Inspection on 31/01/06 for Templemore

This inspection was carried out on 31st January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Templemore 24/10/06

Templemore 04/08/05

Templemore 17/11/04

Templemore 11/06/04

Templemore 27/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Templemore 121 Harlestone Road Northampton Northants NN5 6AA Lead Inspector Mrs Kathy Jones Unannounced Inspection 31st January 2006 07:45 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 Templemore DS0000012938.V281900.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. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Templemore Address 121 Harlestone Road Northampton Northants NN5 6AA 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) 01604 751863 01604 588638 B & M Care Limited Ms Rachel Rodgers Care Home 73 Category(ies) of Dementia - over 65 years of age (55), Old age, registration, with number not falling within any other category (18) of places Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Two current named Service Users within the category of (MD) Mental Disorder continue to be accommodated in the main house. Residents within the category of (OP) Older People reside in the main house only and do not exceed eighteen. Residents in the category of (DE) (E) Dementia in the main house do not exceed fifteen. Cedars 1 accommodates Residents in the category of (DE) (E) only and does not exceed twenty two. Cedars 2 accommodates Residents in the category of (DE) (E) only and does not exceed eighteen. 4th August 2005 Date of last inspection Brief Description of the Service: Templemore is a care home providing personal care for seventy three older people some who have varying degrees of dementia. The home is owned by B&M Care who have one other home in Northamptonshire and other homes in different parts of the country. Templemore is an old listed building, which is, full of character and located on the outskirts of Northampton. It is close to parkland and local transport to the town centre. There are three units within the home on two floors, the main house accommodates residents in the categories of older people (OP) and dementia (DE)(E). There are also two dementia care units accommodating residents with varying levels of dementia. There are sixty two single bedrooms of which forty five have en-suite facilities. The home has five shared rooms with four of these having en-suite facilities. A passenger lift provides access to those bedrooms on the first floor. The home has attractive enclosed gardens, which include a courtyard sensory garden. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over approximately four and a half hours on the morning of a weekday. Prior to the inspection the inspector spent one and a half hours reading the homes service history and previous inspection report. A comment card from a resident had also been forwarded to the commission. This information informed the planning of the areas to be inspected. Records for two residents, one who had only recently been admitted to the home, were reviewed to check how their care needs had been assessed and how their care is planned and supported. The inspector spent some time observing the breakfast routine on one of the Cedars units. On this occasion residents spoken to were unable to express their views directly on the care provided due to their level of dementia therefore observations of their general well being and interactions between staff and residents were made. The care and protection of residents was discussed with staff and quality assurance processes, resident’s finances and staff recruitment were discussed with the registered manager and records sample checked. What the service does well: The home is well organised and managed, staff present as competent, clear about their responsibilities and understand residents needs. Thorough assessments of residents needs are carried out before residents enter the home with full consultation with residents, their families and where applicable health professionals. Good care planning systems are in place to guide staff in meeting resident’s needs. Residents are supported in exercising choice and control over their lives and care taken to try and achieve an acceptable balance between risks and residents rights. Meals are not rushed and residents given an appropriate level of assistance and support without taking away their independence unnecessarily. The home was clean, warm, comfortable and no unpleasant odours noted. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 6 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. Templemore DS0000012938.V281900.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 Templemore DS0000012938.V281900.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): 3, std 6 is not applicable, as the home does not provide intermediate care. The assessment and admission process provides assurances that the needs of people admitted to the home will be met. EVIDENCE: Records for a recently admitted resident with dementia were reviewed. This confirmed that the resident had been invited to visit the home prior to admission, during which time a thorough assessment of needs had been carried out. There was evidence that relatives were involved in the assessment process and detailed information had been gathered about the prospective residents previous life in order to assist staff in understanding needs and expectations. Records show that there is a clear process following assessment to consider if the home is able to meet the prospective residents needs based on their needs. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 9 Discussion with a senior member of staff confirmed that the assessment process was continuing following admission to ensure that the residents needs can be fully met. Templemore DS0000012938.V281900.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 Residents receive a very good standard of care and support with appropriate access to health care services. EVIDENCE: Review of the care plans for two residents confirmed that care plans to guide and instruct staff as to the actions required to meet their needs are in place. Records confirm that care plans are in place at the point when a new resident is admitted to the home and that these are based on their individual assessment of needs. Care plans are reviewed regularly and updated as needs change or in the case of new residents as additional needs come to light. Care staff record relevant information relating to residents well being on a daily basis and these records are reviewed on a weekly basis. Some advice was given regarding the need for staff to record improvements as well as deterioration of identified conditions. Records confirm that appropriate referrals are made to health professionals such as the District Nurse, General Practitioner and Community Psychiatric Nurse who are then involved in residents care. Advice was given regarding the Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 11 need for staff to be specific in their records about the treatment received by a health professional e.g. type and location of wound. A sample check of medication confirmed that good systems are in place for the management of resident’s medication. Practice in relation to the administration of medication was also observed to be good with the staff member taking time to assist residents appropriately. Templemore DS0000012938.V281900.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): 14, 15 Residents are supported in exercising choice and control over their lives and provided with a good standard of meals. EVIDENCE: Residents are supported in exercising choice and control over their lives. Review of a complaint received since the last inspection confirms that care is taken in the case of residents with dementia to consult with residents, relatives and health professional’s in order to agree a reasonable balance between residents wishes and their rights and the risks. Where residents have no one to act as an advocate, advocacy services are accessed where required. The inspector observed the breakfast routine on the Cedars 2 unit. Residents had a good choice of cereal or porridge and the option of having a cooked breakfast with fried or scrambled eggs and toast. Staff offered choices, however were mindful that too many choices are difficult for residents with dementia. One member of staff had a good knowledge of the resident’s preferences and was able to offer appropriate choices. Residents were not rushed and staff provided any necessary assistance and encouragement with the meal. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 13 There is a four week menu in place which the cook advised is altered according to residents comments either through residents meetings or informal feedback as the cook talks to residents. The cook advised that staff check each morning with residents to see if they require an alternative to the set menu. The cook is aware of individual dietary needs and ensures that where food needs to be liquidised that individual foods are liquidised separately to retain colour, flavour and an appetising presentation. A comment card received from a resident confirmed that they liked the food. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 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 the following standard(s): 16,18 The home has procedures for dealing with concerns and complaints and staff are aware of their responsibilities in protecting residents. EVIDENCE: The home have a procedure for dealing with complaints and a comment card from a resident confirmed that they knew who to talk to if they were unhappy with their care. Concerns and complaints are taken seriously and records kept of all concerns raised with details of the actions taken to address the concern. The Commission for Social Care Inspection (CSCI) has received one complaint since the last inspection. The complaint related to a situation where the home was aiming to achieve the correct balance between an individuals right and the risks. CSCI were satisfied that decisions were made in conjunction with the resident, relatives and with the full involvement of the Community Psychiatric Nurse. Discussion with a member of staff confirmed that she was aware of her responsibilities for protecting vulnerable residents and reporting any concerns about their treatment and care. No concerns were identified during the inspection and a resident has commented that they feel safe in the home. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 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 the following standard(s): 26 Residents live in a home that is clean and hygienic with good infection control procedures in place. EVIDENCE: The inspector viewed the communal lounges and dining areas on the residential unit and one of the Cedars units during this inspection. All areas were found to be warm, comfortable and clean and there were no unpleasant odours. Discussion with a member of staff confirmed that good infection control procedures are in place and that staff have received training in infection control. Templemore DS0000012938.V281900.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, 29, 30 Residents are cared for by a well trained and competent staff team. EVIDENCE: Observations during the inspection confirmed that there are sufficient staff to meet the needs of residents. Staff presented as competent and caring and had a good understanding of their responsibilities in meeting residents needs. Review of a sample of staff files confirmed that good recruitment and selection procedures are in place. References and criminal record bureau clearances are obtained prior to staff working in the home. Staff receive induction training prior to working with residents and initially work alongside an experienced member of staff. Induction training is based on the National Training Organisation specifications and records are signed by the member of staff and supervisor to confirm the areas completed. Templemore DS0000012938.V281900.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): 33, 35, 36 Residents benefit from a well managed home with clear internal systems for reviewing the care provided, management of their money and supervision of the staff who support them. EVIDENCE: Recommendations have been made at previous inspections to develop the quality assurance processes. It continues to be the case that the company do not have a formal quality assurance process. The manager has developed some internal systems to audit various aspects of the home and has confirmed that residents and relatives meetings are held to gain feedback. The manager confirmed that monthly unannounced visits continue to be carried out by various head office personnel looking at a particular aspect of the home. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 18 The findings of the inspection do not indicate any concerns regarding the standards of care however it continues to be a strong recommendation that the company implement their own systems. A sample check of money held on behalf of residents identified that clear recording systems are in place for all transactions made. Staff confirmed that they receive regular one to one supervision sessions, which provide an opportunity to discuss any development, and training needs. Templemore DS0000012938.V281900.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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 3 X X Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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. 1 Refer to Standard OP33 Good Practice Recommendations The quality assurance systems should be further developed. Templemore DS0000012938.V281900.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Templemore DS0000012938.V281900.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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