Inspection on 05/06/06 for The Conifers Care Home

This inspection was carried out on 5th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

The Conifers Care Home 12/09/07

The Conifers Care Home 07/10/05

The Conifers Care Home 07/09/04

The Conifers Care Home 02/09/03

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 The Conifers Care Home 15 Bakerdale Road Bakersfield Nottingham NG3 7GJ Lead Inspector Mary O`Loughlin Unannounced Inspection 5th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 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. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Conifers Care Home Address 15 Bakerdale Road Bakersfield Nottingham NG3 7GJ 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) 0115 9110024 0115 9110024 Mrs Debra Frances Yates Mrs Debra Frances Yates Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. any service user with a physical disability cannot be accommodated in the first floor bedrooms in the new section of the care home 7th October 2005 Date of last inspection Brief Description of the Service: The conifers in an adapted and extended property situated in the heart of a residential area of Bakersfield. The home provides accommodation and personal care for up to 16 residents within the category of old age. It does not provide nursing care. The accommodation is well maintained throughout. Ten bedrooms have en suite facilities. The bedrooms are on the ground and first floor and there is a stair lift to provide access to the upper floor. The adjacent property is now connected to the home and is registered with the Commission for Social Care Inspection since January 2006. Two of the first floor bedrooms can only be accessed via a stairway that does not have a chair lift and can only be used for mobile residents. Local shops, public houses and public transport are easily accessible from the home, although the road has a slope so people with mobility difficulties may need assistance to go out. The range of fees are from £307.00 to £345.00 per week. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted unannounced and used a range of information to inform the outcomes of the care provided at the home. The main method of inspection was case tracking which means the care plans of the residents were viewed and the care they received examined to ensure they had access to planned care and external professionals. The Commission received 12 responses from questionnaires sent out to residents, which were all positive and complimentary about the service. 6 residents were spoken with and gave an account of their lives at the home, and one relative was spoken with during the inspection. The manager, deputy manager and a carer were on duty and each was spoken with. The home was compliant with its responsibilities to meet the National Minimum Standards and exceeded them in most areas. What the service does well: The home has a sustained track record of meeting the National Minimum Standards and where areas for improvement emerge the manager recognises and manages them well. The home provides an excellent standard of accommodation with aids and adaptations including facilities for the disabled. The quality of the fixtures and fittings is excellent and each room is homely and very well maintained. Residents are treated respectfully and the staff promote their independence in all areas of their daily lives. Residents and their relatives are treated as part of the family. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The manager is presently implementing new care plans for the residents that also include an audit of the residents’ abilities to self-care. This document provides good information on which staff assist people with their personal care at the level required for their individual needs. The manager should consider extending this type of care planning to include health and social care elements. The manager should ensure that when care plans are drawn up and as they are reviewed the resident and or their representative signs the plans to ensure they are in agreement with the aims and objectives of the care provided. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 7 The care plan files could be separated out to provide a clearer system of how each element; Health, Social and personal care are to be managed. Through this process the manager should also incorporate the present auditing/ quality assurance system of using the National Minimum Standards as a yardstick to ensure that all the required documents that demonstrate compliance with the minimum standard are within the care plan file. The manager should also provide a sit on scale to ensure that residents can be weighed as part of their nutritional assessment monthly. 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. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 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 the following standard(s): 1-2-3-5-6 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Prospective residents have the information they need to choose a home which will meet their needs. Residents are assured that the home can meet their needs following a comprehensive assessment prior to admission. Residents receive a contract of the terms and conditions of their residency. Intermediate care is not provided. EVIDENCE: The homes statement of purpose has been reviewed this year and includes information on the increase in the size of the home. There has been a sustained track record of the home meeting these standards. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 10 Responses to Questionnaires show that residents receive information prior to admission to the home, have opportunities to visit or have trial stays and are visited at their place of residence by the manager or deputy. The emphasis on helping residents understand the information given to them is by staff spending time with them and explaining all about the home. The staff make special effort to help people to settle in and introduce them to other residents. Each person gets a clear contract of the terms and conditions of the home and these are copied and held within each persons file. All new residents receive a comprehensive assessment of their needs and a care plan is drawn up with them and their relatives or representatives. Case tracking the last admission to the home at the inspection confirmed these actions. Residents are given a verbal agreement that the home is able to meet their needs; the manager was advised to ensure this was put in writing and a copy retained. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-8-9-10 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. The health, personal and social care that a resident receives is based on their individual needs. Residents are safeguarded by the home’s practices in the safe management of medicines. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Three residents were case tracked. Personal care records demonstrate that residents are encouraged to be as self caring as possible. The home has a strong ethos in involving residents and relatives in all aspects of their daily life. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 12 Each resident has a care plan in place which is reviewed monthly or as conditions change. One relative spoke about the care plans in place and was aware of the content, staff use more direct communication with residents and relatives to communicate effectively the care planning process. it would be good practice to ensure that plans were signed by all those involved wherever possible. Further work is being undertaken to ensure the newly implemented care plans have recognised risk assessments for pressure sore prevention and nutritional assessment. The home would benefit from having a set of sit on scales to ensure they can weigh people at least monthly to inform any nutrtional plan. Presently people are not weighed but a record of the diet provided is held and staff know each person well, noting any changes in their diet within the daily records and referring people to the Doctor if there are any concerns. Residents requiring pressure relieving equipment were able to access this from the district nursing service and equipment was seen in use where indicated. Residents and relatives spoke of how the staff were caring and committed and they felt like one big family Through observation and talking to residents it was clear that each resident is treated respectfully, as an individual and their dignity is upheld by robust procedures and guidance of a well-informed staff team. Medicines in the home are safely managed and compliant with safe custody regulations. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-14-15 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Social, cultural and recreational activities meet the expectations of the residents. Residents receive a healthy, varied diet according to their preference and needs. EVIDENCE: Residents and relatives are informed of activities both within the homes statement of purpose and through daily communication. There is a wide range of activities available to suit the individual needs of the residents. Each person is supported to maintain their hobbies or previous interests and relatives were very happy that they have opportunities to be involved in social activities both inside and outside of the home. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 14 Residents access local community events, clubs and venues. Residents lead a full and stimulating lifestyle with a variety of options to choose from. There is a strong commitment to considering each persons individuality and taste. Food is considered very important and the home advises that visiting does not take place during mealtimes. Residents commented on the choice of food and that they enjoyed their meals. Refreshments are available for visitors free of charge. One relative was encouraged to take meals with her relative at the home, as this would provide a normal social lifestyle for that individual. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 15 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): 16-17-18 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure, are protected from abuse and have their legal rights protected. EVIDENCE: There is a robust system in place that informs residents and relatives how they can complain. Each resident has a copy of the complaints procedure within their room. The home has a local adult protection policy in place and staff are trained in adult protection both through external providers and within their NVQ training. There have been no formal complaints recorded, the manager always deals with any concerns as they may arise and residents/relatives are listended to and assured. The service aims to promote the individual rights of each resident, to live as normal and independent life as possible. This includes the opportunity to attend places of religion. Residents are able to vote and are registered on the electoral role. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 16 Residents and relatives said they are very happy with the service and feel lucky to have chosen such a lovely home where the manager has such a good understanding of people, is approachable and responds to any changes in the needs of the residents The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The design and layout of the building enables residents to live in a safe well maintained environment, which encourages independence. Effective policies and procedures are in place to control any spread of infection. EVIDENCE: The responses from relatives and residents show that staff encourage people to see the home as their own home. The statement of purpose informs people who use the service that they are seen as part of the family. It provides a very safe and well-maintained home that is attractively presented and provides a good range of equipment including a disabled toilet facility on the ground floor. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 18 The rooms are very well planned and provide ensuite facilities. The fixtures and fittings are of a high quality, well maintained and adapted for the needs of the residents. There is a selection of communal areas and a pleasant outside space that allow for residents to sit quietly or entertain their visitors in private. There are ample bathing facilities and assisted bathing available. Infection control procedures are in place to protect the residents. The home is compliant with local Fire and Environmental services. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27-28-29-30 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. Staff at the home are trained, skilled and sufficient in numbers to fill the aims and objectives of the home and meet the changing needs of the residents. EVIDENCE: Responses from residents and relatives confirmed that there were sufficient staff on duty to meet people’s needs. A duty record is held and confirms the numbers and times of staff on duty. There is no agency staff in use. One relative commented that staff also give up their own time to escort or support people to outside events. There is a safe recruitment practice in place that has the needs of the residents at its core. The manager seeks good quality care staff to ensure an excellent service is provided. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 20 There is clear evidence that staff retention is excellent and provides a skilled and knowledgeable staff team who are trained to National Standards from the start of their employment and throughout their employment. The home has one member of cleaning staff and the hygiene of the entire home was excellent. Care staff are trained in Food Hygiene and they prepare all meals at the home. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 21 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): 31-33-35-38 Quality in this outcome area is excellent. This Judgement is made using available evidence including a visit to this service. The management and administration of the home is based on openess and respect, has an effective quality assurance system developed by a competant manager. The management of health and safety safeguards residents and staff. EVIDENCE: Since the previous inspection the manager has implemented an audit of all areas within the home and this is in line with the National Minimum Standards. The manager meets regularly with residents and any suggestions are acted upon. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 22 People are asked for their views of the service through questionnaires and the manager meets people individually to provide any feedback on issues presented. The manager/owner of the home has the required experience and knowledge to undertake her role. She has a sound knowledge of the financial planning and review to ensure that the service is efficient and value for money. She continues to attend updates on areas of practice in the care of older people and is researching methods of care management through clinical experts such as the Alzheimers Disease Society. Residents, staff and relatives feel the manager communicates a clear sense of direction, is approachable and shows great understanding of the needs of individual residents. Staff were confident workers and felt valued. Residents monies are not managed by the home. Residents are enabled to manage their own money and they are provided with secure facilities in their room in which to keep money and valuables. There is good evidence that the home is open and transparent with the views of residents and staff listened to and valued. The manager fullfills her responsibilities to ensure that all events in the home are notified to the Commission if significant. The health and safety management of the home ensures that all parts of the home are safe and all necessary training, servicing and maintenance of systems are compliant with regulations and the homes obligations under the health and safety at work act. There are taining programmes in place to ensure staff remain up to date in areas of mandatory training. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 23 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 4 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 3 18 4 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X N/A X X 4 The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 24 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. 1 2 Refer to Standard OP8 OP8 Good Practice Recommendations The registered person should provide a sit on scale for residents that are unable to stand. The registered person should consider separating out the elements of Health, Social and Personal care plans and through audit using the National Minimum Standard develop the present care planning system. Ensuring each care plan review contains evidence of those people involved and wherever possible has their signature. The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Conifers Care Home DS0000002194.V294286.R01.S.doc Version 5.2 Page 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. 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