Inspection on 27/11/08 for Spring Cottage

This inspection was carried out on 27th November 2008.

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

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

Other inspections for this house

Spring Cottage 19/12/06

Spring Cottage 14/02/06

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 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Spring Cottage Bazley`s Lane Langton Road Norton, Malton North Yorkshire YO17 9PY     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pauline ORourke     Date: 2 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Spring Cottage Bazley`s Lane Langton Road Norton, Malton North Yorkshire YO17 9PY 01653695354 F/P01653695354 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Wendy Ann Marucci Type of registration: Number of places registered: Mrs Wendy Ann Marucci,Mr Paul Marucci care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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. The ground rises to the rear of the building and consequently the first floor bedrooms can, if necessary, be accessed without the need of the stair 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 conveniently situated for the public transport network. It is set in large landscaped gardens with appropriate seating for people who live in the home. The home has its own vegetable and fruit garden and is adjacent to a racing stable that tends to be of considerable interest to people in the home. The home has its own car parking area. The accommodation in the main building is on two floors. The communal space consists of a dining lounge and two Care Homes for Older People Page 4 of 26 0 Over 65 15 Brief description of the care home further lounges. The home is working towards a no smoking policy. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission of Social care Inspection inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.csci.org.uk The key inspection has used information from different sources to provide evidence for this report. These sources include: Information provided by the registered person on an Annual Quality Assurance Assessment. Care Homes for Older People Page 6 of 26 A visit to the home by one inspector that lasted for six hours. Information received from surveys from people using the service and professionals involved with Spring Cottage. During the visit eight people using the service, two staff members and the manager were spoken with. Care records relating to four people using the service, four members of staff and the management activities of the home were inspected. care practices were observed, where appropriate and time was also spent watching the general activity in the home. This enabled the inspector to gain an insight of the work done at Spring Cottage. Information about Spring Cottage is available in the form of a Service User Guide and Statement of Purpose on request. As of the 25th November 2008 the cost to stay at Spring Cottage was three hundred and eight pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed and a care plan is drawn up from this. This ensures their needs will be met. Evidence: People thinking about moving in to Spring Cottage undergo an initial assessment, if the manager and staff feel they can provide the care and support required then that person is admitted to the home for a two-week holiday stay. During this stay a more comprehensive assessment is carried out. The information collated includes a personal history and a description of their likes, dislikes and interests is included. This ensures the home has a detailed knowledge of the needs of each individual before deciding if these can be met. All the staff are involved in this process. After two weeks the person returns home before a decision is made about whether they want to move in permanently. At this point the current group of people living in the home are consulted and their opinions are taken in to account during the final decison making process. Care Homes for Older People Page 10 of 26 Evidence: This process helps people settle in quickly because everyone has an understanding of their needs. As people admitted to the home are usually from the immediate locality they very often know some if not all of the people living in the home and many of the staff. This emphasis upon encouraging new admissions from the surrounding area has created a close knit and supportive atmosphere. Intermediate care is not provided. Several people spoken with during the inspection said that: this is a wonderful place Ive been here three years and it is like a home from home One person was on a holiday stay and she said that she was enjoying being in the home. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care a person receives is based on individual needs. The principles of respect, dignity and privacy are put into practice. Medication is not handled in a safe manner. Evidence: Several case files were seen and they each contained a care plan. These were detailed documents and pertinent to the individual concerned. All specialist aspects of care are carefully considered and any professional advice is incorporated. The plan covers likes and dislikes in detail, the way in which people may wish to spend their time and their preferences in food, drinks and any other aspect of daily living. This ensures peoples needs are understood and met. Care plans are regularly reviewed with input from the person concerned, family, GP or any other health care professional involved. Observations and discussions with staff emphasised that they are knowledgeable about each person in the home. Evidence was also available in the case files to show that people receive support from Care Homes for Older People Page 12 of 26 Evidence: a variety of health care professionals according to their need. People spoken with said that they could request to see a doctor at any time and staff would help them with any other appointments. As people are local to the area they retain their usual doctor when they move in to Spring Cottage. The medication seen was not stored properly; currently the medication is stored in a filing cabinet. The Royal Pharmaceutical Society has introduced new guidelines and the manager needs to ensure their knowledge remains up to date. A controlled drugs cabinet should also be provided to ensure that if anyone is prescribed a controlled drug it could be stored safely. A monitored dosage system is in use and several of the records were incomplete. Medication had been dispensed but the records did not support this. A new supply of medication had arrived for the following month and this was stored on the floor in an unlocked office. Arrangements must be made to ensure any medication is stored securely at all times. Staff have received suitable medication training. Staff prompt regular review of medication by calling a GP if there is any change in an individuals condition. Throughout the visit staff were observed treating people in the home in a friendly and relaxed manner. It was clear that the relationships between staff and people in the home are valued. Even where someone was confused everyone in the home treated him or her with patience and respect. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home are enabled to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities exceed peoples expectations. People receive a healthy, varied diet, which they enjoy. Evidence: People enjoy a full and stimulating life according to their capacity and particular interests. They have control over their lives. The staff know each individual well and plan opportunities with their preferences in mind. Each person said they enjoyed their life at Spring Cottage. One spends a great deal of time outdoors caring for animals, another helps with washing up, and another enjoys light domestic chores in the home. Many of them are reasonably independent and are able to follow such pursuits. In the summer months people said that they lent a hand with preparing vegetables for the freezer. These had been grown in the extensive gardens belonging to the home. People indicated that they enjoyed helping with these light duties as it gave them opportunities to spend time discussing how they did things when they were younger. Several people commented that they often went out in the car with Mr or Mrs Marucci or staff. Many outings are spontaneous and people are asked if they would like to go along if a member of staff happens to be going somewhere. Organised trips out had Care Homes for Older People Page 14 of 26 Evidence: included going to Bridlington and Whitby and also shorter trips out to go shopping or to the garden centre. People in the home are also interested in the fortunes of the racehorses belonging to the stables adjacent to the home. Those who are less physically able are also offered the opportunity to become involved in activities. A carol service and a visit by the Salvation Army band are planned before Christmas and people said that they were looking forward to these events. The childrens choir sits on the lounge floor in the middle of people they have come to entertain. Where people are unable to attend these concerts staff will go and sit with them and sing-a-long with them so that they can feel involved. Those who had more severe physical impairments and are in their rooms for much of the time are helped to feel a part of what is going on with frequent visits from staff and people and there is often lively conversation. Visitors are welcome at any time and people were seen coming and going throughout the visit and they are offered refreshments or a meal when they call. People living in the home said that when visitors called more than one person often knew them and so they could all chat together. There is also a choice of lounges so that people can have visitors in greater privacy if they wish. People can go to their rooms at any time and separate heating is provided when this happens. Food is very important at Spring Cottage and meal times are considered a social occasion. Each member of staff who cooks is well aware of the dietary needs and preferences of each person. The menu is varied, with healthy options and an emphasis upon good home cooking. Those who require assistance during mealtimes are helped with sensitivity and kindness. A midday meal was sampled and was of a very high standard. People commented that the meals provided had elements in them that had been provided through the homes extensive gardens and people spoken with said that the food was delicious. The atmosphere was relaxed and there was much natural conversation and laughter. People are able to go into the kitchen when they wish subject to a risk assessment and snacks are available when requested. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to an effective complaints procedure; their complaints are listened to and acted on. People using the service are protected from abuse. Evidence: The home has an up to date, clearly written complaints policy. People spoken to in the home said they knew they could complain should the need arise. All said that they were sure this would never need to happen. The manager said she welcomed any comments from anyone using the service whether complementary or otherwise, as her aim was to provide the best for those in her care. People spoken with said that the manager was always available as were the staff and dealt with any minor grumbles immediately if any were raised. People said if there is a problem with care I would speak to the manager who is always around to listen. If it is an emotional problem all the staff are good listeners If you havent got a smile on your face Wendy wants to know why Staff have received training in abuse awareness and were clear on what would be done should they have a suspicion of abuse. The home values and promotes the rights of people using the service and policies reflect this. This open and progressive approach Care Homes for Older People Page 16 of 26 Evidence: supports peoples right to safety and to complain. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, well-maintained and comfortable environment. Evidence: The home is well pleasantly decorated in a homely style. The lounges have open fires, which are protected at all times by chained fireguards. The staff attend to the fires. The manager and staff encourage people living at Spring Cottage to feel they are at home. Each person has an individual assessment for any equipment needed and where necessary this has been provided. Care has been taken to assist with individual needs, for example, people with sight impairment have been provided with large number telephones, talking clocks and talking books where relevant. Care has also been taken with the lay out of rooms to accommodate those whose sight is failing. An arrangement of mirrors has been set up to allow one person to sit by the window and watch the world go by. The home has sourced a night-light, which someone with memory problems can accept without damaging. The home also has a hoist and stair lift. There is a good choice of communal lounges with quiet areas and other areas where people can chat more freely. People said the temperature in their rooms could be changed to meet their individual choice. The home complies with the environmental health and with the fire authority. People spoken with during the visit said: the fires are wonderful its just like being at home Care Homes for Older People Page 18 of 26 Evidence: This place is just right for me nothing too fancy Its wonderful here so warm and welcoming Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained and in sufficient numbers to fulfill the aims of the home and meet the changing needs of people in the home. Evidence: Staff are employed in sufficient numbers to meet the needs of people living in the home. People spoken with said that staff always had time to sit and talk to them. In the afternoons staff sit with them and they all complete the crossword in the Yorkshire Post. People enjoy doing this as their eyesight has diminished and it allows them to continue with one of their pastimes. Many of the staff have worked at Spring Cottage for a long time and are very knowledgeable about the people who live there. Feedback received from staff surveys indicated that they felt there was enough staff on duty to support people in the home More than 50 of staff have NVQ at level 2. They have been well recruited according to policy and all received a Criminal Records Bureau check prior to commencing employment. The administrative assistant has devised training folders for each of the staff. This includes induction and foundation training and other training relevant to their role. No new staff have been employed since the last inspection. Care Homes for Older People Page 20 of 26 Evidence: Staff said they felt well prepared to carry out their role and has confidence they would receive the training they required. This ensures that people are protected and that their needs are appropriately met. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Spring Cottage benefit from an open style of management based on respect and from the considerable experience of the manager. Peoples views inform practice. Peoples welfare is protected by good health and safety systems. Evidence: The manager has many years experience of running the home. One of the registered providers has completed a National Vocational Qualifications level 4 in management and care. There is a philosophy of openness where the running of the home is concerned and people reported being consulted over many areas of their care and the management of the service. The manager is focused on the needs of residents as of central importance and leads a capable staff team. On the day of the visit the manager returned form a two-week holiday and it was clear that she had been missed by people in the home. People said: Wendys lovely nothing is too much trouble Care Homes for Older People Page 22 of 26 Evidence: If youre not smiling Wendy wants to know why She is wonderful always pleased to be here The administrator has devised quality assurance questionnaires for people living in the home and has distributed them. However, people in the home and other interested parties expressed their views directly or had written to the home with their comments throughout the year. The home had taken a selection of comments and included these in the service users guide which is sent out to people thinking about moving into the home and available to visitors and people currently living at Spring Cottage. In this way, feedback had been received and shared with others. People said they made suggestions whenever they wanted to and any necessary changes would be made straight away. The home does not become involved in peoples finances, those who keep their own moneys are provided with secure storage. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home. All accidents and incidents are recorded and when necessary they are reported to the Commission of Social Care Inspection. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Medication must be stored securely and safely. This makes sure that medicines are safe to administer. 27/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Handwritten entries and changes to MAR charts should be accurately recorded and detailed. This makes sure that the correct information and dose is recorded so a person receives their medication as prescribed. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!