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Inspection on 01/09/05 for Inglemere House Residential Home

Also see our care home review for Inglemere House Residential Home for more information

This inspection was carried out on 1st September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This small family run home provides residents with a warm and friendly environment, which is clean and pleasantly decorated. Staff were caring and kind and residents appeared well looked after. Visitors are always welcomed at any time and are offered hospitality.

What has improved since the last inspection?

A number of improvements have been made to the home since the last inspection. The bathroom floor has been repaired, the taps in the washbasin have been replaced, the toilet roll holder has been replaced and the fire door at the top of the stair on the first floor closes properly. Concrete ramps have been added to the front and back door of the home to enable residents to enter and leave the building in safety. Care records have been improved so that staff know what care needs to be given to each resident. More activities are being provided to keep residents occupied. The menu has improved to offer residents more choice and variety.

What the care home could do better:

The repair to the bathroom floor needs to smoothed down so service users don`t trip. The door to the lift motor room needs to be locked to ensure staff and residents safety. The way staff are recruited should be improved to protect residents.

CARE HOMES FOR OLDER PEOPLE INGLEMERE HOUSE Waterloo Road Crowthorne Berkshire RG45 7NW Lead Inspector Julie Willis Unannounced 1 September 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. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Inglemere House Address Waterloo Road Crowthorne Berkshire RG45 7NW 01344 772120 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) Mrs Y Y Jackson Care Home 14 Category(ies) of Older Person (OP) registration, with number of places INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 05/05/05 Brief Description of the Service: Inglemere House provides a service for older people in need of care by reason of old age only. It is registered for fourteen residents of either gender. The home does not provide nursing care.The home operates within a Victorian house with later extensions to each side. The house is located in a residential area which is ten minutes walk of the shopping and other facilities in Crowthorne High Street.This is a privately operated home owned and managed by Mrs Y. Jackson, who lives on site most of the time. Mrs Jackson has operated the home since January 2000, having purchased it as a ‘going concern’ from the previous owner.The accommodation is on three floors. All the bedrooms are single with hand basins. There are two bedrooms with en suites (one is a bath/toilet, the other a toilet). The home has a passenger lift serving all floors. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a weekday morning and afternoon over a period of four and a half hours. A tour of the home was undertaken in which the service users accommodation and communal space were visited. A number of care records, staff files and health and safety documents were examined. The inspector spoke at length to 6 of the 10 service users, spoke to two visitors and three of the staff. The inspector spoke with the Homes Registered Manager/ Proprietor at the beginning and end of the inspection when brief feedback about the inspector’s findings was provided. All of the 14 requirements and 3 recommendations from the last inspection had been acted upon. There were 3 new requirements arising from this inspection. What the service does well: This small family run home provides residents with a warm and friendly environment, which is clean and pleasantly decorated. Staff were caring and kind and residents appeared well looked after. Visitors are always welcomed at any time and are offered hospitality. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 6 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. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 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 INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 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) 3 Service users are assessed by the home prior to admission to ensure the home will be able to effectively meet their need. EVIDENCE: Examination of the pre-admission assessment documentation evidenced that although minimal in content all necessary information was gathered which would form the basis of the care plan. Information about the users health and personal care needs would be gathered along with information about dietary needs, communication, mobility, history of falls, continence and mental state. The assessments were all carried out by the homes proprietor/manager either at home or in hospital. Where individuals had been referred through Care Management arrangements a copy of the Care Management assessment and care plan had been obtained. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 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 There is a care plan in place, which provides staff with sufficient information to enable them to provide appropriate care. Health needs of users were met with some evidence of multi-disciplinary working. The medication administration arrangements are clear and procedures are in place to maintain the safety of users. EVIDENCE: The ‘Standex’ system has been adopted by the home as a basis for the care plans. The proprietor recognises that this system is not particularly userfriendly, as it requires some medical knowledge to use it effectively. The proprietor has therefore produced a pen portrait of each user, which indicates their specific needs, likes and dislikes and assists staff to provide appropriate care in the way each resident wishes. Examination of the health notes indicated that along with regular screening and preventative treatments users are visited by their doctor at the home when required. Visits by the Community Nurses are also recorded. One user is INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 10 having regular dressings applied to a sore heel. Few users regularly visit the dentist but all users have 6 weekly chiropody treatments and yearly eye tests. A number of users have hearing difficulties and have been provided with hearing aids. The system for the administration of medication was a ‘monitored dosage system’ provided by a local chemist. The medication charts were pre-printed to reduce the likelihood of error and the storage and returning of drugs to the pharmacy was found to be safe and effective. The inspector had the opportunity to speak with several users who confirmed that the home met their personal care needs effectively and called a doctor when necessary. Several users confirmed that they were offered routine health screening and yearly vaccination against influenza. Residents said that staff were kind, caring and attentive to their needs. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 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, 13, 14, 15 Since the last inspection progress has been made to offer service users a range of activities designed to meet their needs. Visitors are made welcome and offered appropriate hospitality during their visits. The routines of the home are designed flexibly around the needs of users. The meals provided to residents are varied, nutritious, plentiful and tasty. EVIDENCE: Service users confirmed that since the last inspection they have had increased opportunities to engage in regular activities and entertainments. Each afternoon they are provided with a choice of games, quizzes and puzzles by the staff. Outside entertainers including ‘sing-a-longs’ and other musical entertainments are provided fortnightly. Two users go to a local day centre each week for coffee, cakes and to meet with friends. The service users are offered fortnightly communion by both the local Protestant and Catholic churches and the Brownies visit each Christmas to sing Christmas carols. The home is now keeping accurate records are kept of resident’s participation in these and other activities. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 12 The inspector had the opportunity to speak with two visitors during the inspection. The visitors said that they felt the home “was always clean’ comfortable and staff were warm, welcoming and hospitable”. They said that they could visit at any time and were always kept informed about the health and welfare of their relative”. The visitors were highly complimentary about a recent birthday party provided for one of the residents. They said, “ there was a huge range of food available” and “that they were pleased to see that all residents of the home were served before visitors and staff”. Discussion with staff and residents evidenced that users may rise and retire at a time of their choosing. All users can choose what they wear each day and are offered a choice of meal if they don’t want to eat what is on the main menu. Meals are provided at regular times but these may be adjusted to meet the needs of the users. Examination of the menu indicated that meals were varied and nutritious. Lunch on the day of inspection was lamb stew with potatoes, carrots and beans followed by Bakewell Tart and custard. Fresh fruit is prepared and offered to users each afternoon and drinks were offered frequently. Tea was soup and sandwiches followed by cake or ice cream. Bread butter and biscuits are offered with a hot drink later in the evening. Breakfast is cereal, porridge and toast or a cooked breakfast if required by users. Service users confirmed that the menu had improved since the last inspection and that the food was to their liking and was plentiful. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 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 The home has a satisfactory complaint system where users feel confident that their concerns will be listened to and acted upon. Service users are protected from abuse by staff that demonstrate knowledge of the homes abuse of vulnerable adults and whistle-blowing policies. EVIDENCE: Examination of the complaint record indicated that there have been 2 complaints made to the home since the 1st January 2005. The details of the complaint were well recorded and indicate that investigation has taken place and that a satisfactory outcome has been provided to the complainant. Service users and visitors were aware of how to make a complaint and felt confident that management would address the issues of concern. Staff interviewed by the inspector demonstrated a working knowledge of what actions may constitute abuse and were aware of the need to whistle-blow. All staff have received refresher training in the Abuse of Vulnerable Adults in the past three months and were appropriately certificated. One of the staff interviewed said that ‘abuse’ had been a core module of their NVQ level II. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 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, 26 The home was clean and hygienic throughout offering users a comfortable environment in which to live. EVIDENCE: Since the last inspection a number of premises issues have been addressed. All doors have been repainted where door furniture had been changed, the toilet roll holder in the first floor bathroom had been replaced, a new pair of taps had been fitted to the washbasin and the lino had been repaired. There is a need to ensure that the repair is flush with the rest of the flooring to avoid the risk of trip hazard. The fire door at the top of the stairs on the first floor has been fixed so that it effectively closes into its frame. There is a need to ensure that the lift motor room is kept locked so as to avoid a risk to staff and service users health and safety. The Occupational Therapists recommendations made in November 2004 have been acted upon including the fitting of a permanent concrete ramp to the rear and front entrances of the home and the fitting of a handrails and step to the shower. All flooring in the bathrooms is non-slip. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 15 Service users and visitors confirm that the home is always clean and comfortable and bedrooms are spacious and individually personalised. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 16 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) 29 The selection and recruitment procedures at the home require review to ensure the safety of users. EVIDENCE: Examination of the recruitment procedures at the home indicated a need to review the application form to ensure that more information is elicited from applicants to safe guard users from abuse and exploitation. There is a need to ensure that the application form asks for a complete work history and that two proper references are sought. Several staff files contained references that were not on headed paper and were not stamped to indicate authenticity. A number of references on file were from peers, friends or relatives of the applicant and had been sent to the referee’s home rather than the business address. Staff interviewed during the inspection confirmed that they had to complete an application form, give two references, complete a health questionnaire and provide evidence of identity. There was evidence on file of job descriptions, formal interview, job offer letter, contract of employment, induction and training certificates. Several staff have gained NVQ qualifications. All staff should have ah enhanced CRB (criminal records bureau) check. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 17 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) 33, 36 The home is currently reviewing aspects of its performance through a programme of self-review and consultations which include seeking the views of users, staff and relatives. Service users benefit from living in a home where staff are effectively supported and supervised in their work role EVIDENCE: At the time of inspection the home was undertaking a quality assurance survey of service users, their relatives, friends and staff. The responses will be collated by management and used to focus the service more effectively on the areas identified for action by the survey. The inspector spoke to 6 of the 10 residents who confirmed that they liked living at the home and felt that they were receiving a good quality service. Service users said that they felt that their opinions mattered and that staff would go out of their way to listen to them and to help. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 18 Service users benefit from the close working relationship between staff and management. Staff are being supported in their work role by the manager/proprietor who meets with them individually on a bimonthly basis and works with them daily in a ‘hands-on’ capacity offering support and advice when needed. Staff confirmed that they were able to express their opinions and that their ideas would be discussed in team meetings and acted upon accordingly. Service users told the inspector that they felt that the staff and management were approachable and caring. INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x 3 x x INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 20 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. 2. Standard 38 38 Regulation 13 (4) a 13 (4) a Requirement Ensure that lift motor room is kept locked Ensure that the repair to the lino in the first floor bathroom is flush to the floor and does not pose a trip hazard Ensure that the recruitment procedures and documentation are reviewed Timescale for action By 2.9.05 By 1.10.05 3. 29 19 (1) a By 1.10.05 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 INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA 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 INGLEMERE HOUSE H51-H01 S11127 Inglemere House V245608 010905 Stage 4.doc Version 1.40 Page 22 - 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. 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