CARE HOMES FOR OLDER PEOPLE
The Cottage Residential Home Nocton Hall Nocton Lincolnshire LN4 2BA Lead Inspector
Toby Payne Unannounced 01 July 2005 08:45 a.m 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. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Cottage Residential Home Address Nocton Hall Nocton Lincolnshire LN4 2BA 01526 320887 01526 323055 Info@bsbcare.co.uk Mr B Bhandal BSB Care Limited Mrs Sharon Sills Care Home 26 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) Category(ies) of OP Old Age Both 26 registration, with number DE (E) Dementia - over 65 of places Both 26 The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 16th December 2004 Brief Description of the Service: The Cottage Residential Home is a period converted two storey building situated seven miles from the south of the city of Lincoln in the grounds of Nocton Hall, a former nursing and residential home which has stood unused for years and is now derelect following a recent fire. The Cottage provides personal care for up to 26 residents over the age of 65 years of age. The home is approached by a long tree lined driveway and is not on a bus route but is within walking distance of the village of Nocton. Car parking is available to the front of the home. There are gardens surrounding the property which are on one level and easily accessible for pedestrians and wheelchair users. There are also garden chairs and tables at the front of the home. Accommodation is provided on both ground and first floors. The first floor is served by a shaft lift. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 8.45 a.m. It took place over 5 hours. The inspector spoke to 10 residents, one visitor, 2 staff as well as the deputy manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received by the checking of records, discussion with them, the care staff and observing the care delivered. What the service does well: What has improved since the last inspection?
New policies and procedures have been introduced to enable staff to care for the residents. Two bedrooms have been redecorated on the first floor, new carpets provided in a number of bedrooms and the “smoker’s lounge” which has also been redecorated. Radiator covers have been installed and measures to prevent residents being scalded have been introduced. Locks have been fitted to bedroom doors to enable residents to have privacy and staff to enter in case of an emergency. The menu is now displayed in the dining room to enable residents to see what is available to eat for the day. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 6 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.
The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 standard(s) 1, 2 and 3 The Cottage meets the needs of residents coming into the home. The home provides information to enable them to make a choice whether or not to come into the home. People receive an assessment before entering the home, which results in their needs being met. EVIDENCE: Since the last inspection a statement of purpose and service user’s guide has been produced which outlines the services provided by the home and the way it operates. This information is in large print and easily understood. A visitor told said, “my friend was visited before she came into the home and an assessment was carried out by the manager”. Each resident receives a contract/terms and conditions before coming into the home. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 10 The care planning system has improved and is now clear and more detailed. This ensures that the health and welfare needs of people living in the home are met. Staff respect the privacy and dignity of residents. EVIDENCE: Since the last inspection, care plans are now more detailed and describe how the needs of the residents should be met. Records outlined their assessment needs, personal care, care plan including where required risk and moving and handling assessments. Records showed evidence of being reviewed monthly. These care records showed evidence of promoting resident’s independence, respect, dignity and choice. Staff were seen to be talking politely in a friendly manner and giving residents guidance. Comments from residents were “the staff are very kind and friendly”. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 standard(s) 13, 15 Visitors are made to feel welcome and supported. Meals are provided which are nutritious, balanced and offer a varied diet. EVIDENCE: Several residents were sitting outside the home, as it was hot day. A visitor during the inspection commented, “that whenever I visited I was always made to feel welcome and kept fully informed”. All residents said they enjoyed the food. The menu is now displayed on the wall of the dining room. Resident’s lunch was served in an unhurried manner in the dining room with staff attending to those people who needed assistance in a kind and patient manner. Several residents commented, “I like the food” and “it is nicely served”. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 standard(s) 16 Any complaints received are handled properly and residents know that any complaints they have will be listened to and taken seriously. Although systems are in place to ensure that residents are safe from abuse there is concern that some of the practices could put residents at risk. EVIDENCE: Each resident receives a copy of the complaints procedure and a copy is displayed on the wall at the entrance of the home. No complaints have been received by the CSCI and the home since the last inspection. None of the residents and a visitor had any complaints about the home. They felt they could approach staff and discuss any concerns they had with the staff and manager. Staff also knew what they should do if they received a complaint. A recently appointed member of staff said that she had been recruited correctly and abuse prevention training is being provided for all care staff in the home. Records confirmed this. However as a result of information brought to the inspector’s attention during the inspection staff require training to understand and manage residents who have behavioural problems as a result of old age. There was however no evidence to show that residents were at risk during the inspection. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 standard(s) 19, and 25 Residents live in clean, safe accommodation. EVIDENCE: Residents who spoke to the inspector said they liked their bedrooms and that the home was clean. There was no evidence of any odour in the home. Since the last inspection measures have been introduced to ensure that residents are safe from being scalded by hot water and being in contact with hot surfaces. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 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 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 and 30 There was a well trained and competent team of staff. The numbers of staff were sufficient to meet the needs of residents. Training is provided for staff in order to address their needs. This however, needs further development in order to ensure that staff understand and are able to manage behaviours, which arise as a result of old age and dementia. EVIDENCE: None of the residents had any worries about the level or availability of staff. During the inspection staff were seen to attend to residents in a prompt manner. Residents commented “we are as one with the staff” and “they are there if you need help”. Staff also felt they had sufficient time to care and support the residents. They commented,” this is the best home I have ever worked in”, “we have enough time to care” and “I feel safe working here”. Staff said that formal training in the form of National Vocational Qualifications is to start in August 2005. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 14 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) 32 and 36 The home is well lead by a competent manager and staff are supported in their work. EVIDENCE: A visitor commented “I have total confidence in all the staff “. Residents commented, “staff are very kind and polite”. Staff commented “we work as one team”, “supervision has been introduced recently and I feel I can discuss any issues I am unsure of with the manager”. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 15 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x 3 x STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 x x x 3 x x The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 16 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 30 Regulation 18(1) Requirement Staff involved in the care and support of residents must receive training concerning how to manage and understand behaviours which arise as a result of old age and dementia. This to enable them to meet all the needs of people living in the home. Timescale for action 1/9/2005 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 37 Good Practice Recommendations It is recommended that the system used to store records is reviewed as 2 offices are being used and information was difficult to find. The Cottage Residential Home C53 C04 S56118 The Cottage V235378 010705 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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