Care Home: Breadalbane

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What the care home does well People said that they enjoyed living at the home. They said that they were well looked after by staff who cared about them and who they were very fond of. One person who was visiting the home said that they visit very often and found it to be "the best". Another relative said in a survey that the home "treats people as individuals and tries to meet their needs" They also said that there is a "homely atmosphere" People said that they enjoyed the food at the home and the trips out which are organised for them. The manager makes sure that care documentation is in place to inform staff of how best to meet people`s needs. He also makes sure that, wherever possible, people are involved in saying how they would like to receive their care. People are supported to follow their own routines and to make choices about how they spend their time. What has improved since the last inspection? The new manager is making sure that staff get the training they need to do their jobs properly. What the care home could do better: The manager needs to make sure that there is a system in the home for checking that water temperatures are safe. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Breadalbane Breadalbane 2 Park Avenue Castleford W Yorks WF10 4JT     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: Gillian Walsh     Date: 2 8 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 25 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 25 Information about the care home Name of care home: Address: Breadalbane Breadalbane 2 Park Avenue Castleford W Yorks WF10 4JT 01977518794 01977518794 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Jacinto Leao Fernandes Type of registration: Number of places registered: Ecce Cor Meum Limited care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care home only - Code PC, 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 - Code OP; Dementia - Code DE(E); Mental Disorder Care Homes for Older People Page 4 of 25 Over 65 15 5 15 5 0 0 0 0 Code MD(E) and Physical disability - Code PD(E) Date of last inspection Brief description of the care home Breadalbane is a care home providing accommodation and personal care for up to 15 older people who require residential care. The home is privately owned and is situated in a residential area of Castleford. The home is a large converted house, which has been adapted and extended to provide accommodation over three floors. There is a passenger lift operating between the floors. The home has one double bedroom; the remainder are for single occupancy. Accommodation provided in the newer part of the house offers en-suite facilities. In May 2009, the weekly fees at Breadalbane were £416 The service provider ensures that information about the service is available to people by way of the homes Statement of Purpose, the Service User Guide and through CSCI inspection reports. Care Homes for Older People Page 5 of 25 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: As part of this inspection we visited the home without telling when we were going. During the visit we spent time speaking with the people who live at the home, a person who regularly visits their relative, staff and the homes manager and owner. The purpose of the visit was to make sure that the home is operating and being managed in the best interests of the people who live there. We also used information we have received about the service since the last inspection. This included information sent to us by the manager in a document known as an Annual Quality Assurance Assessment and surveys that some of the people who live at the home, their relatives and some staff completed and returned to us. Care Homes for Older People Page 6 of 25 Whilst at the home we also looked around the building, looked at how medication is managed and looked at documentation relating to care and to staff recruitment and training. 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 8 of 25 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 25 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. People do not move into the home without being given confirmation, following an assessment, that their needs can be met at the home. Breadalbane does not provide intermediate care. Evidence: The manager said that whenever possible either himself or the owner of the home will go out to meet and assess the needs of any person wishing to move into the home. Again wherever possible the person is invited to spend some time at the home, having a look around and meeting the people who live there before they make their decision about moving in. Pre admission assessment forms are completed to help the manager decide if Breadalbane is the right place for the person wishing to move in. The manager Care Homes for Older People Page 10 of 25 Evidence: considers the persons care needs and if the home can meet them and if the person will fit in with the people who already live there. One person had needed to move into the home quickly for respite care. The manager said that he had obtained as much information about them as possible from their social worker and their family. This information had then been transferred onto the pre admission assessment form. Breadalbane does not provide intermediate care. Care Homes for Older People Page 11 of 25 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 are involved in decisions about their care and are well supported in making sure that their needs are met. Evidence: During the visit to the home the care notes for four people were looked at. Each person had a care plan based on their activities of daily living such as mobility, eating and drinking, recreational and hygiene needs. The care plans gave clear details about the support people needed to meet their needs and also gave information about the individuals choices and preferences within their daily routines. The care plans had been signed as agreed by either the person themselves or, where appropriate, their relative. Discussion took place with the manager about developing short term or acute care plans when a person has a particular problem which may need the staff to take extra or particular actions to meet their immediate needs. An example of this is where a Care Homes for Older People Page 12 of 25 Evidence: person had sustained a fracture and needs additional support. The manager said that he would start to do this. Assessments covering such as nutrition, skin integrity and risks to the individual are completed but are not kept with the care plans. Possibly as a result of this the assessments have not been reviewed and kept as up to date as the care plans. Following discussion, the manager said that he would look at keeping all the care records together. Each file included a multi-disciplinary record which showed when people had been seen by their GP, district nurse, chiropodist optician or other healthcare professional. These records showed that people get the healthcare they need when they need it. People spoken with said that staff were kind in their approach and that they respected their privacy. This approach was observed throughout the visit. Systems for ordering, storing and administering medications were looked at. All of these systems were good and mean that people receive their medications safely. Care Homes for Older People Page 13 of 25 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 are enabled and supported to enjoy their own routines and social and leisure interests at the home. Evidence: The manager said that the home does not employ an activities organiser but that care staff try to engage people in activities in an afternoon. The manager went on to explain that he is looking at changing some shift patterns so that a carer can be dedicated to providing activities each day. The manager said that they have various day trips out both locally and farther afield and arrange various entertainers to come to the home. One recent activity had been of an artist coming to the home and doing some chalk portraits of the people who live there. The people in the portraits were proud and pleased that they had been framed and were displayed on the wall. The manager said that representatives of various churches come to the home to provide services and that some people go out to local church activities. Care Homes for Older People Page 14 of 25 Evidence: One person visiting a relative said that the people who live at the home often sit out in the front garden and people from the community stop and chat. During the visit people were seen waving to passers by and being waved back at. The visitor said that this was this home is the best and they enjoyed visiting and chatting with not just their own relative but other people as well. One person was celebrating their birthday and staff had styled their hair for them and had planned a party for later in the day. People spoken with said that they were happy with their lives at the home. The lunchtime meal was served in the comfortable dining room to most people but others chose to take their meal elsewhere. People were offered choices and the meal looked nutritious and appetising. People said that they enjoyed their meals at the home. Care Homes for Older People Page 15 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they are listened to and are safe. Evidence: A complaints procedure is available at the home and people are made aware of it. No complaints have been received since the last inspection. People said that they would speak to the care staff if they had a problem. The manager is aware of local policies and procedures for safeguarding people and has arranged training for staff who have not yet received it. Staff spoken with knew that any form of abuse or suspicion of abuse must be reported but were unclear who to report it to. Care Homes for Older People Page 16 of 25 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 live in a clean and homely environment. Evidence: Breadalbane provides a small but comfortable and homely place for people to live. There is only one lounge which appeared a little crowded and impersonal with chairs arranged all around the walls even across the feature fire place. A small conservatory accessed through the lounge could provide an extra sitting area for people wanting to sit quietly, see visitors or perhaps watch the small television available in the room. However this room was being used to store furniture which made it difficult to access. The manager may also wish to consider more use of the dining room to ease the crowding in the lounge. Some of the chairs in the lounge are wearing a little but the manager said that he and the owner were looking at replacing the more worn furniture fairly quickly. A new bathroom has been fitted to help people with reduced mobility to bathe more easily. Care Homes for Older People Page 17 of 25 Evidence: The home was clean and, other than the conservatory, pleasant and tidy throughout. All of the bedrooms seen were very nicely decorated and furnished and people had brought in their own bits and pieces to make their rooms homely and personlised. Care Homes for Older People Page 18 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the support they need from a caring staff group who are following training programmes to assist them in their jobs. Evidence: People spoken with during the visit said that the staff are very good, kind and helpful and that they always respond to their needs quickly. People appeared genuinely fond of the staff. Observations during the visit were that staff and the people who live at the home enjoy a relaxed, friendly and mutually respectful relationship. The manager said that he is in the process of employing another member of staff which will improve the numbers of staff on duty. Staff files included all of the necessary checks and clearances to make sure that the individuals are suitable to work in a care home. The manager said that he was aware that staff training in important areas such as safeguarding and dealing with medications was overdue and showed the inspector confirmation of bookings he had made for the staff to receive the training and updates they need. Care Homes for Older People Page 19 of 25 Evidence: Five of the current staff team have achieved the NVQ (National Vocational Qualification) in care at level two or above and a number of other staff are currently studying for the award. Care Homes for Older People Page 20 of 25 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. Peoples health safety and welfare are protected. Evidence: The homes manager has been at Breadalbane since July 2008. Since then he was successful in his application to the Commission for Social Care Inspection for registration as the manager. The manager is an experienced nurse who has worked in care homes for some time. The owner of Breadalbane, who is also registered with the Commission as the responsible individual, spends a lot of time at the home and supports the manager in his role. The manager showed the inspector some of the responses to the quality monitoring surveys he has recently sent out to people living at or otherwise involved with the home. The responses were very positive. The manager had also completed a Care Homes for Older People Page 21 of 25 Evidence: document known as an AQAA which is a document sent to the home by their Commission to use as part of their quality monitoring and to return to the Commission informing us of how they think the home is performing and of any changes and improvements they are planning. Some of the people who live at the home request that small sums of their money are looked after by the manager in the homes safe. The manager keeps good records of when money is put into the safe and of when and how it has been spent by the individual concerned. The manager is aware that staff are in need of training and training updates to make sure that they work safely and he has organised this training. Fire drills are taking place in the home but when asked, the manager was unsure about how and when hot water checks are carried out. it is important that these checks are done to prevent the risk of scalding. People living at the home have any risks to their safety assessed and plans put in place to minimise the risk. However these plans are not kept with the persons care plan and therefore are not readily available to staff. The manager should consider keeping all such documentation together so that staff become familiar with the documentation and work to the plan. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 30 18 All staff working at the home 24/07/2009 should receive training and updates to make sure they have the skills necessary to do their jobs and to keep people safe. To make sure people are cared for appropriately and safely 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 1 2 3 18 28 38 Training needs to continue to make sure that all staff are aware of local policies and procedures to protect people. NVQ training should continue until at least 50 of the staff team hold the level two award in care. The manager should make sure that hot water checks are completed weekly to make sure that people are not at risk of scalding. Care Homes for Older People Page 24 of 25 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. 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