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Inspection on 22/06/05 for Inglewood Residential Care Home

Also see our care home review for Inglewood Residential Care Home for more information

This inspection was carried out on 22nd June 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 home has a conscientious staff group, some of whom have worked at the home for a long time. The staff turnover rate is very low and over half of staff members are either qualified to NVQ level 2 or above or are undertaking their training. The home has a reward scheme for staff members who have completed their NVQ award. Service users spoke warmly about the manager and her staff and they said "nothing was too much trouble for them."

What has improved since the last inspection?

The dining room had been decorated recently and refurbished to provide a more pleasant homely environment for the service users. The new dining chairs enable some service users to sit and stand independently and in safety. The requirements and good practice recommendations that had been made at the previous inspection had all been acted upon except the inspector looked at some care plans that remained unsigned by the relevant service user.

What the care home could do better:

Although the care plans contained relevant information some service user or their representative had not signed their own plan of care to indicate that they were happy with what it stated. It is recommended that the manager looks at this matter and ensures that all care plans are reviewed and signed appropriately.

CARE HOMES FOR OLDER PEOPLE Inglewood 139 Dalston Road Carlisle Cumbria CA2 5PG Lead Inspector Jane Strawbridge Unannounced 22 June 2005 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. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Inglewood Address 139 Dalston Road Carlisle Cumbria CA2 5PG 01228 526776 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) Sylvia June Clark Sylvia Lynn Bendle Care Home 26 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 25 Older People 2. And 1 Older Person with Dementia Date of last inspection 10 February 2005 Brief Description of the Service: Inglewood is a care home providing accommodation and care for up to 26 older adults, one of whom may have dementia. The home is an older property, which has been adapted for its present use. It is situated in the Denton Holme area of Carlisle, approximately one mile from the city centre. The accommodation for service users is provided on two floors, and there is a passenger lift and stair lift. There is one bedroom that is shared by two people, the remaining rooms are for single occupancy. A large number of the bedrooms have ensuite toilet facilities. There are bathrooms, which are equipped to assist people with a disability. There are two communal lounges and a dining room. People who wish to smoke can do so in the conservatory. The home has a pleasant garden to the front of the home with seating. There is a small car park. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the home, and during the inspection the Inspector talked with the Manager, service users and care staff, looked at a selection of records relating to the care of service users and the day to day running of the home. The Inspector looked around all parts of the home including communal areas and service users private rooms. Requirements made at the last inspection had been met. What the service does well: What has improved since the last inspection? What they could do better: Although the care plans contained relevant information some service user or their representative had not signed their own plan of care to indicate that they were happy with what it stated. It is recommended that the manager looks at this matter and ensures that all care plans are reviewed and signed appropriately. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 6 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. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 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 Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 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, 5 The practice of the thorough assessment of potential service users ensures that the home can provide a service to meet all the needs of the residents. EVIDENCE: New service users were admitted to the home on the basis of an assessment of need. Prior to offering a place the manager or head of care visited the potential service user at home or in hospital to confirm that the home could meet the identified needs and to offer them information about the home. The care plans were drawn up using the available information gathered at this pre - admission assessment The senior staff encouraged prospective service users and their relatives to visit the home for the day to see for themselves whether the home would be suitable. Some service users confirmed that this had been useful in helping them to make a decision. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 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, 10, 11 The health and care needs of service users are well met with evidence of multi disciplinary working taking place on a regular basis. EVIDENCE: Each service user had a care plan detailing their health and social care needs and how these needs would be met. A recommendation had been made at the previous inspection because some care plans had not been signed by the service users or their relative. There were still some that had remained unsigned therefore the good practice recommendation remains until this shortfall has been addressed. The staff arranged for the appropriate health care professionals to attend to service users’ health care needs and they recorded visits to the home by district nurses and GPs. The district nurses visited daily if required and the chiropodist every three weeks. Assistance was given to service users to attend out patient appointments at local hospitals and clinics. Service users said that they felt comfortable when the doctor or nurse visited them because they were able to see them in private in their own room. They also said that the staff treated them with respect and courtesy and they always Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 10 knocked on their bedroom doors before entering. During the inspection this was seen to be the case. This home has a policy of observing the wishes of the service user who is seriously ill. They seek advice from the relatives and medical professionals would only move someone into hospital if necessary. The care plans had a section for the wishes of the service user after death with reassurances that these would be observed fully. The home encouraged the relatives of seriously ill service users to stay all day and night if they wished. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 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) 13, 15 Service users’ wellbeing is encouraged and promoted by continued social contact with families and friends. The meals in this home are good offering a varied range of food that meets the service users tastes and choices. EVIDENCE: Service users said that they enjoyed living in this home because they had been able to maintain their long - standing friendships as staff had encouraged them to invite friends into the home or to go out as much as they wished to social events. One service user said that she had been supported to organise taxis into town to meet up with friends for shopping and coffee or lunch several times a week. The home had an “open door” policy regarding their visitors who were welcome at reasonable times of the day. Service users said that their visitors were always made to feel welcome by the staff on duty when they visited. Some visitors saw their relative and friends in the communal rooms and others in the privacy of the bedrooms. The meals in the home are served either in the pleasant dining room or in service users’ own rooms. Three full meals a day were served, always with a choice of menu. Care staff provided assistance to service users at meal times as required. Service users said they enjoyed their meals and there was always a further choice if there was something on the menu that they did not want. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 Staff members have a sound knowledge and understanding of the home’s policies and procedures which protect service users from risk of harm or abuse. EVIDENCE: All service users had been given a copy of the home’s complaints procedure on admission to the home. There also were copies displayed in the private rooms. There had been no complaints since the last inspection. Service users said that they knew who to speak to if they were unhappy about something and they were confident that they would be listened to. Others said that they would ask someone else to speak on their behalf if necessary. Staff had been given training on the protection of vulnerable adults and how to recognise abuse. The home has a whistle blowing policy and the staff have been given training on how to use it. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 This home has been well maintained to provide a comfortable and safe environment for those who live and work there. EVIDENCE: The manager routinely identifies areas of the home that require maintenance and refurbishment and these are addressed in priority order. The home had a policy to replace carpets as soon as they showed any signs of wear and the inspector saw several rooms where new ones had recently been fitted. There had been some external damage to the building as a direct consequence of extraordinarily high winds earlier in the year. The occupants who shared the room nearest the damaged gable had agreed to move to the safety of a similar room nearby for their protection. The inspector was shown around the house which was clean and tidy, providing a homely yet hygienic environment for the benefit of service users, staff and visitors. Staff members had been given training in food hygiene and infection control and protective clothing and gloves were available for use at appropriate times. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 Staff turnover and sickness are low resulting in a stable trained and competent staff team that provides consistency of care within the home. EVIDENCE: On the day of the inspection there were sufficient members of staff on duty to meet the needs of the service users. The registered manager was in charge of the home and she was available to offer advice and support when needed. All care staff had been offered the opportunity to complete an NVQ in care and they were rewarded with a pay rise on achievement. Currently there were four members of staff who were taking the award at levels 2, 3 and 4. All care staff were given mandatory induction and foundation training following their appointment. The home offers a range of training opportunities for all staff and training records are kept. The manager said that there were some members of staff who had worked with her for the last 12 years and the majority of people who had left had done so to further their career or for personal reasons. Service users said that it was helpful to have few changes in the staff team because it meant they could get to know each other and they could remember staff names. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 33, 38 This home was managed effectively by a qualified and experience Registered Manager to ensure that staff provided the best possible quality of care for the service users. EVIDENCE: The registered manager has achieved the Registered Managers Award and NVQ Level 4 in care. She was in charge on the day of the inspection and was available to direct and support the staff on duty when needed. Service users said that they saw her whenever she was on duty and they felt that the home was managed well and she “had their interests at heart” dealing with any problems promptly. The home’s health and safety records showed the home’s staff group are committed about ensuring the health and safety and wellbeing of the service users, themselves and colleagues. The fire log was up to date and training for staff had been completed within the required time limits. Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 16 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 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 x 3 3 x 3 x x x x 3 Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 17 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations Care plans should always be signed by the service user or their relative if appropriate Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Inglewood F58 F10 s22693 inglewood v225825 220605 ui stage 4.doc Version 1.30 Page 19 - 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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