Inspection on 09/08/05 for Old Wall Cottage

This inspection was carried out on 9th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Old Wall Cottage 20/06/08

Old Wall Cottage 06/06/07

Old Wall Cottage 13/02/07

Old Wall Cottage 14/12/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Old Wall Cottage Old Reigate Road Betchworth Surrey RH3 7DR Lead Inspector Mary Williamson Announced 09/08/05 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. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Old Wall Cottage Address Old Reigate Road, Betchworth, Surrey, RH3 7DR 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) 01737 843029 European Healthcare Group plc CRH N 43 Category(ies) of DE(E) - Dementia - over 65 - 20 registration, with number MD(E) - Mental Disorder - over 65 - 32 of places OP - Old Age - 6 DE - Dementia - 2 Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate up to: 32 residents within MD(E), 20 within DE(E), 6 within OP and 2 within DE. The age range of residents accommodated will be: 65 years and over with 2 female residents being under the age of 65 years. Up to 2 (two) beds may be used for respite care. Date of last inspection 21/10/2004 Brief Description of the Service: Old Wall Cottage is a care home providing care and accommodation for fortythree service users whon are old some of whom have dementia. The home is located in Betchworth Village near to Dorking Town and all the local amenities. The home provides accommodation in twenty-four single and nine double rooms, all but three are situated on the ground floor. There is ample communal space available, to include well maintained garden to the rear of the property. Electronic gates leading to a car park in the front of the home also secures the home. Old Wall Cottage is now part of European Health Care Group Ltd. since May 2005. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and the first in The Commission for Social Care Inspection programme year 2005/2006. Mary Williamson who is the Lead Inspector for the service undertook the inspection over six hours. The home has changed ownership since the last inspection, and the new providers are European Health Care Group PLC. The home manager Mrs Glenys Scadden who has been in post since June 2005 was the organisations representative throughout the inspection. The Deputy Manager Mr. Paul May was also present for the duration of the inspection. A tour of the premises was undertaken and records relating to the care of the service users and the management of the home were examined. Two relatives comment cards were received. Several service users and four relatives were spoken to during the inspection. There was also the opportunity to talk with over half the staff team on duty. Service users were taking part in an exercise class during the morning and this was well attended. The home was functioning well and all service users were well cared for and relaxed. The inspector would like to thank the service users, relatives, staff, and the management team for their positive contribution to the inspection process. What the service does well: The home provides good quality nursing care to service users in single and shared rooms. Service users are well cared for by a team of staff in a caring and respectful manner. The senior management team are new to post since the home changed ownership in May 2005, and continue to develop the various policies and procedures required for the administration of the home. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 6 The catering arrangements in the home are well organised. The choice of food offered was wholesome, well balanced, and appetising. All service users who were able to express an opinion stated that the standard, quality, and quantity of the food is very good. 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 Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 7 contacting your local CSCI office. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 8 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 Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, and 3. Prospective service users do not have the required information available to them to make an informed choice about the home. Care needs assessments are undertaken prior to admission. These assessments need to be more detailed. Written client agreements are in place. EVIDENCE: The manager stated that the company are currently developing a statement of purpose and service users guide so therefore it was not possible to sample these documents during the inspection. One relative stated that he was given the information regarding the home verbally to include the fee range. The deputy manager and a senior member of staff undertook the most recent per admission needs assessment on a service user in hospital. A selection of assessments were sampled and these need to be more detailed to include specific dates of admission, social history, name and telephone number of GP, orientation and mental state, and written information on next of kin. The manager stated that she is introducing a new and more effective assessment tool for this purpose. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 10 Written client agreements are in place, which have been signed either by the service user or their designated representative. One copy is given to the service user and a second copy retained on file. These were sampled during the inspection. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 11 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, and 10. Appropriate arrangements are in place to ensure service users health care needs are being met. Individual care plans were randomly sampled with some minor shortfalls noted. The procedures for the administration of medication need to be reviewed. EVIDENCE: All the service users have an individual care plan in place, which outlines information regarding the physical care needs of service users. These plans are written from information gathered at the pre admission needs assessment, input from the service user and their relatives, and medical reports available at the time of completion. The care plans need to be developed to include social and emotional needs and must be signed by the service user or their relatives. Service users have access to appropriate health care services. They are all registered with a local GP who visits the home weekly or more frequently if required. Chiropody treatment is available six weekly. There is access to a dentist and an optician and visits can be arranged on a regular basis. Physiotherapy is available privately or on referral by the GP. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 12 There is a policy in place for the administration of medication. Currently there are no service users in the home who self medicate. Records are kept on all medicines entering and leaving the home. Facilities are in place for the recording and storage of controlled drugs. Practices must be reviewed to ensure that only qualified members of staff administer medication. It is also recommended that the medication cupboard mounted on the lounge wall is moved and re-sited in the clinical room. Staff were observed interacting with service users in a caring and respectful manner. They were observed to knock on bedroom and bathroom doors prior to entering. The home has several double rooms and during a tour of the premises two double rooms did not have screens to protect privacy and dignity. An immediate requirement was made accordingly. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 13 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, 14, and 15 Service users are able to maintain contact with their family and friends, and are supported to make choices in their daily life. The catering arrangements in place meet the assessed needs of the service user. EVIDENCE: On the day of the inspection there was an exercise class taking place in the dining room and was very well attended. The instructor stated that it is a very popular activity. Relatives and friends are encouraged into the home at any reasonable time. Four relatives spoken to during the inspection stated that they are well supported and kept informed of any relevant changes and that they are made welcome at any time. Staff stated that service users have the choice when they get up and go to bed. A choice of what clothing they wish to wear and preference to a bath or shower are also encouraged. A choice of menu is also offered and their preferred place to eat for example their own room or dining room is also considered. Since the last inspection the catering arrangements have been reviewed and the new organisation now employs a catering company to take responsibility Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 14 for all the catering arrangements in the home. The catering manager was present during the inspection and was able to provide details regarding the catering. Two chefs work to cover all meals throughout the week. Menus are planned on a six weekly cycle using as much fresh, seasonal, produce as possible. Special diets are catered for and currently there are seventeen service users having a pureed diet. There is the opportunity for drinks and snacks to be served throughout the day. Relatives may also have a meal with service users by arrangement. The kitchen was clean and orderly and the kitchen staff stated that were looking forward to the delivery of a new dishwasher. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 15 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, and 18. Service users and their relatives can be confident that their complaints will be acted upon. Procedures are in place to protect service users from abuse. EVIDENCE: The organisation has produced a new complaints procedure and a copy of this is included in the “clients agreement”. There have been no recorded complaints since the last inspection. During discussion with service users and some relatives it was evident that they understood this procedure. They also reported that they had no concerns or complaints about the home. The home has a copy of Surrey’s Multi Agency Procedures for the Protection of Vulnerable Adults in place. The manager stated that all the long- standing staff members had received training in these procedures, and that training would be organised for all new staff. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 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 standard(s) 19, 21, 24, and 26. It was evident from a tour of the premises that service users live in a safe environment, which was clean and tidy and free from mal odour. One bathroom was being used inappropriately to store equipment. EVIDENCE: The location and layout of the home is suitable for its stated purpose. There is an ongoing programme of decoration and refurbishment in place and several carpets and floor covering has been replaced since the last inspection. There are ample toilet and bathroom facilities located throughout the home. Some of these have been adapted to meet the assessed mobility needs of the service users. Bathroom 24 is being used inappropriately to store a collection of wheelchairs, a hoist, and toilet seats. Alternative storage facilities must be provided for this equipment. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 17 Accommodation is provided in twenty -one single and nine double rooms. These rooms are well decorated and have been personalised to reflect individual personalities. It was noted that two double rooms did not have screens to preserve the privacy and dignity of the service users occupying these rooms. A requirement has been made accordingly. The home was clean and tidy and free from mal odour. Arrangements are in place for the collection of clinical waste. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 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 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 and 29. The service users care needs are met by the number, and skill mix of staff employed in the home. The home does not have a recruitment procedure in place and this reflected in the shortfall of employment documentation in place. EVIDENCE: The duty rota was sampled and the staff spoken to. There was a good mix of staff skills available on each shift to meet the assessed needs of service users. Service users and relatives stated that the care provided is good and they were satisfied with the level of support available. The home needs to develop and implement a recruitment procedure to safeguard the service users in the home. Five staff employment files were sampled and all five did not have a Criminal Records Bureau (CRB) check in place. There were also a number of written references not in place. A discussion took place with the manager regarding this and a requirement has been made. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 19 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, and 38. The home is run in the best interests of the service users. The manager is newly appointed to post and is supported by a deputy manager also newly appointed. EVIDENCE: The home changed ownership in May 2005. The organisation has appointed a manager who has an application in progress with The Commission for Social Care Inspection to become the registered manager of the home. A deputy manager who, was appointed in July 2005 supports her. There is also a new administrator in post and recognition should be given to all three staff for all they have achieved in two months. The home is operating well, and the senior management team continue to identify and develop the required policies and procedures necessary for the smooth management of the home. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 20 Risk assessments are in place for safe working practice. Health and safety policies and procedures were sampled during the inspection and were satisfactory. Some steps in communal hallways were identified as being a trip hazard due to cracked rubber trims and need to be replaced immediately. The fire safety records were seen and are satisfactory. All staff receive fire safety training as part of their induction training. The procedures in place for the recording of accidents are satisfactory. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 21 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 2 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x 2 x 3 STAFFING Standard No Score 27 3 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 3 x 3 x x x x 2 Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 22 NO Are there any outstanding requirements from the last inspection? Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 23 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 1 Regulation 5(1)(a) Requirement The service users must be provided with a statement of purpose and service users guide prior to admission to the home. A well documented care plan and assessment of needs must be in place for all service users and these must be signed by the service user or their representative. The registered person must make arrangements fot the safe handling, administration and safe keeping of medication. The registered person must make proper provision to preserve the privacy and dignity of service users and provide screens in double rooms. The registered person shall provide suitable storage facilities for equipment required in a crae home. The registered person must ensure that all necessary documentation is in place prior to the commencement of employment, this is to include written references. The registered person must ensure that all parts of the care home are kept in a good stste of repair to include the rubber trim on cteps which have been identified as a potential trip hazard. Timescale for action 21/09/05 2. 2 and 7 15(1) 21/09/05 3. 9 13(2) 21/09/05 4. 10 and 24 12(4)(a) 21/09/05 5. 21 23(2)(j) 21/09/05 6. 29 19(1)(b) 21/09/05 7. 38 23(2)(b) 21/09/05 Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 24 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 9 Good Practice Recommendations It is recommended that the medication cupboard mounted on the wall in the large lounge is mover to the clinical room. Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Old Wall Cottage h09-h58 s64426 Old Wall Cottage v235237 090805 Stage 4.doc Version 1.40 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. 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