told me all about it. It was my decision to move here”. “I have been here since February and have settled in very well”. “I visited the home prior to my Mothers admission and a representative from the home visited my Mother prior to her discharge to the home”. Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 9 Assessments viewed for three residents confirmed details of their personal history, health care needs, medication, likes and dislikes and risk assessments are in place to ensure the home can meet their needs. Observation and discussion with relatives, visitors and residents confirmed the home is meeting their needs. “I am very pleased with the home” (Relative) “I have been here for twelve months and couldn’t find a better place” (Resident) Good Companions DS0000005324.V308715.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): Standards 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with dignity and respect. Residents health, personal and social care needs are addressed in care plans and care needs are met effectively. Medication administrations are recorded and policies and procedures are in place. EVIDENCE: Three care plans viewed demonstrated the care needs of individual residents are being met. Care plans and records are kept up to date and reviewed regularly to reflect changing need. A ‘residents individual requirements’ record is maintained and regularly updated when the need arises. Access is available to health care professionals and all visits by GP, district nurse and chiropodists are recorded. Care files viewed showed that personal care needs are reviewed regularly to monitor weight, pressure care, risks and moving and handling needs. Staff interviewed demonstrated a clear understanding of the care needs of the residents and felt that there is sufficient information in place to ensure they provide the correct care. Surveys and comments received from
Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 11 residents confirmed that the home is meeting their needs and the staff employed always treat them with dignity and respect when providing the care. “The staff are very good with me” “The staff are very patient” “I need help with bathing and they are always very nice” Medication policies and procedures are in place and records kept of all administrations made. The senior care staff are responsible for the administration of medication and have received training in this. All medication is securely stored. Information is obtained from residents in a sensitive manner to ensure the home meets their wishes at the time of their death. Good Companions DS0000005324.V308715.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): Standards 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are helped to exercise choice and control over their lives, receive a wholesome and appealing diet and maintain contact with friends and family. EVIDENCE: A varied menu is provided with alternatives, which enables the residents to have a choice. Dietary needs and likes and dislikes are discussed with the residents and recorded in their care files. The cook is provided with this information to enable her to provided meals of their choice and suitability. Residents spoken with commented that they are able to have their meals in the lounge or within the privacy of their own rooms if they wish. Residents were observed to receive this service during the inspection. Residents and relatives spoken with and surveys received provided their comments on the food available: “Meals are wonderful” (Resident) “They will give you alternatives as they get to know what you don’t like” (Resident) “Meals are specially prepared for my Mother due to her medical condition” (Relative)
Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 13 Activities are provided and include board games, quizzes and trips out in the homes mini bus. A recent barge trip has taken place on the canal for some of the residents. Residents have the choice if they wish to take part or attend the trips out. Surveys received and residents and relatives spoken to provided the following comments on the activity programme. Some comments were positive: “Plenty of activities. My Mother usually attends” (Relative) “I enjoyed the barge trip” (Resident) While other comments made include: “More stimulation for residents would be good” (Relative) “There a very few activities” (Resident) This was discussed with the deputy manager during the inspection who confirmed that activities are regularly reviewed to meet the residents needs but it is sometimes difficult to get them to join in. The deputy manager agreed to review the activity programme with the residents. Residents have access to attend services of their religious beliefs. Relatives and friends are encouraged to call at any time and have a choice of rooms to meet with the residents i.e. two lounges, dining room or bedroom. Visitors were observed to call in at all times of the day and made very welcome by the staff. One resident and her relative were spoken with prior to them going out for lunch together both provided positive comments regarding the care and support provided. Relatives and a visitor spoken to commented: “I am always made welcome” (Visitor) “I only need to ask for anything. The staff are always willing to help. The girls are all very nice”(Relative) Good Companions DS0000005324.V308715.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): Standards 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are confident that their complaints will be listened to and acted upon. EVIDENCE: Abuse policies and procedures in place are available for staff reference. Staff sign to confirm their understanding of all policies and procedures in place. Staff spoken with demonstrated their awareness of abuse and the action to take. A complaints procedure is available to all residents and those spoken to confirmed that they are aware of how to complain and would speak to the manager or a member of staff. One resident said “I have no complaint about the home”. Finance policies and procedures are in place and receipts and signatures obtained for all transactions made. Residents and families are encouraged to control their own financial affairs were possible. Good Companions DS0000005324.V308715.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): Standards 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers very comfortable, ‘homely’ accommodation and all areas are well maintained. This contributes to a good quality of life for the residents. EVIDENCE: All communal areas and a number of private rooms were viewed. Private rooms contained resident’s own personal possessions. The home provides a pleasant, comfortable and homely setting for residents and is well maintained. The home is a large, three storey converted building. A passenger lift provides access to all three floors and the home is accessible via steps and a ramp. Assisted bathing facilities are in place. There are car-parking facilities at the front of the building and a large garden at the rear, which is used in the
Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 16 summer months. Two communal lounges provide areas for the residents to sit, meet their visitors, read, watch TV or take part in activities. All areas of the home were found to be clean and odour free. A well organised laundry service is in place. The home employs sufficient domestic staff to maintain the home to a good standard. Repairs and maintenance are addressed when required and the home has an ongoing improvement plan. Since the last inspection a number of improvements have been made and these are contained in the section ‘Improvements since the last inspection’ at the beginning of this report. Residents were observed to be comfortable in their surroundings as some residents sat in the lounge reading the papers, or watching TV, while others relaxed in their own rooms. A number of residents had relatives and visitors call to see them during the visit and these were seen in the privacy of their own rooms. Residents, visitors and relatives commented on their satisfaction with the standard of the home. “I have my own furniture to remind me of home” (Resident) “Lovely and clean” (Visitor) “I love my room” (Resident) Good Companions DS0000005324.V308715.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment and selection procedures must be more robust to protect the residents. The staff are trained to care for the residents. EVIDENCE: Sufficient staff were on duty at the time of the unannounced visit to meet the needs of the residents. A selection of staff files viewed contained two written references but failed to provide up to date CRB records. Discussion took place with the deputy manager to confirm that CRB’s are not transferable and an enhanced CRB is required for each member of staff employed. The manager confirmed that these will be applied for all staff were these are not in place. This is contained in the requirements of this report. A photograph of each staff member must be available on file for identification purposes. A training plan is in place and covers all statutory training required, i.e. manual handling and first aid. Additional training is also provided in areas relating to the care of the elderly i.e. dementia. Staff interviewed confirmed that the training is good and kept up to date. All training is conducted with Mulberry House, with the exception of first aid. The home has a training room to conduct ‘in house’ training and they are hoping to become an NVQ accredited centre. Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 18 Staff are encouraged to undertake National Vocational Qualifications (NVQ). Seven of the nineteen care staff have at least NVQ Level 2 or above (36 ). The home must continue to encourage staff to take this qualification and aim to reach 50 . Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 19 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): Standards 31,33,35,36,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ finances are safeguarded by the home’s policies and procedures. The home is well managed in the interest of the service users. EVIDENCE: The home is well managed by managers who have worked with the elderly for many years. The managers are supported by two deputy managers, senior carers and care staff. Annual quality assurance surveys are conducted and the home has recently achieved a satisfaction level of 97 . The home has policies and procedures in place for handling residents’ finances. All financial transactions are recorded and receipts and signatures obtained. All finances are securely stored.
Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 20 All certificates for services are up to date as quoted in the pre inspection questionnaire and a number of certificates were checked to evidence this. All accidents and injuries are recorded and water temperatures checked to ensure residents safety. Fire and emergency lighting records are up to date. A training programme is in place to equip the staff with the skills to carry out their roles. The deputy manager confirmed that a staff supervision process is in place, however records could not be accessed to confirm this at the inspection and the deputy manager agreed to forward these to the Commission. Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 21 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 Requirement The registered person must ensure that up to date criminal record bureau checks are obtained for all staff employed. A photograph of the employee must be obtained for identification. Timescale for action 31/12/06 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 OP28 OP12 Good Practice Recommendations The home should continue to encourage staff to take NVQ qualifications to reach the standard of 50 The home should continue review the activity programme in view of the comments made in the report. Good Companions DS0000005324.V308715.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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
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