Inspection on 04/11/08 for The Homestead

This inspection was carried out on 4th November 2008.

CSCI found this care home to be providing an Good service.

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

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 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Homestead 24 Flax Crescent Shilton Park Carterton Oxfordshire OX18 1NA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marie Carvell     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Homestead 24 Flax Crescent Shilton Park Carterton Oxfordshire OX18 1NA 01993845754 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Methodist Homes for the Aged Type of registration: Number of places registered: care home 68 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 68. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Dementia (DE). Date of last inspection Brief description of the care home The Homestead, opened in June 2008 is a purpose built home catering for the needs of forty four service users who have care needs associated with dementia on two units and a third unit for twenty four service users who have nursing care needs. The Homestead is managed by Methodist Homes for the Aged. The home is situated in a Care Homes for Older People Page 4 of 26 Over 65 0 68 68 0 Brief description of the care home residential area of Carterton. The fees for this service range from 580.00 pounds to 720.00 pounds per week. Items not covered include hairdressing, chiropody, newspapers and toiletries. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the first inspection of this service since registration in June 2008. The inspection of the service was an unannounced Key Inspection. We arrived at the service at 10.00 am and was in the service until 16.15pm. It was a thorough look at how well the service is doing. It took into account detailed information provided by the previous manager in September 2008 and any other information that we have received about the service since registration. We looked at how well the service was meeting the standards set by the goverment and have in this report made judgements about the standards of the service. We toured the premises, examined a sample of records required to be kept in the home including the case tracking of four service user files and spent time talking to service Care Homes for Older People Page 6 of 26 users in groups and individually. We also spent time with the newly appointed manager, Service Manager, staff on duty, relatives and visitors to the home. In addition we observed how care was being delivered to service users and joined service users in the communal dining room for the midday meal. Feedback was given to the manager during and at the end of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and their representatives are given information about the home and encouraged to visit in order to make an informed choice about moving in to the home. Service users are fully assessed prior to admission to ensure that their needs can be effectively met by the home. All service users are able to move into the home for a trial period, before making a decision to stay permanently. All service users are provided with a contract and terms and conditions. Evidence: All prospective service users and their representatives are provided with information about the home, including the homes brochure, service user guide and information about the organisation. All prospective service users are assessed before being offered a trial period in the home. Care Homes for Older People Page 10 of 26 Evidence: Service users and their representatives are encouraged to visit the home, before deciding whether the home is able to meet their needs. Service users, relatives and visitors spoken to expressed their satisfaction of the admission process. Comments made on one survey completed by a service user included I met the deputy manager and made a few visits to the home before it opened. I have had dealing with the MHA for many years and know the ethos of the organisation. Relatives commented that it was appreciated that staff were available during the initial visits to the home to answer questions and give reassurances. All prospective service users are admitted for a trial period of between four and eight weeks, a review meeting is held before a decision to stay permanently is made. Service users receive a contract and terms and conditions. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are detailed and are drawn up with the service user/ representative, agreed and signed. The healthcare needs of service users are fully met and involve a range of healthcare professionals as necessary. Medication administration, recording and storage were seen to be well organised and maintained. Service users feel that they are treated with dignity and respect. Evidence: All service users have a comprehensive care plan in place, drawn up from the pre admission assessment of need, to ensure that all identified needs are fully met. Service users and their representatives, as appropriate, are involved in the care planning process. Care plans are agreed with the service user, signed and dated. Care Homes for Older People Page 12 of 26 Evidence: Risk assessments are in place, these include falls, moving and handling, tissues viability, nutrition and weight monitoring. Risk assessments seen were up to date and well documented. Healthcare professionals, such as the falls specialist are involved with risk assessments as necessary. Service users who completed surveys and in discussion confirmed that they always received the care and support needed. Service users were observed to be well groomed and appropriately dressed. Attention is given to ensuring that service users have their dentures, spectacles, hearing aids and mobility aids in place at all times. The healthcare needs of the service users are met by a local GP practice and a range of healthcare professionals are available as necessary. From evidence seen and from discussion with service users, staff on duty and relatives, the healthcare needs of service users are well met. Surveys received from two service users confirmed that their healthcare need were always met. One service user wrote Im not ill very often, but I know that the carers keep an eye on me to make sure that I stay well. Medication was seen to be appropriately stored. Medication administration records were seen to be well maintained, with no obvious gaps in recordings. Medication is administered by qualified nurses to service users receiving nursing care and care staff administer medication to service users receiving social care, following completion of medication administrative training and assessment. Time was spent with service users in groups and individually. Service users were complimentary about the care provided. Comments included nothing is too much trouble, lovely staff, very kind and always patient, thoughtful and I only need to ask. Staff were observed addressing service users by their preferred term of address and interacting with service users in a calm and respectful manner. There is a good rapport in the home between service users and all members of staff. This was confirmed in discussion with service users, staff on duty and visitors to the home. As in many other care homes, there is a wide range of racial, ethnic and faith backgrounds represented within the staff team compared with the current service users. From discussion with the person managing the home and staff on duty, we consider that the home is able to provide a service to meet the needs of individual service users of various religious, racial or cultural needs. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are encouraged to make choices and to remain independent for as long as possible. There is a range of activities in place to meet the social needs of service users and this is being further developed. Service users are provided with a varied, wholesome and nutritious diet. Evidence: Information about weekly activities is displayed on notice boards throughout the home. An experience and enthusiastic activities organiser has been in post since early September and is employed full time. All service users have a living, working and recreational care plan, which includes information about interests, hobbies, religious beliefs and any additional support needed. Daily records of activities, hobbies and other social interactions are well recorded and validate the information recorded in the care plan. Comments made on surveys completed by two service users, stated that there was usually activities arranged by the home that they could take part in. This is acknowledged by the activity organiser and plans are being implemented. Comments made by one service user who completed a survey included I enjoy keeping busy and helping. We now have more activities to do. Im looking forward to going out on visits Care Homes for Older People Page 14 of 26 Evidence: and for drives. Sometimes PAT dogs come over and I like to see them. I like the church services on a Sunday. The home is to employ their own dedicated Chaplin as more service users are admitted. Regular service user meetings take place and one service user commented We have residents meetings, we can make suggestions about what happens at the Homestead. Many of the suggestions are being implemented. Many of the service users have friends and family who are able to visit on regular basis. Service users said that their visitors were always made welcome and this was confirmed in discussion with visitors spoken to during this inspection. Service users confirmed that the routines in the home are flexible, such as being able to choose how they spend their day, when to go to bed and when to get up in the mornings. One service user said that although he/she required a lot of support in the mornings from care staff, this didnt seem to be a problem. We joined service users in the communal dining room for the midday meal. Tables were laid with napkins and condiments. The days menu was displayed and service users confirmed that there is always a choice of meals. Records are maintained of meals provided to individual service users. Menus evidenced that a varied,wholesome and nutritious diet is provided. At the time of this inspection, no service users required a special diet. The meal served was hot, tasty and served attractively. Staff were observed assisting service users in a quiet, discreet and dignified manner. Most service users said that they enjoyed the meals provided. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a clear, detailed complaints procedure in place. Policies and procedures are in place to protect service users from abuse. Service users are confident that their complaints or concerns would be listened to, taken seriously and addressed. Evidence: The home has a clear, detailed complaints procedure and this is displayed in prominent places throughout the home. Two complaints have been received since the home started to admit service users in August, both complaints were clearly documented and detailed action taken and the outcome. The home has a policy of recording all complaints whether received verbally or in writing. Service users and visitors spoken to confirmed that they were aware of the homes complaints procedure and were confident that their complaints or concerns would be listened to, taken seriously and addressed. The home has an open door policy and looks at complaints as a useful tool for monitoring and developing the service. Since the home was registered in June 2008, the Commission has not received any information regarding complaints about the service. All staff receive training in the homes policies and procedures for protecting service users from abuse and the homes whistle blowing policy. This was well documented and confirmed by staff in discussion and in training records. Training is provided during Care Homes for Older People Page 16 of 26 Evidence: staff induction and then updated on a regular basis. The home has a copy of the Oxfordshire Safeguarding Adults procedures. No safeguarding adult referrals or safeguarding adult investigations have taken place since the home was registered. No referrals have been made for inclusion on the POVA (Protection of Vulnerable Adults ) list. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides safe, well maintained and spacious accommodation for service users. The layout and location of the building is suitable for its stated purpose. Service users and visitors expressed their satisfaction of the premises and facilities provided. The home was seen to be clean, well maintained and free from unpleasant odours. Evidence: The home is newly build and was opened in June 2008, service users were admitted from August 2008. The home is situated on a new housing estate in a residential area of Carterton. The layout and location of the building is suitable for its stated purpose. A range of community resources including a community centre, shops and a public house are planned to be build in the near future near to the home. Communal areas of the home are comfortable and well furnished. Throughout the home there are quiet areas for service users and visitors to use. Attention has been given to making the home comfortable and welcoming. Service users have access to a safe and secure garden area, currently being developed. Care Homes for Older People Page 18 of 26 Evidence: Hot water outlets in bedrooms and bathrooms are maintained at the recommended temperatures. All windows are fitted with approved restrictors and radiators are covered. A nurse call alarm system is installed in all communal areas, bedrooms and bathrooms. All bedrooms are for single occupancy and have en-suite shower, washbasin and toilet. Bedrooms are of a reasonable size and are able to accommodate wheelchairs and aids to assist with daily living with ease. Service users are encouraged to personalise their bedrooms. Many service users and relatives spoken to expressed their satisfaction of the premises, facilities and being able to visit the home, before moving in and to be able to be involved in choosing colour schemes and soft furnishings. Communal bathrooms and toilets are fitted with appropriate aids and adaptations to help maintain independence. All areas of the home were seen to be clean, well maintained and free from unpleasant odours. From discussion with housekeeping staff on duty, it was evident that they take pride in maintaining high standards of cleanliness throughout the home. The laundry is well equipped. All housekeeping and laundry staff have received training in COSHH, infection control and health and safety. Policies and procedures are in place. Staff are provided with protective clothing, such as disposable aprons and gloves for use when carrying out their duties. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels appear adequate to meet the needs of the current service users. Staff recruitment procedures are robust and protect service users from harm. Staff are well trained. Evidence: From discussion with staff on duty, examination of duty rosters and direct observation, staffing levels appear to be adequate to meet the needs of the current service users. The home is actively recruiting staff to fill nursing, care and ancillary posts. Members of staff are encouraged to undertake NVQ ( national vocational qualification) training. From examination of a sample of staff personnel, discussion with the person managing the home, the service manager and staff on duty, it was evidenced that the home has robust recruitment procedures in place. This includes volunteers and self employed individuals providing a personal care service in the home. Staff personnel files contained all documentation required by regulation and evidence was seen that a formal interview, undertaken by two senior staff takes place. All permanent appointments are subject to a satisfactory probationary period. Care Homes for Older People Page 20 of 26 Evidence: All new members of staff undertake induction training, appropriate to their role once in post, complete mandatory training and specialist training as appropriate. MHA has its own training centre that provides a high standard of training both in house and external to the home. There is a staff training and development programme in place, this is regularly reviewed and updated as new staff are recruited. Staff spoken to during the inspection expressed their satisfaction of working in the home, felt that working conditions were good and felt well supported. Communication systems appear to be well organised, with staff handovers at the start of each shift. Staff meetings take place and staff felt that morale in the home was good. All grades of staff were observed to be professional in their approach to service users, colleagues and visitors to the home. Staff were courteous, knowledgeable and helpful at all times. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well managed home. Service users, staff and relatives are now looking forward to a period of consolidation and the home being able to move forward. Evidence: The manager registered with the commission at the time of the homes registration left the home in September to take up another role within MHA. The person since appointed to manage the home, commenced her duties the day before this inspection. She is preparing to submit an application to the Commission in the next few weeks. She is an experienced and well qualified nurse and has extensive experience in care home management. The manager is supernumerary to the homes staffing levels and is supported by a full time administrator. In discussion with service users, staff and visitors, all expressed the view that the Care Homes for Older People Page 22 of 26 Evidence: home was run in the best interests of the service users. During the period of having no manager in place the home, the deputy manager and senior nursing staff have been supported by the Service Manager. Records including service user records and financial records are well maintained and kept up to date. All staff receive formal 1-1 supervision every two months from either a senior member of staff or manager/deputy manager. Records of supervision seen were well maintained, actions agreed and signed by both the supervisor and supervisee. Policies and procedures are in place and are reviewed by MHA on a regular basis. Quality assurance systems are in place and regular audits are undertaken. Evidence was seen that the views of service users are obtained to measure the homes success in meeting the aims, objectives and the homes statement of purpose. The Service Manager, completes a written report on behalf of the provider, following an unannounced visit to the home each month, these were available for examination. Communication systems in the home appear to be well organised. A sample of records relating to health and safety and service records were examined and found to be up to date and well maintained. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 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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