Care Home: April Cottage

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Inspecting for better lives Key inspection report Care homes for older people Name: Address: April Cottage 1 Park Road Selsey Chichester West Sussex PO20 0PR     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: Liz Palmer     Date: 2 3 0 4 2 0 0 9 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. that people have said are important to them: They reflect the things 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 23 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: April Cottage 1 Park Road Selsey Chichester West Sussex PO20 0PR 01243602450 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr Catherine Helen Condon,Dr Hugh Charles Condon care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 20 The registered person may provide the following category of service only: Care home only(PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home April Cottage is a detached property situated in a quiet residential part of Selsey, within walking distance of local shops and the sea. There is a spacious garden surrounding the home and car parking space. The accommodation is arranged on two floors, comprising of two single bedrooms on the first floor and eighteen bedrooms on the ground floor. The first floor is accessible by stairs. Communal rooms comprise of a large lounge cum dining room and a smaller lounge. The home is owned privately by Dr H and Dr C Condon and managed by Mrs E Davitt. The weekly fees range from #410.00 to #510.00. Care Homes for Older People Page 4 of 23 Care Homes for Older People Page 5 of 23 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: The inspection included a site visit to the home over a period of five hours. During this time three staff were spoken to in private and the registered manager assisted with the inspection. Three service users were met and spoken to privately, others were observed and spoken to during the inspection. Care plans, medication records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included the homes Annual Quality Assurance Assessment (AQAA) that they completed and returned to us. Care Homes for Older People Page 6 of 23 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 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 8 of 23 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. Improvements to the assessment process mean that people wishing to move here will be assessed, prior to admission to ensure their needs can be met. Evidence: At the last inspection we made a requirement stating that residents must only be admitted after a full assessment and liaison with relevant professionals. Assessments relating to two new residents were looked at. They were seen to include details of care needs and other relevant information about the person including their medical history, mental health needs, care needs, religious preferences, hobbies and interests and next of kin. There was evidence that other professionals were involved as well as close family members if appropriate. People spoken to on the day said the process was made easy for them by the home. One person said she was very worried about the move but was reassured by the Care Homes for Older People Page 9 of 23 Evidence: manager who supported her through the transition. Care Homes for Older People Page 10 of 23 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. People who use the service have their health and personal care needs met. Arrangements are in place for the safe handling of medication. Evidence: Three care plans were sampled. These were drawn up from the initial assessments. The care plans contained detailed information and were seen to be kept under regular review and changes are made as necessary. There was written evidence that medical assistance is sought when needed and residents confirmed they can ask to see a doctor if the need to. They said they felt well cared for and in safe hands. Care plans showed evidence of person centred care in that they detailed any emotional support needed to an individual. One care plan seen clearly identified the personal preferences of a resident regarding her care and through speaking to this person it was clear their individual needs and wishes were met. The manager showed us an example of the new care plans currently being drawn up. The example seen was person centred and focused on individuality and personal wishes. All residents could benefit greatly from such a detailed plan. Care Homes for Older People Page 11 of 23 Evidence: As required at the last inspection the home has reviewed its storage of medication and installed a new controlled drug cupboard. The records and stock of controlled drugs was checked and found to be accurate. The administration, storage and recording of other medication was sampled. The medication cabinet was seen to be suitably secure, clean and organised. One error was seen on the records. The manager said she would investigate this. We were told that only staff who are trained and deemed competent by the manager are permitted to administer medication. The residents spoken to said they are treated with respect by staff that are always polite and loving. They felt their privacy is respected and their dignity upheld when receiving personal care. Staff were observed on the day speaking in a polite and friendly way to residents. Care Homes for Older People Page 12 of 23 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. People have a range of activities on offer in the home and are supported to live the life they choose. The home provides wholesome food to suit the needs and tastes of residents. Evidence: In their AQAA the home tells us that residents are able to choose what they do and where do it. They have care plans which are tailored to their requirements. They are able to choose when they get up and go to bed. They can remain in their rooms to eat if they wish. They are given a choice of food. they can refuse to see visitors if they wish. If we have an entertainment they are not made to come it is their choice. They also tell us that they have a member of staff employed who comes twice a week and will shop for residents or take them out if they want to go out themselves. Records seen confirmed this and discussions with residents and their relatives also confirmed that they are happy with the arrangements for their social life and entertainment in the home. Residents told us that staff have time to chat with them. One person said they were very grateful that their wish to opt out of organised entertainment was respected. They also said their visitors are can come and go and are always made welcome by staff and the manager. Care Homes for Older People Page 13 of 23 Care Homes for Older People Page 14 of 23 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. People who use the service have confidence in the home to resolve their concerns and complaints and are protected by the homes policies for safeguarding them. Evidence: A complaints procedure is available in the home. Residents spoken to say they know how to make a complaint and feel that any concern they may have would be dealt with by the staff or the manager. They said staff were open and friendly and the manager was approacable and easy to talk to. Residents gave examples of minor concerns that had been resolved to their satisfaction. No complaints have been made to the home since the last inspection. Staff were asked about the homes procedure for safeguarding adults. They said they had received training and were their responsibilities if they suspected any abuse or were told of any. Certificates were seen to confirm they had undertaken training in this area. There are currently two open safeguarding referrals which are being dealt with by Adult Services. Care Homes for Older People Page 15 of 23 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a clean and homely environment, which is well maintained. Evidence: The inside and outside of the home are maintained to a high standard. The garden is accessible to all residents with ramps, handrails and seating provided where needed. Their AQAA tells us there is an ongoing programme of refurbishment. Residents say their rooms are cleaned regularly and staff were seen to be wearing suitable gloves and aprons. Risk assessments are in place to promote the health and safety of residents and staff are trained in issues relating to health and safety. Residents bedrooms that were seen had personal belongings and furniture that they had brought with them. Written evidence was seen of relatives being encouraged to bring in items to personalise peoples rooms to help them to settle in. Care Homes for Older People Page 16 of 23 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. The arrangements for recruiting staff protect the people who use the service. The training and support enables staff to carry out their roles confidently and competently. Evidence: During the inspection there were suitable numbers of staff on duty to attend to the needs of residents. Residents spoken to said there were enough staff on duty during the day and night to meet their needs. Two of the residents said their call bells were answered promptly. One told us their call bell was not working, this was tested and found to be working and was responded to by staff immediately. Staff were observed interacting in a positive and respectful manner at all times. The staff spoken to during the inspection were confident and competent at their jobs. They spoke confidently about the needs and preferences of service users. They said there is on going training provided including mandatory courses such as, first aid, food hygiene, infection control, health and safety, safeguarding adults and fire training which are provided to all staff. Comments such as I love it here were made. Staff turnover is low and moral is high at this home. The home has nearly 50 of its staff having or working toward NVQ level 2, or above. The home operates a robust recruitment procedure. The recruitment file of two new staff members was looked at. These contained the records required to meet the standards. For example; an application form two suitable references, a criminal record Care Homes for Older People Page 17 of 23 Evidence: check and a protection of vulnerable adults check. A requirement we made at the last inspection stated that newly appointed staff must receive an induction and be assessed as competent. This must be recorded. This has been taken on board and the manager has engaged a company to implement the common induction standards to new staff. The two new staff employed since the last inspection had completed these standards in their previous employment and the manager told us that their induction at April Cottage involved shadowing the senior carer prior to working alone. The manager had made an assessment of their competency, however this was not recorded. In light of the requirement made the manager agreed to record, in future, all inductions and her assessment which deems staff competent to work alone. The home never employs agency staff and prides itself on the consistent care it provides to people. When we asked staff what they think the home does well they said the way we care for residents, everything and caring side, they are well looked after. Care Homes for Older People Page 18 of 23 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. People who use the service benefit from the home being well managed. Evidence: The AQAA states that the manager is a qualified nurse with 44 years experience in management and care. Residents spoke highly of the management of the home and said they felt it is well run and they are in safe hands. There is a clear line management structure and monthly Regulation 26 visits are carried out by the provider who also visits weekly. The AQAA shows us that they know what improvements they would like to make and how they will be achieved. The home undertakes their own quality assurance and they act on the things that people tell them. Regulation 37 notices are sent to the Commission with regard to significant events in the home and the policy for reporting safeguarding is in place and accessible to staff. Staff tell us that the home has a policy on regular supervision as well as annual Care Homes for Older People Page 19 of 23 Evidence: appraisals. Staff said they are well supported and attend regular staff meetings where they feel they can air their views and be listened to. Records relating to the testing of the fire alarms and equipment were sampled and found to be up to date. The requirement for staff to undertake training in moving and handling was shown to be met by talking to staff and checking their training certificates. A requirement regarding the storage of residents care and medication records has been met by now storing them in a lockable cupboard when not in use. Care Homes for Older People Page 20 of 23 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 21 of 23 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 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 23 of 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!