CARE HOMES FOR OLDER PEOPLE
Sycamore Cottage 14 Harborough Road Oadby Leicester LE2 4LA Lead Inspector
Helen Abel Announced 4 May 2005 at 10.00am 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. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Sycamore Cottage Address 14 Harborough Road Oadby Leicestershire LE2 4LA 0116 2711720 0116 2711880 None Sycamore Cottage Limited 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) Vacant Care Home 14 Category(ies) of OP Old Age - 14 registration, with number of places Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: To agree to a named person to be admitted to Sycamore Cottage under the DE (E) category 29th January 2004. Date of last inspection 28th September 2004 Brief Description of the Service: The home is set on Harborough Road in Oadby. Sycamore Cottage offers care for 14 older people. The home is set on two levels and is generally spacious. Rooms have en-suite with central heating throughout. Some rooms look south over the garden. There is a stair lift to the first floor. A choice of menu is offered daily and special diets are catered for. A smoking room is available for service users. The home is maintained to a good standard and is very clean and tidy. Within short walking distance there is Oadby shops, two churches and transport routes, there are many local amenities available. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over five hours. Four services users were interviewed to seek their views, in their rooms the smoking area and in the lounge. All parts of the home were inspected. The Inspector joined services users for lunch briefly in the dining area. In the afternoon the Inspector spent time viewing documents and talking with staff and the management team. What the service does well:
The Service User Guide is available to prospective service users together with a summary of the last inspection report. The Service User Guide is comprehensive and easy to read. Service user’s health, personal and social care needs are good and reflected in individual care plans. Service users confirmed they were happy with the care received at the home and felt they were treated with respect. Two service users preferred to spend long periods in their rooms. Their privacy was respected with staff visiting and talking with service users at intervals throughout the day. A Musician entertained service users one evening in April and sang and played on his keyboard. Service users and their relatives and friends were invited. Refreshments were provided. The social event was a key time for everyone to get to know the new Registered Provider Mrs Jagpal and her family. Photographs were taken of service users singing and dancing. The service is good at providing varied, balanced appealing meals. Service users confirmed they were offered a choice of food at each meal. The food tasted good. Diabetic food alternatives are always provided. The dining area was clean and well presented. Service users told the Inspector “Meals are good”. “Nice food”. Maintenance is ongoing. The garden area is currently being cleaned up so as service users may enjoy the garden of fruit trees, lawn and border plants. Garden furniture is available. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better:
The Registered Provider should ensure service users agree to, and sign their care plans were possible. The Registered Provider is reminded to take steps to ensure a formal monthly review takes place due to the changing needs of a identified service user. In respect of medication management the Registered Provider should prompt the review of medication for two identified service users; obtain a bound book for controlled drugs; obtain a thermometer that reads the minimum, maximum and current medicine fridge temperatures. With these improvements service users will be protected by the home’s policies and procedures for dealing with medicines. To develop the quality of the meals provided. Changes to be made around purchasing more non-branded food items and fresh milk (in preference to UHT milk). Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 7 Administration procedures to be developed around an improved reference format; Revised procedure for obtaining references from previous residential care employers; Supervision format to be developed to include training and development opportunities for individual staff. These aspects will further safe guard service users. 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. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 8 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 Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 9 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) 1,2, A good standard of information is available for prospective service users. Service Users are assessed prior to admission. EVIDENCE: The Service User Guide is available to prospective service users together with a summary of the last inspection report. The Service User Guide is comprehensive and easy to read. A copy of the current inspection report is held in the home. The Registered Providers confirmed a sign would be displayed to confirm the location of the current inspection report. A new service user received an assessment by the previous Registered Manager but this could not be located. A social workers assessment was available and had been used by the Acting Manager in drawing up the new service users care plan. Assessment formats are available in the home. The Acting Manager is aware of the requirement for a service users admission to the home, only after an assessment. Assessments for other service users were in place. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 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 standard(s) 7,8,9,10 Service user’s health, personal and social care needs are good and reflected in individual care plans. Medication management is generally satisfactory. Service users are treated with dignity and respect and their privacy upheld. EVIDENCE: The home’s care plans were examined and were comprehensive, easy to read and follow. Photographs were available of all service users. A new service user photograph will soon be in place. Care plans are reviewed once a month. A first month’s formal review is due to take place for a new service user. The Registered Provider should take positive steps to ensure this review takes place, due to the changing needs of the service user. The Registered Provider is reminded that service users should agree to and sign their care plans were possible. Health care records were compiled and in order. A chiropodist comes into the home every six weeks. An Optician comes into the home to provide a yearly check. Risk assessments were in place for service users. A new service user is in the process of registering with a new GP. New seated weighing scales have been obtained and all service users will be now weighed regularly.
Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 11 None of the service users self-administer medication. Services users may selfadminister medication following on completing the home’s risk assessment framework. The medication area was well organised with satisfactory administration records held. A bound controlled drugs book should be provided rather than the designated exercise book, as this appears difficult to read. The medicine fridge is regularly checked with records held. A thermometer should be provided that reads the minimum, maximum and current fridge temperature. A suggested printed fridge temperature guide was passed to the Registered Provider. Discussions took place with the Registered Provider around prompting a review of medication for two identified service users. Accredited medication training is due to commence for staff responsible for administrating medication. Service users confirmed they were happy with the care received at the home and felt they were treated with respect. Two service users preferred to spend long periods in their rooms. Their privacy was respected with staff visiting and talking with service users at intervals throughout the day. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 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 standard(s) 12,13,14,15 Service users are able to match their expectations and preferences, recreational interests and needs within the home. They are encouraged to make choices and take control over their daily lives. Every effort to maintain contact with family and friends and the local community is made. The service is good at providing varied, balanced appealing meals. EVIDENCE: A new service user has expressed an interest to walk with a staff member to the local library. Staff are planning for this. She enjoys reading a newspaper over a few days. Carefully chosen video and music sessions are arranged in the lounge area. On the day of inspection service users were watching My Fair Lady. A Musician entertained service users one evening in April and sang and played on his keyboard. Service users and their friends were invited. Refreshments were provided. The social event was a key time for everyone to get to know the new Registered Provider. Photographs were taken of service users singing and dancing. Family and friends of service users are able to visit at any time. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 13 A hot meal was prepared for lunch. Service users confirmed they were offered a choice of pork chops or turkey roast with fresh vegetables. This was followed by home made rice pudding with nutmeg. The Inspector joined service users in the dining room for the first course of lunch. The food was balanced, well presented and tasted good. Diabetic food alternatives are always provided. A new rotating menu is in the process of being drawn up. The dining area was clean and well presented. The Registered Provider agreed to make changes around purchasing more nonbranded food and fresh milk (in preference to UHT milk). Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Complaints are listened to, taken seriously and acted upon. EVIDENCE: The complaints procedure is evident in the Service User Guide. Service users confirmed with the Inspector they felt able to raise any concerns with the staff team or the Registered Provider. A service user gave the example of wishing she could have a prawn sandwich. This was later provided for her tea and thereafter a supply of prawns is held in the freezer. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,25, Maintenance of the home is satisfactory. Service users have access to safe communal facilities both indoors and outdoors. Service users live in safe comfortable surroundings. EVIDENCE: The home is safe, with maintenance seen as a priority and ongoing. The Registered Provider took over the home in February 2005. She is looking to replace some carpets and upgrade the large lounge. The smoking room is in the process of being updated. The garden area is currently being cleaned up so as service users may enjoy the garden of fruit trees, lawn and border plants. Garden furniture is available. The Fire Officer has recently visited and has required some minor work to be untaken. This has largely been done with a follow up visit due in June. The home was warm and comfortable. The boiler for central heating is regulated to a preset temperature, and so are the hot water basins and baths to prevent scalding.
Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.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, 29 The numbers and skill mix of staff meets service users needs. Service users are supported and protected by the home’s recruitment policy and practice. EVIDENCE: The current staff group have been working together for some time at the home. The staffing rota was examined and care staff were deployed apprioately throughout the day There are two volunteers that are supervised by the Acting Manager. The handyperson/carer is on the staff rota and available most days in the home to run errands for service users and staff. The Registered Provider visits the home each week. Staff recruitment files were sampled. Two written references and other checks have been sought and demonstrated staff were correctly recruited. The reference format should be up dated, as the current version is out of date. The Registered Provider agreed to look at the procedure for obtaining valid references for new staff from previous residential care employers. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.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) 36,37 Staff and volunteers are appropriately supervised. Service users rights and best interests are safeguarded by the home’s record keeping, and policies and procedures. EVIDENCE: The Acting Manager has received supervision with the Registered Provider. The staff group receive regular supervision with the Acting Manager. The supervision format should be developed to include training and development opportunities. Volunteers receive training, supervision and support appropriate to their role. Job descriptions are in place for all care staff and volunteers. The Registered Manager’s job description is currently being updated. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 18 Full records of service users care are in place. Service users have access to their records and information. This is highlighted in the Service User Guide. The office area has been updated with new secure storage areas for record keeping. The new Registered Provider is in the process of updating all the home’s policies and procedures. These will be examined at the next inspection. Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.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 3 x x x 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 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x x x 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 3 3 x Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.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. 2. 3. 4. Refer to Standard 7 7 9 9 Good Practice Recommendations The Registered Provider should ensure service users agree to, and sign their care plans were possible. The Registered Provider is reminded to take steps to ensure a formal monthly review takes place due to the changing needs of a identified service user. The Registered Provider should prompt the review of medication for two identified service users. The controlled drugs record should be held in a bound book or register with numbered pages. The bound book will include the balance remaining for each product with a page being maintained for each service user. A thermometer should be provided that reads the minimum, maximum and current medicine fridge temperatures. The Registered Provider to make changes around purchasing more non-branded food and fresh milk in preference to UHT milk. The reference format should be updated. In addition look again at the procedure for obtaining vaild references for new staff, from previous residential care employers.
C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 21 5. 6. 7. 9 15 29 Sycamore Cottage 8. 36 The supervision format should be developed to include training and development opportunities Sycamore Cottage C51 S62462 Sycamore Cottage V216703 040505.doc Version 1.30 Page 22 Commission for Social Care Inspection The Pavilions, 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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