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Inspection on 23/02/06 for South Collingham Hall Care Home

Also see our care home review for South Collingham Hall Care Home for more information

This inspection was carried out on 23rd February 2006.

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

The home provides a domestic and comfortable environment, which is well maintained, in most parts. The manager and staff are very committed to providing good standards of care for the residents. The food is well thought of and residents feel respected and enabled to socialise in a manner that is comfortable for them. The gardens are well maintained and provide a comfortable place to relax, away from noise and traffic. The home`s care planning process and a majority of other documentation required meets the National Minimum Standards.

What has improved since the last inspection?

A number of requirements made at the previous inspection have been addressed. The laundry facilities have been refurbished to a higher standard. The refurbishment program has progressed and five more private bedrooms have been re-decorated to a high standard.

What the care home could do better:

Of the assessment plans sampled there was no evidence of nutrional screening. Also, residents contract agreements did not specify the room to be occupied or the fee to be paid, they were also not signed by the residents or an advocate.

CARE HOMES FOR OLDER PEOPLE South Collingham Hall Care Home Newark Road Collingham Newark Nottinghamshire NG23 7LE Lead Inspector Andrew Sales Unannounced Inspection 23rd February 2006 10:00 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 Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service South Collingham Hall Care Home Address Newark Road Collingham Newark Nottinghamshire NG23 7LE 01636 892308 0115 9818790 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) Broadoak Group of Care Homes Ms Gloria Brown Care Home 39 Category(ies) of Dementia (30), Old age, not falling within any registration, with number other category (39) of places South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. One named service user aged 48 years or older within the category LD as identified in the letter dated 17/9/04 Manager must undertake adult protection training/awareness within 4 months of the registration Old age, not falling within any other within category (OP) (39) Dementia - over 65 years of age (DE) (E) (30) Date of last inspection 4th October 2005 Brief Description of the Service: South Collingham Hall is situated on the outskirts of the village of Collingham near Newark. The home provides 24 hour residential care and is registered for 39 beds. The accommodation is provided over two floors with a passenger lift providing independent access. There are some rooms with en suite facilities and some rooms able to accommodate sharing. The home is maintained in most parts to a good standard with well-maintained enclosed gardens. The home is a converted country house of character with extensive grounds and views of the surrounding countryside. The annexe of the home has been refurbished and provides en-suite facilities. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted by A.J.Sales on 23 February 2006. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspector also spent time talking to other residents in the home, two members of staff and a relative of one of the service users. Overall the feedback was very good. Residents were happy to express their views about the home, they were positive in terms of the skills and attitude of the staff and of the overall standards of care, food, social recreation and the environment. What the service does well: What has improved since the last inspection? What they could do better: Of the assessment plans sampled there was no evidence of nutrional screening. Also, residents contract agreements did not specify the room to be occupied or the fee to be paid, they were also not signed by the residents or an advocate. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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): 2,3,4,5,6, Contracts of residence need to be more specific and signed by residents. Residents and family are able to visit and stay at the home prior to making a decision. Thorough assessments of need have been carried out prior to admission and the residents were fully involved in the process. Residents’ quality of life has been enhanced through the services provided by the home. Residents are confident that the home is able to meet their needs. EVIDENCE: Two of the homes residents were case tracked and a number of others spoken with, including a relative of a recently admitted resident. All of the homes assessments are comprehensive and contain sufficient information to enable staff to ensure that they could meet the residents assessed needs. Contracts of residence do not specify the charge or room to be occupied and are not signed by the resident or advocate. Residents and the relative spoken with felt the staff were competent, friendly and were always in safe hands. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 9 Discussions with staff demonstrated they had a good understanding of the needs and emotional support individual residents may need and were able to describe how they support residents with different personal care and practical tasks. Observations were made of professional interaction with residents, which supported resident’s comments that they feel well respected and supported. Staff spoke of a number of care specific training subjects and courses they have attended, which evidence that the staff team is well equipped with a range of skills and experience to meet the needs of residents. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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. Residents receive a comprehensive assessment. Assessments are updated following a review. The home is able to meet the healthcare needs of it’s residents. Medication issues are managed appropriately. Residents are treated appropriately. There was no evidence of Nutrional screening methods being used. EVIDENCE: Assessment plans are well set out and detail each area of need and an action plan is drawn up to meet this need. Risk assessments are also observed to be well documented. Particular attention is placed in the need to prevent pressure sores, falls and safe working practices. Daily records are well maintained by care staff and professional input from district nurses and GP’s is well documented. The care plans observed did not demonstrate how the home ensures that residents nutrional needs are to be met. Evidence gained from speaking to residents and staff suggested the care planning process was accurate and outcomes satisfactory. Resident’s plans contain details of each individual’s health care needs, including tissue viability and continence risk assessments. There is evidence that people have been appropriately referred to health care professionals. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 11 Care plans contain records of visits by district nurses, General Practitioners and other professionals. Healthcare professionals were observed visiting on the day. The inspector was informed that residents can register with a GP of their choice. The inspector spoke with a district nurse, who stated that they are only visiting one resident. She confirmed that she was confident of the care provided by staff in between her visits to promote tissue viability. She stated that the home was always prompt in referring cases requiring attention and requesting pressure relieving materials. The assistant manager stated that medication training was provided for staff responsible for the administration of medication. The homes medication administration systems have been well maintained. There is a policy and procedure for receiving, recording, storing, handling, administering and disposing of medicines. The home is registered with the local Boots pharmacist and support and advice is obtained as and when needed. The most recent pharmacist audit of the homes medicines was observed. Staff were observed during the visit interacting positively with individuals. A relative spoken with, reported staff provide a good standard of care and areas of concern would be discussed with the registered manager. All residents who spoke with the Inspector commented very positively on the conduct and attitude of the staff. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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. Residents are helped to exercise choice and control over their lives. Residents receive good quality food and a balanced diet in a relaxing atmosphere with support from staff where required. EVIDENCE: The assistant manager, residents and staff confirmed that the routines of the home are flexibly implemented to suit the preferences of individuals. Residents feel they are kept well informed about local events and available activities. There are weekly and monthly planned events, which normally involve singers and musicians and church services coming to the home. Two residents rooms that were observed were well furnished and personalised and they confirmed they are able to bring in their own possessions. The cook described how diets and preferences are catered for. All of the residents confirmed they were very satisfied with the food provided by the home. They described the choices of cooked breakfasts, a varied lunch menu and that fruit and snacks are available at all times. Lunch was observed by the inspector, the food appeared of good quality and plentiful. Staff support was unhurried. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 the following standard(s): 16,18. The home operates suitable complaints and adult protection procedures. EVIDENCE: The home has a complaints procedure, that meets this standard, which is appropriately displayed, throughout the home. Service users and relatives spoken with, stated they would raise concerns with the registered manager and the proprietors. Complaints records were not observed on this occasion. The home has an appropriate Whistle Blowing Policy and a policy detailing Adult Protection Procedures. The homes policies and procedures for responding to suspicion or evidence of abuse, or neglect, are all satisfactory. The home has comprehensive policies regarding service users money and financial affairs. Of the two staff members spoken with, one had attended training in adult protection and demonstrated a positive awareness of exposing abuse and bad practice. The assistant manager confirmed that adult protection training is provided by the home. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 25, 26. The home has been maintained to a good standard. The home provides a safe and comfortable environment. Water temperatures are not managed appropriately. EVIDENCE: All parts of the home were observed to be well furnished and most parts well maintained. All residents spoken with stated they were pleased with the homes décor and furnishings. A cook and one domestic staff were on duty during the inspection. The inspector observed the recently renovated laundry facilities. They are better organised and hygienic, with appropriate equipment and systems in place for the effective cleaning of residents clothes and the home. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 15 The home provides safe heating and domestic lighting throughout. The inspector tested hot water outlets. One outlet, sighted to the ground floor bathroom registered 48.7, above the recommended 43.0c. Although the staff test bath water temperatures, the manager needs to risk assess all residents and consult with the environmental health officer over the control of hot water tempetures. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 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. There sufficient numbers of staff to meet the current needs and numbers of residents. Staff recruitment and training records were not available for inspection. EVIDENCE: There are sufficient numbers of staff on duty to meet the needs of residents. The ratio is borderline and will be required to reviewed carefully upon the admission of any other residents, particularly those assessed with dementia. Staff training and recruitment records were locked away with the key being with the manger who was off duty. Assistant managers or senior staff deemed responsible to be in charge in the managers absence should have access to all records for health and safety purposes and for inspection. Evidence indicates that care staff have been recruited with transferred Criminal Records Disclosures. These are not transferable and the home must immediately ensure all staff have CRB checks requested through he homes own registering body. Evidence from relatives and residents indicate that staff are professional and competent and have a sensitive approach. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38. The home is generally well managed with residents interests put first. Health and safety management is well documented. Staff are generally well supported and supervised. EVIDENCE: Evidence of residents surveys was found on individual care plans. As these are not dated or signed, there is not indication as to the frequency or authenticity, it is recommended that surveys contain evidence of who, how and when the survey was completed. Residents did say they felt they were consulted about day to day issues. The home operates a standard company induction procedure. The assistant manager reported that appraisals are conducted for all the senior and care staff. Records of appraisal were viewed. Staff spoken with had not received formal supervision. The home has the Broadoak group Health and Safety policies and procedures which are comprehensive. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 18 Staff spoken with were aware of health and safety procedures and commented positively on the training provided. Risk assessments are in place for the building and individual service users. Records for Health and Safety monitoring were supplied by the manager after the inspection visit. These specify that service and appliances are tested and serviced regularly, ensuring the safety of the residents. South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 2 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO 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 2 3 Standard 2 7 25 Regulation 5.1.b 17.1.a Sch 3.3.m 13.4.a-c. Timescale for action Ensure contracts of residence are 30/04/06 signed and state charge and room number. Ensure appropriate nutrional 30/03/06 screening methods are employed for each resident. Ensure residents are risk 30/03/06 assessed in respect of hot water temperatures and the manager consults with the EHO Ensure all staff have up to date 30/03/06 CRB’s requested by the home’s own registered body. Requirement 4 29 19.1.b RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations South Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Collingham Hall Care Home DS0000024661.V284399.R01.S.doc Version 5.1 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. 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