Inspection on 24/09/05 for Katherine House Rest Home

This inspection was carried out on 24th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Katherine House Rest Home 02/02/10

Katherine House Rest Home 17/09/08

Katherine House Rest Home 26/09/07

Katherine House Rest Home 14/02/07

Katherine House Rest Home 28/02/06

Katherine House Rest Home 05/03/05

Katherine House Rest Home 17/08/04

Katherine House Rest Home 18/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE New Cote Rest Home New Cote Rest Home Cote House Lane Westbury On Trym Bristol BS9 3UW Lead Inspector Sandra Gibson Unannounced Inspection 24th September 2005 11:45 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 New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 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. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service New Cote Rest Home Address New Cote Rest Home Cote House Lane Westbury On Trym Bristol BS9 3UW 0117 9873540 0117 987773631 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) The Cote Charity Mrs Ann Collins Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th March 2005 Brief Description of the Service: New Cote Rest Home is managed by The Cote Charity and is registered by The Commission for Social Care Inspection to provide personal care to twenty-four residents of mixed gender aged 65 years and over. It is set in secluded grounds a short distance away from Durdham Downs in Bristol. The home is accessible with rooms on one level plus lift to the first floor. The gardens are accessed by way of a sloped ramp. It is situated close to major bus routes and amenities. The City Centre is also a short distance away. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on a Saturday between the hours of 11.45am and 5.15pm. The inspection focussed on general care and welfare of residents. During the inspection six residents, one visitor and two family members were spoken to. A range of different records were examined that included care, health and safety and complaints. What the service does well: What has improved since the last inspection? The information provided to residents and their representatives has improved considerably since the last inspection. This information now ensures that residents can make an informed choice about whether they wish to live at New Cote Rest Home. The system in place to assess a prospective residents needs before admission has improved. Therefore ppeople moving to New Cote Rest Home can be sure that their needs can be adequately met. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 6 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. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 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 New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 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 the following standard(s): 1,2,3,4,5 The information provided to residents and their representatives has improved considerably since the last inspection. This information now ensures that residents can make an informed choice about whether they wish to live at New Cote Rest Home. The system in place to assess a prospective residents needs before admission has improved. People moving to New Cote Rest Home can be sure that their needs can be adequately met. EVIDENCE: There is now a combined statement of purpose and service users guide in place the information gives clear details about how the home operates, what facilities are available and how to make a complaint. The inspector noted that it was readily available for people to view in the office and all current residents had been provided with one. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 9 During the inspection it was noted that a family member who was helping her mother to choose a care home was being shown around by the deputy manager. There is new needs assessment documentation available for the manager and deputy manager to carry out a full assessment before somebody is admitted to the home. Residents admitted to the home have the opportunity to have a formal review with the support of their relatives within 4-6 weeks to ensure that the quality, facilities and suitability of New Cote Rest Home meets their needs. Details of reviews were seen in the sample of case records examined. permament. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 There has been some improvement in care plans and individual risk assessments since the last inspection. Further work is required to ensure that residents’ needs are fully identified and met. The healthcare needs of residents are well met with evidence of good multidisciplinary working taking place on a regular basis. However the medication administration system needs to be improved to protect service users and safeguard staff. EVIDENCE: From the sample of care plans examined it was noted that there were lists of needs identified, but very little detail of how those care needs were going to be met. There was also no evidence of resident or family involvement in compiling the care plans. In some instances there was no signature or date recorded by the member of staff who completed the care plan. This is an ongoing requirement from the last inspection. Up to date risk assessments were noted to be in place. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 11 There was evidence in place to confirm that General Practitioners, Physicians, District nurses, physiotherapists, occupational therapists and chiropodists are all contacted at the appropriate time. Records confirmed that residents were assisted to attend hospital appointments where planned. The deputy manager informed the inspector that there were no residents with pressure sores at the time of the inspection. The systems for the administration, storage and disposal of medication were examined. New Cote Residential Home continues to use the blister pack dispensing system, and the deputy manager told the inspector there was a new community pharmacist who had recently visited the home. It was noted that this pharmacist plans to continue to provide training on the administration of medication to all care staff involved with this practice. A selection of four residents’ medication administration charts were examined. There was an up to date photograph of the individual maintained in each record seen. The administration charts were all up to date, and in good order, and recorded the signature of the member of staff dispensing the medication, or the reason for any omissions of medication. It was noted however that some controlled medication had not been returned to the pharmacy following the death of a resident seven months previously and also that a sample of medication that must be treated like controlled medication was not. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 New Cote Rest Home provides residents with the opportunity to experience a stimulating and varied life where various informal activities are regularly made available. Visitors are made welcome and meals are well managed and provide daily variation, good nutrition and social contact for people. EVIDENCE: There are various activities organised for residents including a regular quiz, armchair keep fit, music and reminiscence sessions. A couple of residents spoke about the jig saw puzzles/ board games available. There is a visiting Red Cross Library and books are Residents told the inspector that church of England services are held at the home once a month and the vicar comes at other times to take communion for some residents. Hymn singing is a regular event on a Sunday evening. A “Pat dog Scheme”. Is in operation. This is organised by a volunteer who visits the home once a week for two hours with her “Pat dog” which residents and staff enjoy patting and making a fuss of. There are regular excursions to local places of interest in the home’s minibus. There are regular resident’s meetings held in the home. A copy of the minutes of the last meeting was available for residents to see in the dining room. It was noted that activities, excursions and catering are regular items discussed in the home. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 13 One resident said “there is enough going on for me here. I am very happy to be here and I am looking forward to the clothes show this afternoon”. One family member said that “I visit my mother at different times of the day and week and I often see the staff chatting to mum. She is often not in her own room but sitting in the conservatory or TV room. She never looks isolated” Another visitor seen during the inspection said “My friend likes it here. She never looks bored and the staff are very attentive,” Both visitors confirmed that they are made to feel very welcome when they visit and are always offered hot drinks by the staff. One visitor said, “the staff are always helpful and always have time”. The inspector did not participate in the communal lunch on this occasion. But all five residents and two visitors confirmed that the food continues to be of a high standard. One resident said, “The food is very good here. They adapt to each persons likes and dislikes. They spoil me”. Another resident said, “The food is good”. One relative said, “ The food is very good here and my mother always has a drink beside her. When she was not well they pureed mum’s food and gave her nutritional drinks.” New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents and their relatives are confident that their concerns will be listened to and have been made aware of the complaints procedure. Arrangements for protecting residents from harm has improved since the last inspection but further work needs to take place to protect residents from possible risk or harm. EVIDENCE: The complaints log was examined it was noted that there had been one complaint from a resident since the last inspection. It was noted that this complain had been dealt appropriately by the manager. Residents, relatives/ and one visitor told the inspector that they were comfortable talking to the manager and deputy manager about any concerns. One relative said: “If I had a complaint I would talk to one of the manager or mum’s key worker. The staff are very respectful towards mum and other residents”. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 15 One resident said “They are very good here, very discreet”. Her visitor confirmed that the resident in question was very content at New Cote and never complained about anything. One resident said, “I have no complaints. If I did I would talk to the manager or person in charge”. Another resident said. “The staff are very good. I am quite content. There are no members of staff I could complain about. No one I would call spiteful or vindictive. All respectful. If I did have a complaint I would talk to the manager.” The Commission has received no complaints for Social Care Inspection since the last inspection. ‘No Secrets in Bristol’ (Local authority Adult Protection procedure) is in place in the home and was noted to be very accessible to all staff. However, it was disappointing to note that none of the staff including the manager and deputy manager have attended adult protection training. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 19,20,21,22,23,24,25,26 A comfortable, clean, safe standard of accommodation is provided for the residents of New Cote Rest Home. EVIDENCE: In general, the environment is well maintained and suited to residents needs. Accommodation for disabled residents is available on the ground floor. New Cote Rest Home is decorated and furnished to a standard that creates a comfortable homely atmosphere. There is a programme of redecoration and refurbishment to further improve the environment. There are a number of lounges through out the care home in which residents and relatives were seen using and appeared comfortable and relaxed. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 17 Residents’ bedrooms looked homely and were personalised with resident’s personal possessions and furniture. The toilet and bathroom facilities are sufficient to meet the needs of the residents. Equipment to support disabled residents is available. The home smelt fresh and the rooms were cleaned to a high standard. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staff are employed in sufficient numbers to meet the residents’ needs. However, there has been very little improvement in staff training since the last inspection with the result that residents may not always be in care for by experienced staff. The staff recruitment procedure needs to be improved to ensure that all service users are protected at all times. EVIDENCE: The staff rota confirmed that there were satisfactory staffing levels in place to meet current residents’ needs. One regular visitor to the home said” I have never noticed staff shortages during my visits, which are on different days and at different times”. Residents spoken to said that staff were very helpful and supportive, that they were treated with respect and they had no concerns. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 19 The following training had taken place in the home during the last twelve months, Induction training for new staff, including: fire safety training, basic food hygiene, manual handling. It was noted however that there was no evidence to confirm that foundation training and specialist training is offered to staff members following their induction. Despite a requirement being made following the last inspection. However it was noted that one member of the care staff was due to start NVQ3 and all senior care staff have obtained NVQ 2. One staff personnel file was examined. It indicated that the manager had not undertaken all the necessary recruitment checks to ensure the protection of residents. The Protection of Vulnerable adult list check had not been carried out prior to a care staff member working in the home. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38. The management team have made good progress in updating their knowledge and skills since the last inspection, which ensures that residents and staff benefit from good leadership. The system in place to support staff and protect residents has improved since the last inspection, but this formal support is long overdue. Further progress needs to be made urgently if this system of support is to be established effectively in this care home. The systems in place to review the health and safety of residents and staff have improved since the last inspection. However, further improvement in record keeping needs to take place to ensure the safety of residents and staff at all times. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 21 EVIDENCE: The deputy manager informed the inspector that herself and the manager were due to start the NVQ4 in Care leading to The Registered Managers Award. The deputy manager is also enrolled to do a manual handling course in training for trainers. It was also noted that the manager and deputy had both recently completed an Introduction to mental health and challenging behaviour. No other staff have received this training to date as discussed previously. Formal supervision has recently been provided to the deputy manager by the manager. However, no other staff member has received formal supervision despite a requirement being made at the last inspection. A formal quality assurance system is in the process of being set up with the support of the nominated responsible individual. It was noted that The Commission for Social Care Inspection receive regular monthly reports about the service provided by New Cote Rest Home. The fire log was examined and it was noted that all periodic tests and checks were up to date. However no fire risk assessment could be found in the care home. New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 22 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 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 x 11 x 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 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 2 3 2 New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 14 Requirement The resident and/or representative must be consulted when compiling a care plan Timescale for action 22/11/05 2 OP9 13(2) All controlled medication must be 24/09/05 returned immediately to the pharmacist when no longer in use All medication that must be treated like controlled medication must be stored appropriately 3 OP18 13(6) All staff including the management team must receive Adult Protection training A Protection of Vulnerable adults list check must be completed on all staff before they work in the home. 24/03/06 4 OP29 19(1) 24/09/05 New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 24 5 OP30 18 (c ) All staff must be provided with foundation training, which meets the National Training Organisation Specification. They must also receive any specialist training that is necessary to meet individual residents needs. This is an outstanding requirement from inspection conducted in March 2005 All care staff must receive formal supervision at least 6 times a year. This is an outstanding requirement from inspections conducted in March 2005 and August 2004 A fire risk assessment must be completed in order to comply with Fire Safety (work place regulations 1997) It must be available for inspection at all times 24/03/05 6 OP36 18(2) 24/12/05 7 OP38 23(4)(a) 24/11/05 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 OP7 Good Practice Recommendations A signature should be obtained from the resident and/or their representative where possible. If not possible the reasons why should be recorded New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 New Cote Rest Home DS0000026512.V253609.R01.S.doc Version 5.0 Page 26 - 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. 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