Care Home: Carisbrooke Care Home

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What the care home does well People living at Carisbrooke find the lifestyle they experience, matches their expectations and preferences and the staff spend time with them engaging in activities of their choice in addition to the activities which are planned and implemented by the activities co-ordinator. People are confident that any complaints or concerns they may raise will be listened to and acted upon. Carisbrooke offers the people who live there a clean, homely and well maintained environment What has improved since the last inspection? The requirements made at the last inspection have been met and no further requirements have been made at this inspection. Care plans are being reviewed on a regular basis and risk assessments are in place where required. Some refurbishment has taken place since the last inspection improving the environment for people and there are plans for this to continue. Staff have received training in all mandatory areas and there is a training matrix in place which shows all the completed training as well as training that is planned. What the care home could do better: The appointment and registration of the new manager will provide people with a more stable management structure. Pre-admission assessments should contain more detail to enable the development of the persons care plan. A letter offering a place and confirming their needs can be met, should be kept on each persons file. Care plans would benefit from further development with more in-put from the person they relate to. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carisbrooke Care Home 22 Carisbrooke Drive Mapperley Park Nottingham NG3 5DS     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: Angela Starr     Date: 2 9 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Carisbrooke Care Home 22 Carisbrooke Drive Mapperley Park Nottingham NG3 5DS 01159605724 01159106613 arksohawon@hotmail.com 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) : Mr Abdool Raouf Sohawon,Mrs Bibi Sohawon care home 20 Number of places (if applicable): Under 65 Over 65 20 20 20 dementia old age, not falling within any other category physical disability Additional conditions: 20 0 20 Service users admitted under the category DE will be 60 years old and over. Service users admitted under the category PD will be 60 years old and over. The maximum number of service users shall not exceed 20 at any one time. Date of last inspection Brief description of the care home Carisbrooke Care Home is an older converted house set in the residential area of Mapperley Park, about two miles from the city centre. The home provides care for older people with nursing needs and is registered for up to 20 service users. It has a pleasant outlook, with safe attractive well-maintained gardens to the front of the property, where car parking facilities are available. There are 18 single rooms, three of which have en-suite facilities and 1 double room. Care Homes for Older People Page 4 of 26 Brief description of the care home There are two lounge areas, dining room, opening into a dining area and a conservatory, where smoking is permitted. Two bathrooms and one shower room are provided and toilets are in close proximity to all individual service users rooms and communal areas. The range of fees are in line with Nottingham City Council rates and are agreed according to level of nursing and care support required. The certificate of registration was displayed, but requires replacing when new manager is registered. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who use the services and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. We ask managers to fill in a questionnaire called an Annual Quality Assurance Assessment, which tells us how well their service provides for the people who use it and how they intend to improve their service. We received this back from the manager within the required timescale and we used the information it provided us with to assist in planning our visit and deciding what areas Care Homes for Older People Page 6 of 26 to look at. We also reviewed all the information we have received about the service since we last visited in April 2008 and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called case tracking which involves us selecting a number of people who use the service and looking at the quality of the care they receive by speaking with them, observation, reading records and asking staff about their needs. We also sent Have your say surveys to a random selection of people who use the service, some relatives and some staff members. The information provided in the replies we received was also a contributory factor in the focus of our inspection visit. We spoke with three staff on duty, the manager, three people who use the service and two relatives to form an opinion about the quality of the service being provided. We also read documents, and medication was inspected to form an opinion about the health and safety of people who use the service. A copy of the latest inspection report can be found by visiting the Care Quality Commission web site at www.cqc.org.uk 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 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to live at the service have a pre-admission assessment completed to ensure that their needs can be met. People are given accurate information about the service that is provided. Evidence: The written information provided to us by the acting manager told us We have a recently revised service user guide and statement of purpose available within the reception area of the home and it is also available in large print. All residents have undergone a pre-admission assessment prior to taking up residence within the home. We saw the service user guide, statement of purpose and complaints procedure on display in the entrance hall of the service along with the certificate of registration and Care Homes for Older People Page 10 of 26 Evidence: a copy of the last inspection report. As part of our case tracking process, we looked at files for three people who live at the home and all contained pre-admission assessments. However, the assessments contained only basic information and lacked detail. We sent questionnaires to eight people who live at the service and four were completed and returned to us. These told us that people did feel they had been given all the information they needed to enable them to make a choice about where to live. Relatives we spoke with on the day of the inspection confirmed this and told us I looked around before my relative came here and as a family, we thought it was the right place. This is near my home and was recommended to me. The acting manager told us that people who are considering moving to the service are able to visit and have a period of up to a month to make their decision. There is no intermediate care provision at this service. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare needs are assessed and provided for in a way which shows respect for the privacy and dignity of people who live at the service whilst meeting their identified needs. Evidence: The acting manager told us in the written information she provided Each resident has their own care plans to ensure their individual needs are met. All residents have access to external health facilities such as dentist, GP, optician and chiropody. The home ensures the safe administration of medication and takes part in regular Pharmaceutical audits. The files we looked at did contain care plans relating to all areas of need and some of these were detailed. There was some evidence that the person had been involved in their development, as well as the reviews which had taken place on a regular basis and were signed by the person. Risk assessments were in place where required. Care Homes for Older People Page 12 of 26 Evidence: Records showed us that people were receiving in-put and support from external health providers including Doctors, District Nurses, Chiropodist etc. In the questionnaires we sent to people living at the service, we asked Do you receive the medical support you need? All four that replied said Always Relatives we spoke with on the day of the inspection visit told us They treat my relative with respect and dignity and I am always made welcome. We observed a medication round and looked at the Medication Administration Records for the people we case tracked. These were completed correctly and signed. People we spoke with at the service told us they feel Well cared for. Nothing is too much trouble. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service experience a flexible lifestyle which is in accordance with their needs and abilities. Evidence: The acting manager told us in the written information she provided The home employs an activities co-ordinator who ensures that residents have recreation during the day. Staff members are involved in activities to ensure that choices and equal opportunities are met. We looked at the activities records produced by the activities co-ordinator and these showed us that people are offered opportunities to take part in skittles, music and dancing, quizzes and art and craft sessions. There are a variety of other activities organised by the staff which take place on a more spontaneous basis according to the wishes of the people living at the service. One relative told us They have a lot of activities. Another relative said The staff spend a great deal of time in the lounge with people and have a good rapport My relative likes sewing and enjoys the crafts Care Homes for Older People Page 14 of 26 Evidence: We observed a staff member organising a sing a long after lunch and several people were enjoying this. The completed surveys we received told us that there are always activities arranged for them to enjoy and that they usually enjoy the food that is provided. Relatives we spoke with told us that they are welcome to visit at any time. One person said they visit twice every day. A menu board in the dining room displayed the menu for the day. We observed people having lunch and staff assisting people where necessary in a discreet, caring and supportive manner. People we spoke with said The food is lovely Ive really enjoyed my dinner Relatives we spoke with said they were unsure about choices being offered but thought the food was usually good. Two people said they would like their relative to be offered something a bit different at times. The information received from the acting manager did tell us that the service is currently looking to revise the menu to include new items. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to complain and are confident that any concerns would be acted upon and responded to. People living at the service are safeguarded from harm and abuse by the services policies and procedures. Evidence: The acting manager told us The home has a clear complaints policy and procedure that is provided in the service user guide and is displayed in the reception area. This is positioned to ensure that all residents and visitors can see it. There is a complaints book in place where staff members enter complaints received and the nature of the complaint. Complaints are then investigated by the service provider and dealt with. We looked at the records of complaints and saw that two had been recorded since the last key inspection. Both related to items that had been lost and records told us that these had been investigated and that people had been satisfied with the outcome. One relative told us that they had once made a complaint and it had been responded to satisfactorily. In the questionnaires we sent to people we asked Do you know who to speak to if you are not happy? Four people replied and all said Always. People we spoke with told us that they would tell the manager or the staff if they were unhappy or worried about Care Homes for Older People Page 16 of 26 Evidence: anything. Four staff completed questionnaires and all said that they know what to do if anyone raises any concerns. Staff files we looked at showed us that they have had training in Safeguarding Adults and the staff we spoke to confirmed this and demonstrated a clear understanding of the processes. Safeguarding Adults is a process of identifying and reporting suspected or potential abuse of vulnerable people and provides a framework of consistency to protect those individuals who are at risk. We looked at the system for managing peoples finances and saw that the monies and the records were all correct with receipts in place for any transactions. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience 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, safe and comfortable home which is well maintained and is suitable to meet their needs. Evidence: The acting manager told us The home is secure and meets individual and collective needs of residents. Regular maintenance ensures that all fixtures and fittings are safe and regular PAT testing of electrical equipment is carried out. Each bedroom has ensuite facilities Laundry is washed daily. We conducted a partial tour of the home and looked at some bedrooms, bathrooms, communal areas, the laundry and kitchen. All areas of the home were clean, tidy and hygienic. People we spoke with said the home is always clean and fresh and the relatives we spoke with confirmed this. One person said My relative has a lovely bedroom that has just been decorated and had new furniture. Its comfortable and warm. We dont have any problems with the laundry. Another relative said that the items washed in the laundry are not always clean and some clothes have been spoiled. Care Homes for Older People Page 18 of 26 Evidence: People we spoke with told us that the home is comfortable and warm. I have a lovely bedroom and I like being in the lounge. We saw the maintenance record book and spoke with staff about how they report any problems. Staff told us that they make a note of things in the book and they are dealt with quickly by the maintenance person. We saw tasks being carried out during the visit. Records we looked at showed us that all necessary Health and Safety checks on services and equipment are up to date. Some refurbishment has taken place since the last inspection and further improvements are planned. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and protected from harm by well trained staff in sufficient numbers to meet their needs. Evidence: The acting manager told us The home has a consistent staff group with a low attrition rate. Many of the staff have been working at the home for many years and know the residents and their families well. The rota ensures appropriate staffing levels and provides a mix of skills and experience. Recruitment procedures are thorough and ensure that regulatory requirements are met. All new staff complete induction training and are appointed a mentor. As part of our case tracking process we looked at the files for three members of staff including the last person to be recruited. All contained two written references, Criminal Record Bureau and Protection of Vulnerable Adults checks. The files also contained evidence of training that had been completed and this included all mandatory training and additional training to support the needs of the service. We spoke with three members of staff. One who has worked at the service for almost Care Homes for Older People Page 20 of 26 Evidence: five years, told us that they feel supported and value the training which enables them to feel skilled to do the work. This person has completed National Vocational Qualification level 2 and is wanting to do level 3. Another staff member who has been employed more recently told us I enjoy working here. Were here for the residents. This person added that they had received a good induction which gave them confidence to do the work and become part of the staff team. Staff told us that they have meetings every month and have good relationships with the managers. They also said that they feel there are enough staff and they do have time to spend with the people living at the home. One relative said The staff are all very good, always pleasant and take time to talk to you. People we spoke with told us They are lovely. Always happy and take time to talk. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and is being run in the best interests of the people who live there. The manager is in the process of applying to the Care Quality Commission to be registered. Evidence: The Annual Quality Assurance Assessment was completed by the service provider, Raouf Sohawon and it was returned to us within the required timescale. It tells us The service provider remains in place and is available 24 hours a day. Carisbrooke does not have a registered manager at the time of this inspection but a senior nurse at the service is currently completing an application to become the registered manager. On the day of the visit the area manager was present and she told us that she is Care Homes for Older People Page 22 of 26 Evidence: overseeing things until the new manager becomes registered. Staff we spoke with told us that the area manager, the service provider and the senior nurse are all approachable and provide support to the staff team. Relatives we spoke with also said that they feel they can go to the management with any problem and will be listened to. One person said that she had contacted the home on a Sunday evening about something and the service provider was happy to discuss things with her in spite of being off duty. Staff meetings and resident meetings take place regularly and relatives are asked to contribute any suggestions they have about the running of the service. We looked at the outcomes of some of the quality audits that have been completed by the service and this told us that people are given a number of opportunities to make their opinions known and this information is collated and acted upon. People we spoke with told us I feel very safe. Ive no worries at all. The manager always takes time to talk to people. This was directed at the service provider, Raouf and the person added He goes that extra mile for people. Records we looked at showed us that all Health and Safety testing and servicing has been undertaken as required. Staff told us that their health and safety is well protected as well as the people living at the service. We looked at the accident records and noted that seven had been recorded since the last key inspection. These were mainly falls and each had been followed by a risk assessment and where possible, any contributing factors had been eliminated. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 7 Pre-admission assessments would benefit from having more detailed information included in them. Care plans should contain more detail and be developed and agreed in conjunction with the person they relate to. Care Homes for Older People Page 25 of 26 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. 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