Inspection on 16/11/05 for South Cary House

This inspection was carried out on 16th November 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.

Other inspections for this house

South Cary House 19/04/07

South Cary House 02/06/05

South Cary House 30/12/04

South Cary House 09/06/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 South Cary House South Street Castle Cary Somerset BA7 7ES Lead Inspector Sally Murphy Announced Inspection 16th November 2005 09:30 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 South Cary House DS0000016092.V271549.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. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service South Cary House Address South Street Castle Cary Somerset BA7 7ES 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) 01963 350272 MRS CHRISTINE ANNE GARDEN MR RODERICK FINLAY GARDEN MRS CHRISTINE ANNE GARDEN Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd June 2005 Brief Description of the Service: South Cary House is a large Georgian property located on the outskirts of Castle Cary. Service user accommodation is arranged on the ground, first and mezzanine floors. All service user rooms have en suite facilities. A passenger lift and call system are provided. The home has been decorated and furnished to a high standard. There are attractive gardens that are accessible to service users. The home is registered with the Commission for Social Care Inspection to provide accommodation for up to eighteen service users over the age of 65 years who require assistance with personal care. The Registered Providers are Mr and Mrs Garden. Mrs Garden is also the Registered Manager. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as part of the planned annual programme of inspection. The inspection was announced and carried out by one inspector over one day. The previous inspection was unannounced and took place on 2nd June 2005. On the day of the inspection there were seventeen service users residing at the home. Prior to the announced inspection Comment Cards were sent to service users, relatives and healthcare professionals. Fifteen cards were returned in total and each of these provided positive feedback on the home. During the course of the visit service users, relatives, the proprietors and staff members were spoken with. Care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? There is an on-going program of re-decoration and re-furbishment throughout the home. Since the last inspection a new boiler has been installed and a new electrical hardwiring certificate obtained. Staff have continued to receive regular updates in mandatory training. This has included training in the safe handling of medications. South Cary House DS0000016092.V271549.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. South Cary House DS0000016092.V271549.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 South Cary House DS0000016092.V271549.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 (Standard 6 does not apply). Service users are provided with appropriate information regarding the services and facilities offered at the home. An assessment of need is completed prior to admission to ensure that the home will be able to fully meet their needs. Service users are provided with a written contract outlining the terms and conditions of their stay. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at South Cary House. The Statement of Purpose includes copies of recent inspection reports, and is available in the hallway of the home. The Registered Manager ensures that a comprehensive assessment is completed prior to any service user moving in, to ensure that they home will South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 9 be able to fully meet their needs. Completed pre-admission assessments were found within service user plans. Service users are provided with a written contract outlining the terms and conditions of their stay. Two contracts were seen. These provided details of any notice periods required, and had been signed by both parties. Service users confirmed that they were able to visit the home before moving in. Service users who had recently moved in stated that staff had been friendly and welcoming and helped them settle into the home. South Cary House DS0000016092.V271549.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 & 11. The home takes appropriate action to meet the health and personal care needs of service users. Care plans are detailed and provide staff with the information required to fully meet service users needs. Staff follow best practice with regard to the administration and recording of medications. Service users confirmed that staff treat them with dignity and respect. EVIDENCE: Care plans are maintained for each service user. Three care plans were examined. These were comprehensive and included details of individuals’ needs, daily routines and preferences. Care plans had been regularly reviewed and updated appropriately. Risk assessments had been completed as required. A manual handling assessment had been completed for each service user. The home supports service users in accessing health care services, and a record is maintained of all professional visits. The District Nursing Team provide support as required. A chiropodist regularly visits the home. Pressure risk assessments are completed, and appropriate equipment provided. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 11 Since the last inspection, staff have received further training in the safe handling of medications. The home promotes independence and supports service users who wish to manage their own medication. Risk assessments have been completed, and regularly reviewed in relation to each service user who wished to self-medicate. Medications stored securely. Medication Administration Records had been appropriately maintained. All amendments to MAR charts had been supported by two staff signatures. A record had been maintained of all medication received into the home. Definitions had been used as appropriate. An opening date had been recorded for creams and liquid preparations. The home will provide care to a service users until the end of their life, whenever possible. Staff work closely with the District Nursing Team at this time to ensure that service users remain comfortable and that they are able to fully meet their needs. South Cary House DS0000016092.V271549.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. The home has taken appropriate action to meet individual service user’s social needs. Service users are encouraged to exercise choice over their lives. Meals are of a high standard and offer a well-balanced diet. EVIDENCE: The home has recently held a service user meeting to discuss the range of activities available. The Registered Manager advised that this meeting was productive and has provided a number of additional activities that may be tried within the home. Service users are encouraged to maintain interests and hobbies. Current activities provided include: music, walks, sherry evenings, videos, puzzles, gardening, foot spa and manicures. One service particularly enjoys gardening, and has responsibility for a small area within the grounds. Daily routines are flexible. Service users are able to spend time within communal areas, or their own room, as they prefer. Service users are encouraged to exercise choice over their daily lives. Information is displayed regarding CSCI, Age Concern Advocacy Service and Care Direct. Visitors are welcomed at the home. One service user’s relative joins them for lunch at the home each week. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 13 Trips are provided. Several service users told the inspector of how much they had enjoyed the recent trip to West Bay. Holy Communion takes place each month. Meals are prepared on the premises. The main meal is served at midday. The home is able to cater for specialist diets, and is aware of service users dietary preferences and needs. Service users spoke very highly of the meals provided. South Cary House DS0000016092.V271549.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. The home has taken appropriate action to safeguard vulnerable adults. EVIDENCE: The home has a complaints procedure. This includes details of external agencies that may also be contacted such as CSCI. There have been three complaints received by the home since the last inspection. The Registered Manager has ensured that the views of service users and their relatives are listened to and taken action appropriately. The home has appropriate policies relating to the protection of vulnerable adults and whistle blowing. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 15 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. The Registered Manager has taken appropriate action to ensure that service users live within a safe and pleasant environment. The home has been decorated and furnished to a high standard. There is sufficient communal space and bathing facilities to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: Service user accommodation is arranged over the ground, mezzanine, and first floor. All service user rooms have en suite toilet facilities. There is an assisted bathroom, passenger lift and call system available to service users. Communal space comprises of a large lounge and dining room. Adaptations have been provided as required. Since the last inspection, a further stair lift has been installed to improve access to one service user room. Service user rooms have been personalised to reflect individual tastes and preferences. The home has been decorated and furnished to a high standard and is well maintained. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 16 Radiators have been guarded, or risk assessments completed as necessary. Window openings have been restricted on upper floors. A new boiler has been installed. Hot water outlets were tested and found to be within appropriate limits. There is emergency lighting available throughout the home. It is recommended that this be tested on a monthly basis. The laundry was tidy and well organised. The home follows good practice in relation to infection control. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 17 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 provided with appropriate training to undertake their role. There are sufficient staff on duty to meet service users personal care and social needs. The home operates a robust recruitment procedure. EVIDENCE: Duty rotas are maintained. On the day of the announced inspection there was the Registered Manager, Deputy Manager, two Care Assistants, Cook and a Domestic Assistant on duty. Feedback from service users indicated that staffing levels were appropriate to meet their needs. Staff recruitment files were examined for three recently employed members of staff. The Registered Manager had ensured that a POVA First check was completed prior to any member of staff commencing employment at the home. Staff recruitment files were found to contain the documentation required under Schedule 2 of the Care Home Regulations 2001. All staff had received a written contract. Staff are provided with regular opportunities to receive training. This has included training in the safe handling of medications. Staff have also attended courses on continence promotion, protection of vulnerable adults, and promoting and measuring quality. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 18 Staff are provided with regular updates in mandatory training. Many of the care staff have obtained the NVQ level 2 qualification. The trainee Duty Manager is working towards NVQ level 3 in Direct Care. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 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 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, 34, 36, 37 & 38. The home is well managed. There are appropriate systems in place to seek service users’ views. Records relating to service users are stored securely. Staff receive appropriate supervision. Health and safety records have been appropriately maintained. EVIDENCE: There was a relaxed and open atmosphere within the home. Service users spoke highly of the Registered Manager and Provider, (Mr & Mrs Garden) and their role within the home. Service users views are regularly sought, both at service user meetings, and on an individual basis. The home has obtained Quality Rating from Somerset Social Services. Appropriate Employers Liability Insurance is displayed. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 20 Records relating to service users are stored securely. Newly appointed staff receive Induction Training. Staff are provided with regular supervision and appropriate records maintained. Equipment servicing records relating to the passenger lift, stair lifts, assisted bath, hoist and portable appliances have been appropriately maintained. Since the last inspection, the home has obtained a new electrical hardwiring certificate. The fire system had been regularly serviced and tested on a weekly basis. The Registered Manager must liaise with the Fire Department to ensure that an appropriate closure device is fitted to the door of the bedroom where oxygen is stored. Hazardous substances had been stored securely and were not accessible to service users. Accidents have been recorded and reported as required. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 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 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 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 4 4 4 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 3 2 South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? na 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 OP38 Regulation 23(4) Requirement The Registered Manager must liaise with the Fire Department to ensure that an appropriate closure device is fitted to the door of the bedroom where oxygen is stored. Timescale for action 03/03/06 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 OP25 Good Practice Recommendations It is recommended that emergency lighting be tested on a monthly basis. South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 South Cary House DS0000016092.V271549.R01.S.doc Version 5.0 Page 24 - 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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