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Inspection on 02/06/05 for South Cary House

Also see our care home review for South Cary House for more information

This inspection was carried out on 2nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

South Cary House provides a high standard of care to service users within a pleasant and spacious environment. Service users spoke very highly of the staff team, the proprietors and meals provided. Service users are encouraged to exercise choice regarding their daily routines, and are supported in maintaining interests and hobbies. Many of the care staff employed have obtained the NVQ level 2 qualification. The home is set within large, attractive gardens.

What has improved since the last inspection?

There has been an on-going program of decoration and re-furbishment within the home. The medications policy has been reviewed. There has been a significant improvement in the recording of medications.

What the care home could do better:

The home should ensure that additions to the medication records are supported by the date and two staff signatures. The home plans to provide staff with further medications training.

CARE HOMES FOR OLDER PEOPLE South Cary House South Street Castle Cary Somerset BA7 7ES Lead Inspector Sally Murphy Unannounced 2nd June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service South Cary House Address South Street Castle Cary Somerset BA7 7ES 01963 350272 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) Mrs Christine Anne Garden Mr Roderick Garden Mrs Christine Anne Garden Personal Care Home Only 18 Category(ies) of Old Age (18) registration, with number of places South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 30th December 2004 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 D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 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 unannounced and carried out by one inspector over one day. The previous inspection was also unannounced and took place on 30th December 2004. On the day of the inspection there were sixteen service users residing at the home. The Registered Manager & Provider were not present. During the course of the inspection service users, and staff members were spoken with, care practice was also observed, records examined and a tour of the premises was made. The Inspector would like to thank the trainee Duty Manager, staff and service users for their assistance throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home should ensure that additions to the medication records are supported by the date and two staff signatures. The home plans to provide staff with further medications training. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5 (Standard 6 does not apply) Service users are provided with appropriate information regarding the services and facilities offered at the home. The Registered Manager ensures that the home will be able to meet service users’ needs prior to them moving in. EVIDENCE: The home has a Statement of Purpose and Service User Guide. A copy of these documents is available in the entrance hall and includes recent inspection reports. An assessment of needs is completed prior to a service user moving into the home. Pre-admission assessments were found within service user plans. Service users confirmed that they were able to visit the home before moving in. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 &10 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. Medication records are now of a good standard, and follow good practice. Staff treat service users with respect. EVIDENCE: Care plans are maintained for each service user. These include detail of individuals’ needs, daily routines and preferences. Care plans had been regularly reviewed and updated as required. A manual handling assessment had been completed for each service user, and a record maintained of all professional visits. The home supports service users in opticians and dental services. A chiropodist regularly visits the home. The District Nursing team provide support as required. The home plans to introduce pressure risk assessments within care plans. Appropriate action had been taken to address individual service users’ nutritional needs. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 10 The medications policy has been reviewed. There has been a significant improvement in medication records. The home should ensure that all hand transcribed entries are supported by the date and two staff signatures. Service users are provided with assistance to undertake personal care tasks as required. Personal care is provided in private. Service users confirmed that staff encourage them to maintain independence, and treat them with dignity and respect. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,&15 The home has taken appropriate action to meet individual service users’ 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: Service users are encouraged to maintain interests and hobbies. Staff are available each day to spend time with service users. The home aims to provide activities to meet individuals’ needs. Current activities provided include: music, walks, 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 area, or their own room, as they prefer. Visitors are welcomed at the home. Holy Communion takes place each month. Several service users told the inspector of how much they had enjoyed the recent trip to Gant’s Mill. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 12 Service users spoke highly of the meals provided. The home is aware of service users’ dietary needs and preferences. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 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 no complaints received by the home or CSCI. The home has appropriate policies relating to the protection of vulnerable adults and whistle blowing. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 14 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) 19,20,21,22,23,24,25,&26 The home has been decorated and furnished to a high standard. The Registered Manager has taken appropriate action to ensure that service users live within a safe and pleasant environment. 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. 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. Radiators have been guarded and window openings restricted on upper floors. Hot water outlets were tested and found to be within appropriate limits. The South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 15 laundry was tidy and well organised. The home follows good practice in relation to infection control. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 16 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) 27,28, & 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. EVIDENCE: Duty rotas are maintained. On the day of the unannounced inspection there was the trainee Duty Manager, two carers, cook and a domestic assistant on duty. Feedback from service users indicated that staffing levels were appropriate to meet their needs. The Registered Manager was not present at the time of the inspection, therefore it was not possible to access staff recruitment files. These will be examined at the next inspection. 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 D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 17 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) 31,32,33,36,37 & 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. The home has taken appropriate actions to promote the health and safety of service users and staff within the home. 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. The Registered Manager has recently issued questionnaires to service users to obtain feedback on the service provided. The home has obtained Quality Rating from Somerset Social Services. Records relating to service users are stored securely. Staff are provided with appropriate Induction training, and regular supervision. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 18 The trainee Duty Manager advised that the Registered Provider had obtained appropriate advice from the Fire Officer regarding fire doors that are wedged open during the day. Fire safety and equipment servicing records were examined and found to be up to date. Hazardous substances had been stored securely and were not accessible to service users. Accidents have been recorded and reported as required. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 19 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 3 x 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 3 3 4 4 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 3 3 South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations All hand transcribed entries should be supported by the date and two staff signatures. South Cary House D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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 D53 - D02 S16902 South Cary House V228746 020605 Stage 4.doc Version 1.30 Page 22 - 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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