Inspection on 10/01/06 for The Coombe House

This inspection was carried out on 10th 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 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 Coombe House 19/12/06

The Coombe House 24/06/05

The Coombe House 09/11/04

The Coombe House 29/06/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Coombe House The Coombe Streatley On Thames Berkshire RG8 9QL Lead Inspector Stewart Mynott Unannounced Inspection 11:30 10 January 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Coombe House Address The Coombe Streatley On Thames Berkshire RG8 9QL 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) 01491 872174 Mrs M J Windebank RGN Mrs Suzanne C Major Mrs Susan Rosemary Hutchinson Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th June 2005 Brief Description of the Service: The Coombe House provides accommodation and care for up to twenty-four service users over the age of sixty-five, who have care needs associated with old age. The home is not registered to provide care to individuals who have dementia or require nursing care, over and above the care that can be provided by the community nursing team. The home is located in a rural village and is within walking distance of a range of amenities. Accommodation is situated on the ground and first floors of the home and five bedrooms are situated in an annexe, which is separate to the main building. There are twenty single and two double occupancy rooms. The home and gardens are maintained to a high standard, with appropriate aids and adaptations to meet the care needs of service users. There is a registered manager in post. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection during the day lasting for four hours. The scope of this inspection was to assess a limited number of standards as most of the key standards were assessed during the previous inspection. A short tour of the home facilitated by a senior carer and one of the provider’s. During this tour a number of residents were introduced and spoken to. During the inspection about half of the residents at the home were spoken to and most staff on duty to gain their views about life experienced at the home. Time was also spent with the registered manager and a provider in discussion to gain further information. A limited number of records were assessed to further evidence standards in the home. Service users spoken to prefer to be called “residents” and this term is used throughout this report. What the service does well: What has improved since the last inspection? What they could do better: The home met the ten standards assessed during this inspection. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 6 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 Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 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 The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 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 and 5 Prospective residents are encouraged to visit before admission to the home. An assessment is completed by the management team to ensure prospective residents support needs can be met. EVIDENCE: Several residents discussed their experiences of choosing the home. Most stated they had chosen the home with family support based on information they had gained before admission particularly when visiting the home. One resident who has recently moved in described her satisfaction stating the facilities offered at the home are “akin to that of a hotel”, (which met their needs). Another resident stated “it was the people and the atmosphere that sold it to me”. Information about admission is available in the statement of purpose. The home’s admission policy was viewed and explained by the registered manager. The registered manager described that residents and their families are encouraged to visit the home so pre-admission information could be collected to ensure the right choice for prospective residents and to ensure the home could meet their needs. Specific examples evidencing this were described. Admission documents for the last resident admitted were viewed and complete. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 to 11 were not assessed during this inspection. EVIDENCE: The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Residents confirmed they have autonomy and choice in their day-to-day life. EVIDENCE: Residents described the ethos in the home was one of them “firmly feeling in control of their day” and “staff were available to provide support when they needed”. Residents described the staff as respectful with their personal choices. This was approach was observed during the inspection and residents gave many examples to evidence this ethos. Residents confirmed that they receive visitors in private and some residents are able to go out locally and attend to some of their personal care without requiring staff assistance. All residents met had their personal possessions in their rooms and stated that they were encouraged to bring in their own belongings to make it “not just a home, but my home”. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 11 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): Standards 16 to 18 were not assessed during this inspection. EVIDENCE: The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 12 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): Standards 19 to 26 were not assessed during this inspection. EVIDENCE: The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 13 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 and 30 Resident’s needs are currently met by a sufficient number of staff on duty that have received appropriate training. Over half of the care team hold a recognised qualification. The residents are protected by the provider’s employment policy and procedures that ensure new staff undergo appropriate checks to ensure their fitness. EVIDENCE: Residents confirmed that they felt there are sufficient staff available on duty to attend to their care and support needs over a 24-hour period. Observations and discussions with residents confirmed their support needs are particularly centred around activities of daily life with more minimal personal care needs required. The staff rota was viewed for the previous two weeks that demonstrated two care staff on duty during the afternoon and evening that appear to be sufficient to meet resident’s needs. Two care staff and additional support staff are available in the morning to ensure residents ancillary needs are fully catered for. Residents further described the staff team stating “nothing is too much trouble” and “you just press the bell in your room and they are there for you”. The rota, as confirmed by the provider, recorded that sixteen staff were described as care assistants including bank staff and those staff with dual roles. There are eleven care staff identified as having a direct care role within the home. Nine of the care staff hold at least an NVQ level 2 with most now The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 14 holding an NVQ level 3. This should be regarded as a significant proportion as many staff are part time. Many of the care staff are long serving and the team is regarded as very stable. The home has a recruitment policy, which was explained by the provider who has a direct role in this area. Only one member of staff has recently been recruited. Their personnel file demonstrated that the recruitment policy had been followed, and all necessary pre-employment checks had been collected to evidence their fitness to work, which ensures the protection of residents. Staff spoken to confirmed that they felt there was sufficient training available and were particularly positive with the opportunity to progress to higher NVQ levels. Training certificates are held on personnel files to evidence staff training as seen on two staff files. A separate training file was seen that listed training completed in the past year for nine staff. This revealed that mandatory topics relating to the health and safety of residents had been kept up to date. The senior carer on duty is currently mentoring the newest carer through the induction process. The senior was able to demonstrate how the induction was recorded and what topics were covered to meet the specified standard. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 and 38 The registered manager is qualified and in combination with the providers manages the home to the benefit of the residents. The records relating to fire safety and assessment to minimise risks to residents and staff have been completed to ensure their welfare and protection. EVIDENCE: The registered manager has worked in the home for approximately nine years and registered with the CSCI to become the registered manager in July 2004. The registered manager confirmed that she has completed the registered managers award and this confirmation is recorded in the statement of purpose. The registered manager takes the main responsibility for the care delivery, whist the providers take overall responsibility for the management and administration in the home. The registered manager records time spent working as a care assistant and on management tasks. This demonstrates sufficient supernumerary time to complete allocated responsibilities. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 16 Residents were complimentary about the manager and the providers at the home. Staff described the management team as approachable and changes were discussed at meetings, which are held on a regular basis. The fire safety records held at the home were viewed. These were completed in line with the provider’s policy and all records are up to date to include the regular servicing of the fire alarm system and equipment. Fire risk assessments are in place. The home has a number of health and safety polices to protect residents and staff in the home. Risks associated with the environment and safe working practises for using equipment were wide ranging to ensure staff and residents protection. The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X X X 3 The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Coombe House DS0000011218.V270475.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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