Inspection on 17/05/05 for Home Close

This inspection was carried out on 17th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Home Close 20/05/08

Home Close 25/05/07

Home Close 05/06/06

Home Close 07/12/05

Home Close 22/11/04

Home Close 25/05/04

Home Close 08/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Home Close Cow Lane Fulbourn Cambridgeshire CB1 5HB Lead Inspector Jenny Cangy Announced 17 May 2005 @ 10:00 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 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. Home Close Version 1.10 Page 3 SERVICE INFORMATION Name of service Home Close Address Cow Lane Fulbourn, Cambridgeshire CB1 5HB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01223 880233 01223 881728 hcmanagerhomeclose Home Close Ltd Care Home with Nursing 44 Category(ies) of OP 44 registration, with number of places Home Close Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: No more than 20 persons requiring nursing care Date of last inspection 22/11/04 Brief Description of the Service: Home Close is a purpose built home situated in attractive grounds in a quiet lane close to the centre of the village of Fulbourn. The accommodation is arranged in flats. Each flat has a kitchenette and a loung area. There is a large communal lounge/dining room on the ground floor. The service user accommodation is on two floors with the upper floor being accessed by a passenger lift. The home provides care for older people with both social and nursing care needs. There is a day centre on site and the home has ambulance bus transport available for outings. Home Close Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived at 10.00 and was greeted by the acting Manager/care manager Alison Smith and the area training manager Jill Potter. Time was spent with the senior staff going through the records and reviewing the progress made since the last inspection. Concerns raised by relatives about changes to the use of communal rooms in the home, where chiropody is carried out and the cleaning of wheelchairs were discussed. The standards that were not met in full at the last inspection were reviewed and all have been dealt with. The standards being inspected at this visit and what action was required to ensure that standards are met and maintained were discussed. A tour of the building took place and staff service users and visitors were spoken to. One service user who was very upset at the changes made to sitting areas in the flats made her concerns known. A further meeting with the management to feed back inspection findings took place. During the tour of the building it was noted that the home was fresh and clean throughout. A mealtime was observed and time spent chatting with groups of service users at the tea table who were keen to talk about an outing to Newmarket they had been on that morning. What the service does well: What has improved since the last inspection? Home Close Version 1.10 Page 6 Carpets in some area have been replaced due to them being worn or damaged. Others are due for change. A new manager has been recruited and was due to start work on the Monday following the inspection. The last inspection report is displayed on the reception desk for visitors and staff to view. Staff training has been maintained at a high level and over 50 of staff have NVQ level 2 or above or the equivalent. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Home Close Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Home Close Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3&4 Service users have access to sufficient information to enable them to judge that the home is able to meet their needs. The staff are able to meet the needs of any service user that moves into the home and the service user and their families are assured of this. EVIDENCE: There is a statement of purpose and service user guide sent to all prospective service users that contains information about the home and how it is managed. There is also information about the care and activities provided. The care manager or one of the senior staff assesses every prospective service user to establish that the physical and emotional needs can be met. The information gathered at the assessment forms the basis for the service users care plan. Information is gathered from social workers and the hospital discharge planning team. Outside professional expertise is sought for anyone with special needs such as sensory impairment. The staff training program ensure there is a good skill mix of staff. All prospective service users have a letter formally accepting them as a resident and stating their needs can be met. Home Close Version 1.10 Page 9 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 standard(s) 7,8,9&11 The home has sufficient information on care plans to ensure the service users needs are known and met. Medication is appropriately controlled. The home can support service users who wish to remain in control of their medication The home makes every effort to ensure service users preferences are known with regard to their final illness. EVIDENCE: Care plans have information regarding service users physical and emotional needs. These are compiled by the key worker or named nurse using the preadmission assessment as a basis. The service user or their representative is included in the compiling of the plan and are signed by tem to agree the content. They are reviewed at least monthly and more often if necessary and all changes are agreed. There is an annual review to which all relevant parties are invited. All service users have access to a local GP, chiropody, opticians and dentists as needed. Local district nurses visit the home as do community psychiatric nurses if required. On the day of inspection no service users were managing their own medication with the exception of inhalers. All service users have lockable facilities in their rooms to keep medication should they wish to. Medication records were accurate and up to date and a controlled drug register Home Close Version 1.10 Page 10 is properly maintained. All staff involved in the administration of medication are trained to do so. The service users wishes for their last illness are recorded in the care plan and where possible service users are able to remain within the home during this time with the support of the GP and when necessary District Nurses if this is the service users wish. Home Close Version 1.10 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 standard(s) 12-15 Service users are able to make choices about their daily lives, but on occasions their choices are restricted and their opinions not sought. Cultural and religious needs can be met are. A wide range of activities are available to service users. Service users are able to have visitors where and when they like. EVIDENCE: There is a full activity program available to all service users. This is displayed on notice boards around the home. The activity co-ordinator meets all service users on an individual basis to establish their preferences. A disabled access bus is available for use for outings. There is a varied 4 weekly menu with choices to select from. This is changed seasonally and preferences are sought at a service user meeting. The change in use of the lounges attached to the flats has taken away the choice of service users to sit and dine in small groups and imposed restaurant style dining on them. This has implications with regard to privacy and dignity. Those who require help with eating or may have difficult in feeding themselves now have to eat in full view of every one else. Visiting is open within reason and the inspector was able to meet with some visitors who confirmed they are able visit when they like and see their relative in their room or in one of the lounges. They are also able to use the kitchenette to make drinks. Service users have a full range of choice about their daily lives and are able to personalise their rooms. Service users are able to access their records if they wish, as are their next of kin with the service users permission or if they Home Close Version 1.10 Page 12 hold power of attorney. Changes were made to the use of sitting rooms without consulting with the service users and this has resulted in several relatives contacting the CSCI and concerns raised by a service user and relatives on the day of inspection. The management agreed that no consultation had taken place but stated that it was only for a trial period. No decision had been taken for how long this trail was to be. It has been 5 months since the change and at a recent service user meeting several service users expressed their dismay. Home Close Version 1.10 Page 13 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 standard(s) 16-18 Service users have sufficient information to enable them to voice concerns and make formal complaints. Service users legal rights are recognised and upheld. The manager and staff are knowledgeable about abusive practice and how to prevent it. EVIDENCE: The complaints procedure is in the service user guide and also displayed on notice boards around the home. A complaint log is kept and all complaints are investigated and audited regularly by the area manager. The address and phone number of the CSCI is also in the service user guide if a complainant is not satisfied with the outcome of an internal complaint. Service users are able to consult a solicitor and are given the privacy to so if necessary. Any incidents of alleged abuse are reported to the Protection of Vulnerable Adults’ (POVA) team. Staff have POVA training. Staff also have training in dealing with difficult behaviour. All service users are registered to vote and at the recent General election those who wished and were able either exercised a postal vote or went to the local polling station. Home Close Version 1.10 Page 14 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 standard(s) 19-24 The home is a safe environment however some minor shortfalls were noted. The service users have safe access to the garden and all communal areas of the home. EVIDENCE: Some damage to carpet joins in corridors was noted, presenting a tripping hazard. This was disappointing as on the last inspection a similar problem was noted in a different area. Broken tiles in a bathroom with tile chips loose on the floor was also noted. The acting manager made assurances that tis would be rectified with immediate effect. Otherwise the home was well decorated and bedrooms personalised and homely. The home is purpose built and meets the minimum standards for bathroom and toilet provision. Hoists are available and any aids and adaptations are provided either by the home or the district nursing service. Home Close Version 1.10 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 There is sufficient staff with appropriate skill mixes to ensure the needs of the service users are met. Recruitment policies ensure service users are in safe hands at all times. Staff are well trained to provide appropriate care. EVIDENCE: The home has a staff complement of trained nurses, care staff, domestic, catering and laundry staff. In addition to these there is an activity co-ordinator and an administrator/receptionist. The inspector noted a good level of staffing on duty and the staff rotas supported this. Staff spoken to were able to tell the inspector about the induction training and further training available to staff. The homes recruitment policies ensure all staff have two written references and have to produce proof of identity. A current Criminal Record Bureau (CRB) and POVA check is carried out and the inspector saw evidence of this on staff files. The acting manager is on duty during office hours and the person in charge at weekends is a Registered Nurse. The manager post has been vacant for about a year however a new manager takes up her post on the Monday following the inspection. The homes policies and procedures are kept in the staff office where all staff have access to them. Over 50 of care staff have attained NVQ level 2 or higher in care. Home Close Version 1.10 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,36,37,38 Despite being without a registered manager for the over a year there is no evidence to suggest the home was not well managed. EVIDENCE: The acting manager is a qualified nurse and will remain in the home as care manager when the new manager takes up her post. She has always been available for both staff and service users during office hours and out of hours by appointment. The management does need to ensure that service users views are sought before making changes that will have a major impact on those who consider this as their home. Failure to do so has caused distress to several of the service users by depriving them of what they considered to be their lounges. The home is financially viable. Staff are adequately supervised and appropriate records are kept. Health and safety of the service users, visitors and staff is adequately covered with minor exceptions, that is the damage to carpets in corridors as referred to in the section on environment. Home Close Version 1.10 Page 17 An application has been received by the CSCI to register the new manager. This is currently being processed. The home has a quality assurance audit twice a year the result of which are published in the service user guide. There are monthly nurse meetings, 3monthly staff meetings and regular individual staff supervision to ensure all staff are kept up to date and staff enable to participate in the running of the home. Minutes of the meetings and supervision records were available for the inspector. The home has an annual development and business plan and the manager has a budget to work to. There are health and safety policies in place and the home has 2 health and safety representatives. All records required to be kept are in place and up dated as needed. Home Close Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 2 3 3 3 3 x x 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 Standard No 16 17 18 Score 3 3 3 2 3 2 3 x 3 3 2 Home Close Version 1.10 Page 19 no Are there any outstanding requirements from the last inspection? 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 14 Regulation 12(3) Requirement Service users must be consulted about changes to the home that will have an effect on their daily lives. Timescale for action From receipt of this report onward. 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. Refer to Standard Good Practice Recommendations Home Close Version 1.10 Page 20 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Home Close Version 1.10 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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