Inspection on 27/06/07 for Zapuzino

This inspection was carried out on 27th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Zapuzino 24/07/06

Zapuzino 20/01/06

Zapuzino 13/07/05

Zapuzino 09/12/04

Zapuzino 22/06/04

Zapuzino 30/03/04

Zapuzino 27/01/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Zapuzino 205 Alexander Drive Cirencester Glos GL7 1UH Lead Inspector Mrs Janet Griffiths Unannounced Inspection 27th June 2007 11:00 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 Zapuzino DS0000016662.V335008.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. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Zapuzino Address 205 Alexander Drive Cirencester Glos GL7 1UH 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) 01285 651057 F/P 01285 651057 postmaster@charlienicholas.plus.com Mrs Rosemary Teresa Kilby Mrs Rosemary Teresa Kilby Care Home 6 Category(ies) of Old age, not falling within any other category registration, with number (6) of places Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th July 2006 Brief Description of the Service: Zapuzino is a small Care Home within a quiet cul-de-sac, on a large housing estate on the outskirts of Cirencester town. Once inside, the Home offers single accommodation for the elderly person who requires assistance and supervision in some of their daily activities. The communal lounge/diner on the ground floor has been enlarged following an extension of a small conservatory area, which provides the Home with separate dining facilities. Other accommodation consists of one bedroom that is located on the ground floor; this has communal bathing and toilet facilities next door. Five other bedrooms are located on the first floor, accessed by a stair lift and one of these has en-suite facilities, with the other four providing hand washbasins. The home does not have waking night staff and the Registered Provider/Manager provides emergency night cover. Information about the service to include CSCI reports is made available by the provider to prospective service users through the homes’ Statement of Purpose and Service Users Guide. At the time of inspection the fees are from £450 to £475. Hairdressing, toiletries, and newspapers are charged for extra. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. This unannounced key inspection site visit took place over 4 ½ hours on one day in June 2007. During this time the inspector spoke to all of the residents a total of five, staff working in the home and the manager/provider of the home. A tour of the premises took place. All of the bedrooms and communal areas were seen during the course of the day. All of the resident’s files were examined in detail to include their medication records. Other records examined included the service users guide and staff recruitment and training records. Surveys were sent to service users and relatives prior to the inspection and the results were collated and fed-back at the end of the inspection. A pre inspection questionnaire was sent out several weeks before the inspection and returned to CSCI. Information from this was used when completing the site visit and writing the report. What the service does well: It provides care in a small and homely, family run setting. The home has a well- motivated staff team, who all love the work they do and are all very committed to providing a good quality of care for the residents. The manager/ provider is always accessible to both staff and residents. One of the questions in the surveys sent out was ‘what the home does well’. Responses were: • ‘Everything is done very well’ • ‘Far better one to one treatment than would get in a larger home’. • ‘ Zapucino provides a small homely environment. The family of the owner are regular visitors who all take time to talk with the residents’. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 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 Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 3. Standard 6 not applicable. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families have all the information they need to make an informed choice regarding placement at the home and pre-admission visits and assessments take place to ensure that individual’s needs can be met. The home does not accept residents for intermediate care. EVIDENCE: At the time of inspection the home had four permanent residents who have all been at the home for some time and one receiving respite care due for discharge. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 9 All were spoken with during the day although one was unwell and unable to communicate fully at this time. The person on respite care, who had been most recently admitted said that they were very happy with the care provided during their stay, ‘ but its never going to be like home’, and was anxious to go back home. This admission had been arranged as an emergency by Social Services following a hospital admission. A care plan completed by Social Services was seen, but there was no other documentation for this person. A daily record and medication record should have been in place. The manager stated that each resident and their family are given a service users guide on admission and a copy of this was seen. Just one amendment is required to change National Care Standards Commission (NCSC) to Commission for Social care Inspection (CSCI) in relation to the complaints procedure. Surveys received from both residents and their relatives stated that they had received enough information about the home and that they had all received contracts. Signed copies of the homes terms and conditions were seen in each care file. The home does have appropriate paperwork for completing a written preadmission assessment but as no one had been admitted for long term care in the past year there were no examples to see. No relatives were seen on this occasion. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health, personal care and social needs are met through individually planned care and through staff who are trained to meet these needs, whilst respecting their privacy and dignity. Systems are in place to ensure that medication is appropriately handled. EVIDENCE: All of the care files were examined during the inspection. All had an assessment completed, dated and signed by the resident where possible. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 11 From the assessment, care is planned and the care plans seen all reflected the current needs of the resident and were reviewed regularly. Risk assessments were also completed and reviewed. Staff spoken with were fully aware of all the residents needs and how they could meet them. A detailed ‘daily routine record’ was seen in each file which gives clear summarised information on the care required for each resident, which is particularly helpful for any new or agency staff who work at the home and another form completed gives a brief medical history of each person together with details of medications taken, next of kin etc, which would be sent with someone if they had to attend hospital for any reason, or moved elsewhere. A record is kept of doctors and other professionals’ visits showing that the home liaises with other health professionals wherever required, such as influenza injections from the district nurse, a consultation with the epilepsy nurse, visits to the chiropody clinic and a visit from a consultant psychiatrist. All of the surveys received confirmed that they all receive the medical support they need. Relatives’ surveys all confirmed that their relative always received the care they needed and that they were kept informed of any changes. Both the doctor and consultant had been contacted on the day of the inspection regarding the resident who was unwell and staff were taking appropriate action as advised. Medication is dispensed from two different pharmacies but both use a blister pack system with printed medication administration records. Records were checked and were well maintained, with no gaps in recording and variable doses indicated. Medication was all stored appropriately and stock levels were well controlled. The home does not have any controlled medicines at this time. All staff who administer medications have undertaken a distance learning medication course through a local college and certification to confirm this was seen. There are no shared rooms in the home. Staff were observed knocking on doors prior to entering rooms and addressing each resident appropriately. Within the service users guide the homes’ policy on rights includes ‘ the right to dignity and respect’. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are supported to realise their own preferences and expectations, both in the home and in the community and are able to maintain contact with friends and family. Meals provide a wholesome, appealing and balanced diet in pleasant and comfortable surroundings, catering for the dietary needs for the people who use the service. EVIDENCE: Zapucino is a very small family run home. The residents spoken with feel happy here because it is small and ‘homely’ and they are made to feel like part of the family. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 13 One resident said she had seen the provider’s grandson grow from the time he was born, and the home is now looking forward to the wedding of the provider’s one daughter, the weekend following the inspection. Residents also enjoy the presence of the provider’s pet cats and dog. Having just four long-stay residents the staff know what activities each enjoy, for example one loves to read and the home has a good supply of both normal and large print books available. Two others enjoy board games such as snakes and ladders and ludo and they have regular armchair exercises. Two residents go to a local day centre once a week and enjoy meeting their friends there. Whenever possible they also go out with the staff to the local supermarkets, garden centres and just for a walk around the estate for some fresh air. Only one goes out occasionally with relatives. Communion is held at the home once a month and the hairdresser visits weekly. Newspapers are delivered to the home each day and several were observed looking at the papers and later watching the tennis at Wimbledon. Of the surveys completed one said they always joined in activities, one said usually and one completed by a relative stated that they were too ill to take part. All said they enjoyed all the food provided. Most sit in the lounge during the morning and are joined by the staff when their work is completed. After lunch most of them choose to have a quiet couple of hours in their rooms before their evening meal back in the dining room. The manager/provider, or her deputy, usually cook all the meals. A record is kept of all the food provided. Lunch seen served on the day of inspection consisted of chicken and vegetable pie, carrots, cabbage and gravy, which all looked and smelt very appetising. One resident who was unwell was being offered fluids regularly and a food supplement in place of lunch which they could not manage. The Environmental Heath Officer had visited on 2/5/07 and some of the kitchen tiles have been replaced and fly screens fitted at the windows. The manager did food hygiene training in September 2006 and further training is planned. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are protected by the systems the home has in place. EVIDENCE: The home has a complaints procedure included in the service users guide and all the surveys received from both residents and their relatives stated that they knew how to complain and what to do if they were unhappy about anything. One said that their son would sort out any problems they had. One relative said: ‘We have had no cause for complaint during mothers tenure at Zapucino’. Just one minor amendment is to be made to the complaints procedure changing NCSC to CSCI. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 15 There is a notice clearly on display in the home to inform people how they can access an advocate should they need to do so. All staff have received training on adult protection, certificates were seen, and the home has a policy on Adult Protection and prevention of abuse to include the whistle blowing policy, the document ‘no secrets’ and the alerter’s guide. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, clean and hygienic throughout. Individual bedrooms are decorated and equipped to meet the needs of their occupants. EVIDENCE: All of the resident’s rooms and the communal rooms were visited during the inspection. All five residents were spoken with in their rooms. Individual bedrooms seen, reflected the interests and needs of their occupants. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 17 Some residents had brought in favourite items of their furniture such as a chair and there were lots of photographs, pictures and ornaments in most of the rooms seen. However the needs of those who preferred minimal decoration was also respected. All areas of the home were clean and odour free Everywhere was well maintained and in good decorative order. Since the last inspection three new vanity units have been fitted, the dining room chairs have been recovered, one bedroom has been redecorated and one fitted with new carpet. All the bed linen has been replaced, a new radiator fitted in one room and all the carpets cleaned. Two radiators have been guarded to date and this is an on-going programme being prioritised through risk assessments. The residents spoken with were all happy with their rooms and the surveys completed confirmed that the home was always fresh and clean. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has sufficient skilled staff to meet the needs of the current number of people living at the home, who are also protected by the homes recruitment system. Staff are supported to undertake regular and relevant training. EVIDENCE: The home employs four staff currently, including two of the provider’s daughter’s, one who is deputy manager and the other responsible for all the administration in the home. The care staff in the home provides all care, cooking and cleaning. There are no ‘waking’ night staff but the manager/provider who lives in the adjoining house, accessible through a door on the first floor, is on-call; all rooms have emergency alarm bells which sound in the adjoining house. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 19 There was a calm unhurried atmosphere in the home and no one appeared to be under pressure and no residents were observed calling or waiting for attention. All the surveys received confirmed that staff were always available when needed and always listen to what they have to say. There has been no new staff appointed since the last inspection and only one carer who has moved to another position. All staff files were examined during the inspection and all had the required documentation and checks completed to include an application form, with full career history, two written references and a declaration of fitness. It was noted the wording on the declaration states ‘medical and physical fitness’ not ‘mental and physical fitness’. This needs to be changed. All staff have had Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks and all of these were seen. The manager was advised that once seen by CSCI these can be shredded in accordance with Data Protection. Induction training records were seen. There are two members of staff with NVQ level 2 or above and one other plans to start this training shortly. Individual staff training records were also seen with certification to confirm the training. Training completed since the last inspection includes first aid training in November 2006, Infection Control training in June 2006, Fire training in August 2006, Adult Protection training in October, and Moving and Handling updates in January 2007. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33,35, 36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by the manager/provider who is committed to her responsibilities and has an open and inclusive approach. The home is run in the best interests of those living here. Systems are generally in place to protect both residents and staff. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 21 EVIDENCE: The provider/manager, has many years experience in caring for the older person both in a hospital and private care setting. She has completed NVQ 4 Registered Manager’s Award, and also undertakes any relevant training to make sure she is kept up to date and has recently completed adult protection, food hygiene and fire training. As the home is so small with so few staff they meet every day to discuss anything relevant to the home and the people who live there. Records of staff supervision and annual appraisals were seen. The home has carried out surveys in the past but no collation or action plan was seen. They have not repeated this recently feeling the residents would be swamped by surveys, but now this inspection is completed they will repeat their own surveys. Once completed the results should be collated, a report written and any necessary action planned. Other surveys to professional visitors could also be considered. Residents finances are generally their own or their families responsibility and the home does not act as appointee to any resident. The manager does hold small amounts of ‘personal expenditure’ for several residents at either their own or their families’ requests and records were seen to confirm that any expenditure is accounted for, receipted and fully recorded. Records were also seen to confirm that regular maintenance and servicing of equipment is carried out, to include electrical wiring and portable appliance testing, gas and central heating, lift and hoist servicing. Fire equipment s also serviced regularly and fire alarms and emergency lighting tested regularly. Staff also receive fire training, which records confirmed. Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 22 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 2 3 X 3 3 3 3 Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 19(1)(a) Requirement All staff before appointment to a position must sign a statement to confirm their mental and physical fitness. A system must be maintained to review and improve the quality of care provided in the home. This is an outstanding requirement from the last inspection; the timescale of 28/02/07 was not met. Timescale for action 31/08/07 2. OP33 24 31/12/07 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 Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Area Office 1210 Lansdowne. Court Gloucester Business Park Brockworth Gloucester. GL3 4AB National Enquiry Line: 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 © 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 Zapuzino DS0000016662.V335008.R01.S.doc Version 5.2 Page 25 - 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. 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