Inspection on 06/01/09 for Pool Cottage Care Home

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pool Cottage Care Home 21/07/08

Pool Cottage Care Home 30/05/07

Pool Cottage Care Home 30/06/06

Pool Cottage Care Home 23/01/06

Pool Cottage Care Home 26/09/05

Pool Cottage Care Home 09/03/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pool Cottage Care Home Pool Road Melbourne Derbyshire DE73 8AA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Claire Williams     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Pool Cottage Care Home Pool Road Melbourne Derbyshire DE73 8AA 01332863715 01332863715 poolcottage@clara.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mutebi Blessious Kalemeera care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Pool Cottage is a detached property, which has been adapted and extended to provide personal care for up for up to 17 persons aged 65 years and over, and day care for up to 3 persons. The home overlooks Melbourne lake and is close to the town centre, local shops and a bus route. The home has 11 single and 3 double bedrooms located on the ground and first floor, 7 bedrooms have ensuite facilities. Access to the first floor is by stairs and a stair lift. There are 2 lounges, a conservatory and a dining room on the ground floor. The Home has a garden. Information about the service is provided through the Statement of Purpose and Service User Guide, both of which were made available to individuals. 0 Over 65 17 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was unannounced and took place over a period of 6 hours. This is the second Key inspection visit to this service. Following our previous inspection we found that the service was providing poor outcomes for people. This visit was undertaken to monitor and ensure improvements had been made to the service provided to people. In order to prepare for this visit we looked at all of the information that we have received since our last visit which was undertaken on 21/07/08. This includes: Notifications, and information received from the service about events that have occurred. We also used the improvement plan we received as evidence of the improvements the provider said they would make. Care Homes for Older People Page 5 of 25 During the site visit case tracking was included as part of the methodology. This involved the sampling of a total of two people representing a cross section of the care needs of individuals within the service. Discussion were held with those individuals as able, together with a number of others about the care and services the home provides. Their care planning, and associated care records were also examined and their private and communal facilities inspected. Discussions were also held with staff about the arrangements for their deployment, recruitment, induction, training and supervision, and records examined to support the procedures in place. There have been no changes to the fees to live in this service, since our last visit and these have remained as, 367 to 402 pounds per week. Information about what these fees cover are included in the statement of purpose and service user guide. What the care home does well: What has improved since the last inspection? The service had 8 requirements that we issued following our last visit. This visit confirmed that improvements have been made in all of these areas to address or to work towards addressing each of these. The following improvements have been made: The care plans are currently being updated to ensure they include peoples preferences and are person centred. This is to ensure staff have access to the required information to deliver individualised care. Contact has been made with the pharmacy to request a visit to ensure the service meets the new legal requirements for the storage of controlled drugs. A renewal and redecoration programme is in place, which has clear timescales. There was evidence to support some investment has been made in order to undertake work on the building on a priority and need basis. Care Homes for Older People Page 7 of 25 The recruitment practices have been improved and funds are now available to ensure that all of the required checks are undertaken before new employees commence employment. This ensures people are safeguarded from any risks. Arrangements have been made to organize training for staff in relation to the Mental Capacity Act. This will ensure staff will have the skills and knowledge to promote peoples right to make decisions about their life. The staff team have access to the required mandatory training to ensure they maintain their skills and knowledge in order to fulfill their role and responsibilities. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed to ensure the service is able to meet their needs. Evidence: People told us they still have access to information about the service, and they confirmed they have received a copy of the Service user guide. These documents will be reviewed in the near future due to a planned change to the management structure. Individuals and their relatives confirmed they had been assessed before they moved into the home, and this was supported by the assessments in the files that we sampled. One relative we spoke to told us that they found the admission process to be a positive one, and that the staff were very supportive. Individuals spoken with said that they found that visiting for a period of respite enabled them to try the place out and make an informed decision about moving in on a permanent basis. Care Homes for Older People Page 10 of 25 Evidence: The home does not provide intermediate care and there were no residents accommodated at the time of the site visit with diverse cultural or religious needs. The pre-admission documentation is currently being updated to include the six areas of diversity, so that is it inclusive to all people. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a care plan which covers their personal, health and social care needs, which they had been involved in making. This ensures support is provided based on their preferences. Evidence: In the files that we sampled a care plan was in place. We made a requirement in this area following our last visit and work is ongoing to update each file to ensure they are person centred and reflect peoples preferences. This will ensure people receive individualised care which meets their expectations. The care records that we sampled confirmed that contact with external health care services is routinely made, particularly the local doctors and district nurses, as well as a number of health care services, chiropody, and opticians. People we spoke to also confirmed this. All people spoken to told us they receive support which is provided in a safe, respectful Care Homes for Older People Page 12 of 25 Evidence: and dignified manner, and our observations supported this. Discussions with relatives also confirmed this to be the case. People and their relatives spoke positively about the staff team and comments made include; They do an excellent job, and always with a smile, They are marvelous, caring and friendly, I dont think I could be looked after any better than how I do here. People told us they receive their medication in accordance with their wishes. Records were in place to support that medication was stored and administered as prescribed. Staff members that administer medication have undertaken some form of training in this area. Records supported that arrangements to complete an assessment of their practice has commenced. This will ensure staff undertake these tasks safely and in accordance with the procedures. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People find the lifestyle experienced in the service meets their expectations and preferences. Evidence: All care files that were seen contained some information concerning peoples social needs and likes/dislikes. As stated work has commenced to update each persons file to make them person centred and holistic so they cover all areas. Information is provided in peoples file about their life history, which enables the staff team, to learn more about the person and their background. People told us the activities available meet their expectations and the relatives spoken with said that people have enough to do. During our visit people and staff attended a catholic service. People told us they really enjoyed the service and the songs. People told us about their Christmas festivities and how they enjoyed the parties that took place. Each person was presented with a gift from the service which consisted of a photo which was taken of them now, which was scanned into a picture of them when they were younger. People commented on how nice this gift was. A newsletter continues to be provided on a monthly basis, to inform people about future events or about the future plans of the service. We looked at the Care Homes for Older People Page 14 of 25 Evidence: newsletter for December and this demonstrated that several activities were provided, some of which included: Cinderella panto, holistic massages, and school children visited to sing carol songs. There were many visitors in the service during our visit and observations supported they were welcomed into the service. People told us they could see their visitors whenever they wanted and could use either their bedroom or the quiet lounge for privacy. People told us their daily routines continue to be flexible, and they could choose what time they rose and went to bed. People who wanted to stay in their bedrooms were able to do so. People told us the food continues to be good and tasty and that they have choices, which we observed when we joined people for their lunch. People continue to be independent at mealtimes as terrains are provided on the tables for them to help themselves. The cook had information about peoples dietary requirements and their likes and dislikes which is good practice. A brief visit was made to the kitchen and good standards were maintained and all required documentation was in place. Following the recommendation we made previously made, new crockery and equipment has been purchased for the kitchen. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew how to complain and had confidence their concerns would be listened to and addressed. Evidence: There has been no change in this area since our last visit. People have access to a complaints procedure and they told us the management and staff are always available to listen to concerns and their views. The service or CSCI have not received any complaints since our last visit. The staff members spoken to told us they contine to access training in relation to safeguarding vulnerable adults and the training records supported. The service or CSCI have not received any safeguarding referrals since our last visit. In response to a requirement we made following our last visit, staff have received an informal talk about the mental capacity act and how its affects them in their role. Formal training has been arranged and some staff will attend this in February. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe environment, but several areas would benefit from renewal, which would enhance peoples lives. Evidence: There was evidence to support that since our last visit there has been some investment into this service. This includes essential work that was required following the Fire and Environment Health officers visit. Work has also been completed following the landlords visit, which is undertaken to ensure the external and internal areas are maintained. A renewal and maintenance programme is in place and is ongoing to renew areas on a priority basis. A handy person is employed and undertakes work in accordance with the programme in place. A tour of the building was undertaken and all areas were found to be safe for people to use. Many internal areas require redecoration and high cleaning is required in the conservatory. We were told this would be added to the programme and addressed. People who were spoken to said they liked the communal areas and in particular their bedrooms which they had personalised with their belongings. People said they continue to have access to various aids and equipment in order to assist them in their Care Homes for Older People Page 17 of 25 Evidence: mobility and to get around the home. On the day of our visit the building was clean, tidy and free from odour and everybody spoken to was very complimentary about the service provided by the laundry. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a competent staff team, who have been recruited to ensure they are safeguarded from any harm. Evidence: In response to the requirement issued following our previous visit, the recruitment practices have been improved, to ensure staff are vetted appropriately before they commence work. The issues in relation to the funding of such checks has now been addressed and we have received confirmation that sufficient funds will be available for all new employees. We examined the recruitment file for the most recently employed staff member and all of the required information was available to support that all of the checks and information had been obtained before the staff member commenced their employment. There was evidence to support that the staff member is currently completing an induction which meets skills for care specifications, and attending formal mandatory training. Staff members spoken with told us how much they enjoyed working in this service and how motivated enthusiastic, and committed they were to ensure people received a good standard of care. Care Homes for Older People Page 19 of 25 Evidence: We observed that there was sufficient staff on each shift, to meet peoples needs. We were told the staffing levels were flexible and dependent on peoples needs and any planned activities and outings. People and their relatives told us that enough staff are available at all times. Staff members told us they were able to provide a good standard of care and complete all required tasks based on the current levels in place. People said their needs are met and confirmed that staff provided a good standard of care and support, comments made include: They do a brilliant job and are very caring The staff are wonderful, and very kind and caring The staff are very special and would do anything for us, we are very lucky to have them. The staff files and the training matrix demonstrated that staff have access to regular training. This ensures they have the skills and knowledge to fulfill their role and meet peoples needs. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Financial sustainability of the business may impact on the welfare of people using the service. Evidence: Staff, people, and relatives spoken to said that the management team were experienced, supportive and approachable. People said they are consulted about aspects of the service through the provision of meetings, questionnaires and informal discussions. The service have demonstrated that they have addressed, or are in the process of addressing the requirements we issued following our previous visit. We have monitored the financial situation since our last inspection. However based on the evidence provided to us, we still have concerns about the financial sustainability of the business. Care Homes for Older People Page 21 of 25 Evidence: We have been told that the provider and a delegate would undertake unannounced visits to this service and complete the required reports in order to monitor the standards in place. We found that two reports had been completed since our last visit. People told us said they are able manage their finances if they wish, but many said they have given their consent for the management team to do this. People said they were happy with the systems in place, and when checked these were satisfactory for the the people we case tracked. The training records we examined demonstrated that staff are accessing the required training in relation to health and safety. This ensures they support people and work in a safe way. The self assessment that was previously received demonstrated that the service records were up to date and health and and safety audits completed. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 25 The registered provider must continue to ensure the service is financially viable and provide sufficient investment to meet the requirements of the renewal programme and daily running of the service. This is to ensure the service is managed in peoples best interests. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 33 An unannounced inspection should be undertaken on a monthly basis, in order to monitor the standards in the service. A report should be completed of the findings. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!