Care Home: Camowen

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What the care home does well The home is well decorated to an excellent standard with attractive communal areas and bedrooms. Residents are very well cared for and their health and social needs are met in full. All residents spoken to praised the staff and were complimentary about the service they received. Residents are encouraged to pursue a wide range of activities, both in the home and wider community. The activities programme is well thought out and caters to the varied needs of the residents in the home All pre-admission assessments and care plans are in excellent order and focus on individual needs, diversity and choice. Staff have the opportunity to participate in a range of training appropriate to the needs of the residents.Administration and office records are in good order with audits in place to ensure records are completed in full and kept up to date. Overall Camowen offers a very high standard of care to its residents. What has improved since the last inspection? Since the last inspection the previous requirements have been met in full. The home decor continues to be improved upon to ensure all bedrooms and communal areas provide a safe and very attractive environment. Assessments and care plans are currently being improved upon with an emphasis on choice and diversity. Information contained within all care records is clear and detailed to ensure residents needs are met in full. What the care home could do better: There were no complaints or issues to follow up from feedback. All comments received through surveys and feedback was highly complimentary. The home continues to offer a high standard service, which promotes the welfare of the people who live and work there. CARE HOMES FOR OLDER PEOPLE Camowen 30 Parkfield Road West Tarring Worthing West Sussex BN13 1ER Lead Inspector Beth Tye Key Unannounced Inspection 6th February 2008 09:30 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 Camowen DS0000062981.V356523.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. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camowen Address 30 Parkfield Road West Tarring Worthing West Sussex BN13 1ER 01903 202111 01903 200711 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) Asa Care Ltd Mrs Ley Jayne Little Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only persons over the age of 65 years may be admitted Date of last inspection 11th December 2006 Brief Description of the Service: Camowen is a Care Home registered to provide care and accommodation to twenty service users in the category OP, Old age not falling within any other category. The registered premises is a converted property situated in the village of Tarring. Accommodation is provided on two floors in single occupancy rooms, nineteen of which provide en suite facilities. Communal space for service users is provided in two small lounge areas, a dining room and conservatory lounge. Ms. Amershi was registered as the provider in January 2005 and the registered manager is Mrs Ley Little. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection visit was carried out by two inspectors and was arranged to assist us in assessing the home’s compliance with the key standards of the national minimum standards for care homes for older people. Planning for the visit took into account information received on the service since our previous visit, including the annual CSCI self-audit completed by the home manager. Survey forms received from fifteen people living in the home, six relatives and five members of staff also contributed to our planning. On the day of the visit we were on the premises for three hours, and spoke with five people living in the home, the manager, and three members of staff. We sampled three sets of admission assessments and the individual plans of care for three people living in the home. Other records sampled included recruitment and training records for three members of staff, the record of complaints, quality assurance records and records relating to health and safety issues in the home. We undertook a tour of the home including communal areas and bedrooms. We observed a number of interactions between people living in the home and staff, and observed the arrangements for lunch. What the service does well: The home is well decorated to an excellent standard with attractive communal areas and bedrooms. Residents are very well cared for and their health and social needs are met in full. All residents spoken to praised the staff and were complimentary about the service they received. Residents are encouraged to pursue a wide range of activities, both in the home and wider community. The activities programme is well thought out and caters to the varied needs of the residents in the home All pre-admission assessments and care plans are in excellent order and focus on individual needs, diversity and choice. Staff have the opportunity to participate in a range of training appropriate to the needs of the residents. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 6 Administration and office records are in good order with audits in place to ensure records are completed in full and kept up to date. Overall Camowen offers a very high standard of care to its residents. 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. Camowen DS0000062981.V356523.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 Camowen DS0000062981.V356523.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): Quality in this outcome area is excellent Residents needs and preferences are assessed prior to them being admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Camowen provides prospective residents with detailed information regarding the home prior to admission, to enable people to make an informed choice about moving into the home. Information is provided in a comprehensive Service User Guide and a Statement of Purpose. Both documents were seen during the site visit. The manager stated in the AQAA (Annual Quality assurance Assessment), that both documents are updated regularly and are available in large print. Three pre-admission assessments were looked at during the visit. They were all well written, very detailed and were specific to the resident group. The assessments seen focus on the outcomes for individuals in health, personal Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 9 care, social interests and diversity. A strong inference is made on individual choice, with details such as preferred bed times, personal choice on style of clothing and make up, and preferred times of meals. It was noted from the care plans seen during the visit that prospective residents are given the opportunity to visit the home. One care plan showed that one resident had a planned gradual admission over a period of six weeks to enable her to settle in to the home well. The manager states in the AQAA that the Statement of Purpose, the Service User Guide, contracts and pre-admission assessments have been revised and updated in line with the Mental Capacity Act. Camowen DS0000062981.V356523.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): Quality in this outcome area is good Health needs are met with the support of appropriate health professionals. Medication is managed safely by the home. Residents’ privacy and dignity is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans of residents were examined as part of the case tracking process. Case tracking, feedback and discussion with the residents confirmed good practice is maintained in the home. Each care plan contains relevant details relating to the residents health needs and social well-being. Information was up to date and easily accessible. There was evidence to demonstrate residents sign monthly reviews. This practice demonstrates the residents are involved in the planning and changes in their care. Individual risk assessments held on care files support residents to maintain independence where possible and ensures they are safe within their environment. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 11 In relation to health and personal care needs, observation and feedback from residents and relatives reflected that individuals are treated with respect by staff, and their privacy and dignity is upheld. The in house training programme and induction provide staff with the skills and knowledge base to respond appropriately to resident’s health care needs. District nurses visit the home as required. Other specialist needs such as mental health issues are referred to community-based professionals via the GP’s. Correspondence held in individual files supported this. A Chiropodist visits the home on a six weekly basis. The residents seen during the visit were very tidy in appearance wearing appropriate clothing with their nails and hair well groomed. All residents were alert, cheerful and happy to engage with the inspectors. Staff were observed communicating with residents in a caring and respectful manner. One resident said ‘We are looked after very well.’ Another said ‘ all the staff are very kind, they can’t do enough for us’. All staff receive medication training in house. The home has an up to date policy, procedure and code of practice relating to dispensing medication. Medication charts and storage of medicines within the home was examined. All records seen were in good order, demonstrating staff follow appropriate procedures. Residents who wish to self-administer medication, are assessed prior to admission, if this is an appropriate option. Signed disclaimers for selfadministration of medication were seen on resident’s files. This demonstrates the residents involvement in the decision making process. Camowen DS0000062981.V356523.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): Quality in this outcome area is excellent Residents are able to make the day-to-day decisions and choices in their lives. A range of activities is offered to residents. Family and friends are made welcome when they visit. Residents enjoy the quality and choice of meals provided by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans and pre-admission assessments seen show that the home places a high priority on the importance of residents having choices and flexibility in their daily living. There is a variety of activities on offer in the home including craft, quizzes, and music and movement, and shopping trips. Most activities are held in the mornings and afternoons so residents are able to choose what time is best for them to take part if they wish to. On the day of the visit a quiz was taking place in the lounge. The staff member taking the quiz was ensuring that all residents there were able to take part and interacted positively with the residents. Lots of laughter and chatting were going on throughout the quiz. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 13 Activity schedules are pinned to notice boards throughout the home so residents know what is happening when. Posters for a sing-along for Valentines Day were also on the notice boards. Two residents spoken with said that they enjoyed the activities provided by the home. In the AQAA the manager said that they have recently increased their activities to include manicures and film afternoons. The signing in book by the front door gave evidence that visitors are welcomed into the home at any reasonable time. Two residents spoken with said that their visitors are always made welcome. The week’s menu is on each table in the dining room and on notice boards in the home. The menu showed that a nutritious variety of meals are available for each resident. There are choices available for each meal. Residents said that they are able to choose whether to eat in their rooms or in the dining room. The meal served during the visit was well presented and well balanced. Some residents had plate-guards and specialised cutlery to enable them to remain independent with eating. Camowen DS0000062981.V356523.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): Quality in this outcome area is good The home has provided residents and their families with information in respect of complaints. Staff receive adult protection training to ensure they can respond appropriately, should an issue of suspected abuse arise. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The resident/relatives surveys and interviews with residents during the visit indicated that residents know who to speak to if they are unhappy with the care. The registered manager and staff encourage good relationships so concerns can be raised if needed. The Commission has received no complaints about the home since the previous inspection. The home holds a complaints log and no entries had been made since the last inspection. All staff have undertaken a full induction and Adult Protection training to ensure they respond appropriately to suspected abuse in the home. A copy of the West Sussex County Council Multi Disciplinary Adult protection Policy is kept in the office for reference. Staff files seen demonstrate the procedures for the recruitment of staff are robust and provide the necessary safeguards to offer protection to the residents living in the home. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 15 All care staff have undertaken a Criminal Records Bureau enhanced check to ensure they are suitable to work with vulnerable people. Staff stated they felt the management at the home was very supportive, if there was an issue of concern they needed to discuss. Camowen DS0000062981.V356523.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): Quality in this outcome area is excellent The home offers a high standard of comfort and facilities for the people who live there. Bedrooms are all individually personalised and the home is clean, pleasant and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident from the visit that Camowen is decorated and maintained to a high standard. Communal areas are furnished with flowers, ornaments and pictures, which give the environment a homely feel. The standard of cleanliness through out the home is high. Residents commented on the cleanliness of the home and each said their rooms were cleaned daily Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 17 Private accommodation is decorated and furnished to a high standard to suit the needs of individual residents. Residents are encouraged to personalise their own bedrooms to give them a sense of ownership. The dining room was attractively presented and the tables were laid with linen tablecloths, flowers and good quality china. In addition to en-suite facilities the home has shared bathrooms and toilets, which provide ample facilities to the residents. There is a hoist, bath aids and specialist equipment to promote the independence of those who require assistance with personal care. Anti bacterial soap was evidenced at shared sinks. Laundry and sluice facilities are provided. Policies and procedures are in place for infection control, and all of the staff have attended relevant training for infection control and health and safety procedures. This promotes good practice in the area of safety and welfare for the residents and reduces the risk of infection spreading within the home. There is a passenger lift for residents with limited mobility to access all floors of the house. All radiators throughout the home have been covered. A call bell system is provided in every room so staff can attend an emergency situation swiftly, should it arise. The maintenance log showed all maintenance was completed as required on a regular basis. This means the resident’s environment is kept safe and well maintained at all times. Camowen DS0000062981.V356523.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): Quality in this outcome area is good Residents’ needs are met by the numbers and skills mix of staff on duty at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Training records and three staff files were looked at during the visit. They showed that staff have received induction training together with fire safety, manual handling, health and safety, adult protection, and other courses that are relevant to their role such as managing aggression, the Mental Capacity Act and computer literacy. Staff who give out medication also receive training in the administration of medication. Training records also show that the home has reached the target of standard 28.2 by ensuring more than 50 of staff are trained to National Vocational Training level 2 or above. All staff have satisfactory Criminal Records Bureau Disclosures to ensure they are suitable to work with vulnerable residents. All staff files seen were found to contain the necessary documentation required by Schedule 2 of the Care Regulations. Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 19 Two members of staff were spoken with during the visit. They confirmed that they have had all the training required and that they also have regular updates on all the health and safety training. Camowen DS0000062981.V356523.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): Quality in this outcome area is good The management and administration of the home is based on openness and respect and has effective quality assurance systems in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is experienced and holds a City and Guilds Advanced Management in Care qualification. She has now completed an NVQ Level 4 in care to meet the National Minimum Standard. She says she undertakes the yearly health and safety updates with the rest of the staff team. She has recently taken a course in the Mental Capacity Act. Staff said they are trained and feel supported and told the inspector that handovers, supervision and meetings are held regularly. Feedback from staff Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 21 demonstrates a commitment to meeting resident’s individual needs and preferences on a daily basis. Since the last inspection the home has made very good improvements in seeking the views of service users, relatives and other stakeholders. In addition to this each new resident is given an “on admission” questionnaire to enable the home to monitor the experience of residents prior to and during the admission procedure. All information from quality assurance audits is collated and a plan of action set in place so the home is ensures that it is continually improving the outcomes for residents. The results of the most recent audit were seen on notice boards in the home so that residents and visitors are able to read the outcomes. Records of money stored on behalf of residents were seen. The manager confirmed that procedures had been reviewed and systems were now in place to ensure residents could access their own personal allowance at any time they wish. Records of maintenance and safety checks on equipment in the home were seen. All were up to date. The AQAA completed by the manager prior to the visit contained comprehensive information that we were able to evidence during the visit. Clear details were given regarding how the home had improved since the inspection, areas that it needs to improve, and the ways in which they are planning to do this. Camowen DS0000062981.V356523.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 X 4 X X X X 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 4 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 X 3 4 4 4 4 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 X 4 X 3 X 3 3 Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Camowen DS0000062981.V356523.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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