Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Hope Cottage 5-7 Pilkington Road Southport Merseyside PR8 6PD The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Daniel Hamilton Date: 1 4 1 0 2 0 0 8 Information about the care home
Name of care home: Address: Hope Cottage 5-7 Pilkington Road Southport Merseyside PR8 6PD 01704536286 01704543222 hopecottage@cedarscaregroup.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Hope Cottage Limited care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia 0 Over 65 26 Conditions of registration: Service users to include up to 26 DE (E) The service should employ a suitably qualified and experienced Manager who is registered with the CSCI. Date of last inspection Brief description of the care home Hope Cottage is a residential care home that provides care for older people with dementia. The home is Registered for 26 residents and is owned by Hope Cottage Ltd. The Responsible Person is Mr T Yilmaz. The home currently has a vacancy for a Registered Manager. Hope Cottage is situated within a suburb of Southport and is within easy reach of the town centre [1 mile]. The home has been extended to include a conservatory and further bedrooms, bathrooms and toilets. The facilities are spread over 2 floors with a passenger lift serving the first floor. All communal space is on the ground floor and includes lounge, conservatory and dining room facilities. There is an enclosed garden to the rear of the building and parking space at the front. A ramp has Care Homes for Older People Page 2 of 11 been added to provide disabled access. 3 of the bedrooms can provide for residents to share. The current fees at the home range between £415.00 - £510.00 per week. Care Homes for Older People Page 3 of 11 What we found:
The reason for this random inspection was to look at the circumstances surrounding the fall of a resident living in the home on the 24th September 2008 following a door leading from the home to the laundry being left unlocked. The investigation was undertaken by an inspector from the Commission for Social Care Inspection and an officer from the Environmental Health Department. Outcome area - Choice of Home. Examination of records confirmed that a range of assessment information had been undertaken by the service for the resident, prior to being admitted to the home. Copies of assessments had also been received from health and social care professionals, which provided information on the residents health, personal and social care needs. The assessment from a health care professional detailed that the resident had got out of her previous care home on two occasions and was known to wander. Risk assessments had also been completed for a range of areas by the service. The mental health assessment highlighted that the resident had unpredictable behaviour and the service user risk assessment highlighted that the resident needed the supervision of one carer inside the home. The falls risk assessment highlighted that the resident had a history of falls and had two falls in September, two in August and one in July and June. It was difficult to audit the full details of some of the falls as accident reports had not been completed for some incidents. Outcome area - Health and Personal Care. A care plan had been developed for the resident by the service which had been kept under monthly review. The care plan outlined the assessed need; aim of care and key worker instructions. Assessed needs recorded were Maintain a safe environment; communication; breathing; eating and drinking; elimination; personal hygiene; controlling body temperature; mobility; sleeping; mental state and work and play. The care plan completed for the resident provided limited information on how the persons needs were to be met. Similar issues were noted at the last inspection and a recommendation was made for staff to provide more detailed information on how the needs of the people using the service are to be met. The care plan for the resident detailed that Staff are to observe 24 hours a day and ensure the environment is secure and hazard free as possible in the maintain a safe environment section. Furthermore, the care plan detailed that X [resident] is mobile at present with no difficulties and can wander around in the mobility section. A copy of a care plan from a social worker had also been obtained for reference. Outcome area - Environment. The area where the incident occurred was inspected by an inspector from the Care Homes for Older People Page 4 of 11 Commission for Social Care Inspection and an officer from the Environmental Health Department. Since the accident on 24th September 2008, a new door and keypad lock had been fitted at the entrance of the corridor leading to the staff room. A notice was also displayed on the door which had been left unlocked on the day the accident had occurred. The notice detailed: It is imperative that all staff ensure that this door shuts behind them before going into the laundry or out into the garden. This is a very important health and safety issue and must be adhered to. Staff spoken with during the inspection all confirmed that there had been a notice displayed on the door prior to the accident. The door which was left unlocked had been fitted with a yale lock. Furthermore, a new hand rail has been fitted alongside the steps leading out from the home to the laundry. Remedial actions taken since the accident appeared satisfactory and provided better safeguards for the people using the service. A recommendation was made by the environmental health officer to highlight the edge of the treads on the steps, to make them more visible for service users. Outcome area - Staffing. The acting manager reported that there were 23 residents living in the home on the day the accident occurred. On the day of the random inspection there were 19 people being accommodated. Examination of rotas revealed there were three care staff on duty on the morning of the 24/09/08 and this was confirmed in discussion with the Acting Manager. The acting manager also reported that she had been working in a supernumerary capacity and that the administrator had been on holiday. Individual statements from the care staff on duty highlighted that none of the staff were providing care or supervision to the residents at the time of the visit. One carer was outside in the garden hanging washing on the line, a second carer was upstairs making beds and the third carer had gone upstairs to the office at the time the incident occurred. Domestic staff on duty on 24/10/08 were spoken with to establish where they were at 10.00 am and what they were doing. Both the domestic staff reported they were undertaking cleaning duties away from the proximity of residents and were not providing direct care or supervision. Training records viewed confirmed that the three staff on duty had all completed dementia awareness training and a variety of training relevant to their role. Concern was noted that one of the employees on duty had completed only a two hour training course in dementia. Management & Administration Care Homes for Older People Page 5 of 11 The acting manager reported that she had commenced employment in the home on 14/07/08 and examination of training records detailed that the manager had completed a range of training including a National Vocational Level 4 Registered Managers Award and training in dementia and challenging behaviour. The acting manager reported that she was responsible for the production of the staffing rotas and that ancillary staff were no longer employed for laundry duties which was contrary to the information recorded in the previous inspection reports. The incident report detailed that The number of staff on duty at the time of the incident was normal and all were attending to their duties. Concern regarding the staffing levels and arrangements for allocating care and noncare duties was discussed with the manager. The staff allocation sheet detailed staff duties for am and pm but times were not detailed. Therefore, there was potential for all three staff to be engaged in non-care duties at the same time and to overlook the direct care and supervision needs of the people using the service. A staffing and dependency assessment tool had not been established as discussed with the previous manager at the last inspection. What the care home does well: What they could do better:
Arrangements must be made to ensure the care and supervison of the people using the service at all times, to safeguard the health and welfare of vulnerable people living at Hope Cottage. Staffing levels must be reviewed to ensure there are suitably qualified, competent and experienced persons working at Hope Cottage in sufficient numbers to respond to the diverse needs of the people living in the home. Care plans must describe in detail how the assessed needs of service users are to be met. This will help staff to understand how to deliver person-centred care and support in response to assessed needs. A record of all falls and treatment provided to service users must be maintained. This will help to provide information on the circumstances of the falls, injuries sustained and action taken. Reference should be made to guidance produced by the Residential Forum to ensure the staffing levels in the home are appropriate for the needs of the people using the service. The staff allocation sheet should be revised to detail the time that staff are to undertake specific non-care duties, to ensure staff are available at all times to provide direct care and supervision for the people using the service. Care Homes for Older People
Page 6 of 11 All staff should complete comprehensive training in dementia and an assessment of their skills and competency should be undertaken. This will help to ensure that the people using the service are supported by competent staff who fully understand the diverse needs of older people living with dementia. The edge of the treads on the outside steps should be highlighted, to make them visible for service users. 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 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 11 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 1 27 12 Proper provision must be made for the care and supervision of service users at all times. This will safeguard the health and welfare of vulnerable people. 17/12/2008 2 27 18 Suitably qualified, competent 17/12/2008 and experienced persons must at all times be working at Hope Cottage in such numbers as are appropriate for the health and welfare of the people using the service. This will ensure that their are sufficient staff on duty to meet the diverse needs of the people living in the home. 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 7 15 Care plans must describe in 17/12/2008 detail how the assessed needs of service users are to be met. This will help staff to understand how to deliver person-centred care and support in response to assessed needs. Care Homes for Older People Page 9 of 11 2 7 17 A record of all falls and treatment provided to service users must be maintained. This will help to provide information on the circumstances of the falls, injuries sustained and action taken. 17/12/2008 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 2 19 27 The edge of the treads on the outside steps should be highlighted, to make them more visible for service users. The staff allocation sheet should be revised to detail the time that staff are to undertake specific non-care duties, to ensure staff are available at all times to provide direct care and supervision for the people using the service. Reference should be made to guidance produced by the Residential Forum to ensure the staffing levels in the home are appropriate for the needs of the people using the service. All staff should complete comprehensive training in dementia and an assessment of their skills and competency should be undertaken. This will help to ensure that the people using the service are supported by competent staff who fully understand the diverse needs of older people living with dementia. 3 27 4 30 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 © (2008) 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 11 of 11 - 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. You have been warned!
