Inspection on 14/02/06 for Spring Cottage

This inspection was carried out on 14th 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.

Other inspections for this house

Spring Cottage 27/11/08

Spring Cottage 19/12/06

Spring Cottage 28/06/05

Spring Cottage 15/12/04

Spring Cottage 08/07/04

Spring Cottage 21/10/03

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

CARE HOMES FOR OLDER PEOPLE Spring Cottage Bazley`s Lane Langton Road Norton, Malton North Yorkshire YO17 9PY Lead Inspector Mr M. A. Tomlinson Unannounced Inspection 13:45 14 February 2006 th 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 Spring Cottage DS0000007734.V270914.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. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Spring Cottage Address Bazley`s Lane Langton Road Norton, Malton North Yorkshire YO17 9PY 01653 695354 01653 695354 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) Mrs Wendy Ann Marucci Mr Paul Marucci Mrs Wendy Ann Marucci Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2005 Brief Description of the Service: Spring Cottage is registered to provide accommodation and personal care for a maximum of fifteen older people of either sex. The home does not provide nursing care. Should such care be required on a short-term basis then it will provided by the Community Healthcare Services. The general ethos of the home is one of homeliness and the staff endeavour to create an informal and family like environment. If it has the capacity, the registered persons will admit people on a temporary or respite care basis. Invariably, however, the home has a waiting list of pending admissions. The home has a stair lift in lieu of a passenger lift and consequently service users need to be reasonably ambulant on admission. The home has the advantage, however, that the ground rises to the rear of the building and consequently the first floor bedrooms can, if necessary, be accessed on foot without the need for a lift. Spring Cottage consists of the main building and a detached bungalow. It is located on the fringes of the market town of Norton and is reasonably conveniently situated for the public transport network. It is set in large landscaped gardens that have appropriate seating for the service users. The home has its own vegetable and fruit garden. It is adjacent to a racing stable that tends to be of considerable interest to the service users. It has its own car parking area. The accommodation in the main building is on two floors. The communal space consists of two lounges, one of which is designated a smokers lounge. Both lounges have ‘open fires’ that are in addition to the central heating system. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory inspections to be undertaken by the Commission for Social Care Inspection during this inspectoral year. The inspection was unannounced. As there were no requirements or recommendations made during the last inspection, this inspection focussed on the National Minimum Standards not addressed on the previous occasion. Discussions were held with the majority of the service users, two visitors to the home and the staff on duty. Subsequent to the inspection telephone discussions were held with the relatives of two service users. The inspection took a total of three and a half hours including preparation time and the telephone discussions. The inspection was primarily conducted with the assistance of the home’s Administrator although the registered provider was available throughout the inspection. Feedback was provided for the registered provider on the completion of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 6 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 Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 7 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): 3 and 6 Prospective service users are adequately assessed and the information obtained is sufficient for the registered provider to make a considered decision as to the appropriateness of a proposed placement. EVIDENCE: From an examination of three service users’ care records, it was evident that a pre-admission assessment is undertaken on all prospective service users. This was in addition to any assessment provided by a placing authority. This assessment provided sufficient information on which a decision could be made regarding the appropriateness of the proposed placement. A further, and more in-depth assessment was undertaken shortly after a service user had been admitted into the home. The rationale for this was that a service user’s needs, wishes and expectations could dramatically change with a change of environment. These assessments also incorporated a risk assessment of the service user concerned. A number of the service users had come from the local area and had known Spring Cottage before their admission and consequently had made a positive decision to live there. During the inspection a prospective service user and their relative were being shown around the Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 8 home by the staff and the registered provider. It was observed that this was an unhurried process with considerable respect and sensitivity being shown to the prospective service user. The individual concerned was encouraged to ask questions and was introduced to the permanent service users. The prospective service user expressed concern over the use of the stair lift but was given the opportunity to try it out with the assistance of the staff. The registered provider expressed the view that this process of introduction was extremely important to ensure that the prospective service user made a decision for themselves on whether to live in the home and to also provide the opportunity to assess whether they will be compatible with the other service users. The records confirmed that the service users had been provided with a copy of the Terms and Conditions of Residence. The service users had signed these in agreement. The Administrator stated that the Contract or Terms of Residence was read to the service users if they were unable to read it for themselves. Intermediate care is not provided by the home. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 and 10 The service users are supported by a sound care planning process that ensures that their primary needs will be met. EVIDENCE: The care plans of three service users were chosen at random and examined. The care plans identified the primary needs of the service users along with the actions required to be taken by the staff in order to meet those needs. The care plans also identified the positive aspects of a service user such as their abilities and interests. The care plans were sub-divided into elements of care to improve clarity. It was evident that the care plans had been based on the initial assessment of the service users. They also included risk, pressure sores and dependency assessments. The more able service users were aware of their care plans and had been encouraged to sign them in agreement. The care plans also included a profile and life history of each service user. The care records provided evidence that the service users health care needs had been met through good input from healthcare professionals. From discussions with, and observation of, the service users it was apparent that they had established a good relationship with the staff. The conversations with the staff were natural but also contained elements of humour. All of the service users spoken commended the efforts of the staff to provide a pleasant environment. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 10 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 and 15. The service users have the opportunity to lead active and fulfilling lives to ensure that they remain motivated and stimulated. EVIDENCE: It was apparent from discussions with the service users, their relatives and the staff that the service users were encouraged to remain active and relatively independent. At the commencement of the inspection, for example, one male service user was assisting to wash the lunch dishes in the kitchen, another service user was gardening although the weather was inclement and others were folding the laundry in the lounge. All of the service users presented as being reasonably stimulated. It was very evident that the service users had retained a genuine sense of humour with banter, laughter and conversations being natural and spontaneous. Whilst the home did not have a ‘set’ programme of activities it was evident that the service users had been provided with a range of social activities both within and external of the home. Several service users, for example, confirmed that they would often go out to a local pub or restaurant for a meal. Others said that they were taken shopping in the local town. The majority took an interest in the adjacent racing stable and followed particular horses during national race meetings. It was observed that the staff did not ‘fuss’ over the service users but allowed them to move and act independently even where there was an element of risk. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 11 From the steady stream of visitors to the home it was evident that the service users were encouraged to remain in contact with friends and family. The relatives of service users spoken to confirmed that they could visit the home at any time and were invariably made to feel welcome by the staff. They also said that they were kept informed of the state of health and welfare of the respective service user. The service users continued to be provided with good quality meals that took into account their personal preferences as far as possible. The menus indicated that the meals were varied and of a good nutritional value. They were not entirely based on ‘healthy eating’ but included meals such as fish and chips and a full grill. These particular meals were very popular with the service users. As an integral part of the nutritional monitoring programme, the service users were regularly weighed and their weight recorded. The records also confirmed that there had been good input from District Nurses who had an overview of the service users dietary needs from a health perspective. Lunchtime in particular was a social occasion with the service users having time to eat their meals at their own pace. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 12 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): None EVIDENCE: These standards were not assessed on this occasion. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 13 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): None EVIDENCE: Whilst these standards were not fully assessed on this occasion, it was evident that the home continued to present as being informal and domestic in character. The lounges were, for example, arranged in an informal fashion with a variety of furniture that was in keeping with the ethos of the home. Pictures on the walls and ornaments on the shelves enhanced the domesticity of the communal areas. The ground floor areas inspected were reasonably clean, warm, appropriately decorated and totally free from any unpleasant odours. The main lounge and the dining room had an open fire that had an appropriate safety guard. The service users looked very relaxed in their environment and from their conversations appeared to have a degree of pride and ownership over it. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 14 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): 28 and 29 The service users are supported by an enthusiastic, caring and well motivated staff team. EVIDENCE: There had been no regression in terms of the staffing level since the previous inspection. The majority of the staff had been employed in the home for a considerable number of years and had a good understanding of the service users’ needs particularly those elements such as choice and independence that go to provide the service users with a good quality of life. It was evident from discussions with the staff on duty that they enjoyed their work and took pride in the quality of the service provided. The staff records confirmed that the home continued to employ appropriate staff recruitment and vetting procedures that included prospective staff undergoing a CRB/POVA check. It appeared that the majority of staff employed at Spring Cottage had been recruited on a ‘word of mouth’ basis. Over 50 of the staff had achieved a National Vocational Qualification. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 15 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, 33, 34, 35 and 38 The registered manager has a clear understanding of the elements of care that go to provide the service users with a good quality of life and ensures that all decisions made in the home are primarily for their benefit. EVIDENCE: One of the joint registered providers was in the process of achieving the Registered Manager’s Award. The registered provider/manager has amassed considerable experience in managing the care home and demonstrated a sound understanding of her managerial responsibilities. It was evident that the management approach to the home was one of openness, trust and inclusiveness. For example, the staff had been consulted on any proposed changes to the routines of the home and had been delegated specific tasks that were within their remit, experience and capacity. The management team were very approachable and supportive to both the staff and the service users. It was apparent from discussions with the registered Provider and the home’s Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 16 Administrator that all decisions were primarily taken for the benefit of the service users and not solely for the convenience of the staff. It was the stated philosophy of the registered provider that the staff should not become involved in handling, or responsible for, the service users’ personal money. The service users or their representative were encouraged to retain this responsibility. A Quality Assurance Monitoring procedure was in the process of being developed by the home although it was evident that ‘feedback’ was actively sought from service users and visitors albeit on an informal basis. The Quality Assurance system will be validated through future inspections of the home by the CSCI. Evidence was available to confirm that action had been taken to promote the health and safety of the service users. This included training for the staff in health and safety related subjects such as first aid, moving and handling and fire procedures. Safety tests of the electrical system, the fire appliances and the stair lift had been undertaken and a safety certificate obtained. The fire and accidents records were examined. Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 17 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 18 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. 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. Refer to Standard Good Practice Recommendations Spring Cottage DS0000007734.V270914.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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