Care Home: Carisbrooke House Residential Home

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What the care home does well The staff team at Carisbrook House are polite and friendly and work hard to make sure that the people living there are comfortable and well looked after. The manager provides good information to prospective residents to read before making up there mind whether they wish to move in. People have their individual care needs assessed and recorded and are treated with dignity and respect by the staff team. It was observed that residents are offered choices throughout the day in respect of meals, activities, where they wish to sit and what they wish to do. Any complaints are listened to and acted upon appropriately. There is enough staff on duty to meet the needs of the current residents. What has improved since the last inspection? A random inspection was carried out in October 2008 resulting in several requirements to be implemented. All of these have been carried out. The care plans have been developed further and include health and care needs of residents including a plan of how these needs should be met. Risk assessments are included within the care plan so staff can monitor and manage these. The medication system has been improved by having a regular audit and record charts are complete. People are supported to make their own decisions in respect to daily life. The menu provides residents wishes and offers a wholesome appealing diet. The premises is now odour free and in an adequate state of repair although there are two recommendations to implement. Fire safety is followed by not wedging the fire doors open. Hazardous substances are stored securely. Staffing levels are consistent and staff training has been updated. What the care home could do better: This inspection resulted in no requirements being issued, although there are areas within the premises that need the paintwork renewing. There are also two damp areas found, one was in the upstairs lounge and the second in the staff room. Both of these had been attended to by the manager. A builder had been booked to repair loose tiles on the roof and the maintenance man was to replace loose piping in the staff room which had caused the damp problem. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Carisbrooke House Residential Home 10-11 Sandown Road Great Yarmouth Norfolk NR30 1EY     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: Hilda Stephenson     Date: 2 0 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 House Residential Home 10-11 Sandown Road Great Yarmouth Norfolk NR30 1EY 01493855915 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) : Selvaratnam Balaratnam care home 22 Number of places (if applicable): Under 65 Over 65 6 1 22 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 A minimum of three care staff to be on duty during daylight hours. Date of last inspection Brief description of the care home Carisbrooke House is a care home providing personal care and accommodation for up to 22 older people. The registration of the home has just been altered to allow the home to accommodate up to 6 older people who have dementia. The home is located on a street close to the seafront of Great Yarmouth and consists of two adjoining large three storey terraced houses, with small patio areas at the front and back of the building. The accommodation includes 12 single and 5 shared bedrooms, some with en-suite facilities. Three lounges (two on ground floor, one on top floor) and a ground floor dining room make up the communal rooms. Access to the upper floors is by a shaft lift. There is on street parking at the front of the building. The home charges from £268 to £325 for shared rooms and from £281 to £338 for single rooms. Care Homes for Older People Page 4 of 26 0 6 1 0 2 0 0 8 Brief description of the care home Additional charges are payable by residents for hairdressing, chiropody, toiletries and newspapers/magazines. 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: Care services are judged against outcome groups, which assess how well the provider delivers outcomes for people using the service. The unannounced key inspection of this service has been carried out by using information from previous inspections, written information provided by the manager, some residents and their relatives and others who work in or visit the home. This unannounced visit took place during the day of Monday 20th April 2009. The manager was in attendance during the day. Prior to the inspection the manager provided a completed Annual Quality Assurance Assessment giving details of what the homes strengths and weakness were and how these could be adapted to improve care for residents who live there. Care Homes for Older People Page 6 of 26 During the inspection a tour of the building was undertaken, staff practice was observed, records and files were read, and residents were consulted. What the care home does well: What has improved since the last inspection? What they could do better: This inspection resulted in no requirements being issued, although there are areas within the premises that need the paintwork renewing. There are also two damp areas found, one was in the upstairs lounge and the second in the staff room. Both of these had been attended to by the manager. A builder had been booked to repair loose tiles on the roof and the maintenance man was to replace loose piping in the staff room which had caused the damp problem. Care Homes for Older People Page 8 of 26 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving into the home can be assured that they will receive clear guidelines regarding the service and have their care needs assessed. Evidence: The written documents were read during this site visit that are given out to all prospective residents. The information is clear and concise and provides all the information required about the home. The pre-admission records were also read on the latest resident to be admitted to the home and they were also spoken to. The resident was very satisfied on how the admission procedure was carried out. The manager had visited the resident while in hospital and invited them to see the home beforehand. Several questions were asked regarding the residents care and health needs to make sure that the staff could meet these needs. The resident was invited to stay at the home for a month so they could have time to Care Homes for Older People Page 11 of 26 Evidence: make up there mind whether they wished to stay, afterward a review of there care and health needs was carried out and a contract between the provider and resident was put in place, this gave the resident more information how the fees and charges were managed. The current fees charged are from £290.00 - £358.00. The resident confirmed that I was really happy to come here, the staff are so friendly and polite. I cant remember if I read about the home before I came here, but the manager explained everything anyway, and I have the brochure in my room. Care Homes for Older People Page 12 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. People living at the home have their health and care needs met and are provided with a safe medication system. Evidence: Two care plans were read during this site visit and both residents were spoken to in private. The care records provide good clear information regarding the residents health, care and social needs. The three requirements regarding the care plans had been implemented. There were detailed information regarding personal care, risk assessments for them to live as independently as they were able and also there interests and past lifestyle were also included to assist staff to care for the resident as a whole person and not just the health care needs. Within the care plan was a brief life story that had been written by the resident, also evidence that they were included when the care plan was reviewed and the home should be commended for this. Care Homes for Older People Page 13 of 26 Care Homes for Older People Page 14 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. The social and creative activities and meals provide a daily variation and interest for those living at the home. Evidence: Daily activities were arranged and displayed on the white board in the dining room. The care staff implement these. There is a mixture of organised classes such as exercise and games, one to one sessions talking about past times, family and news, as well as dominoes, cards and going out for a coffee to the seafront. Several residents like to visit the shops and this is arranged with their family or member of staff. The manager stated that in the warmer weather there are one or two bus trips arranged but the destination is usually discussed at the residents meetings. Extra staff and family members are sought to help with these events. During this inspection one visitor was spoken to and stated that they were made welcome when they visited. Two requirements issued at the random inspection on how people are supported to make their own decisions and having a choice of wholesome meals had been Care Homes for Older People Page 15 of 26 Evidence: implemented. The kitchen was clean and tidy, the cook was preparing the lunch of cottage pie or baked potato with salad, or cabbage and carrots, with fresh fruit salad and cream or yoghurt for dessert. Residents commented that the food was good and they were happy with the choices. If something doesnt appeal to them when the staff ask for there preference other alternatives are offered. The cook caters for a variety of special diets. The menu is rotated over a three week period and changes to include seasonal fruit and vegetables. Birthday and special parties are also catered for accordingly. Care Homes for Older People Page 16 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. There is an active procedure on the protection of vulnerable adults that protects people and supports the investigation of any cause for concern. Evidence: Residents confirmed that they felt safe, listened to and able to speak with the manager or staff if they were unhappy about anything to do with their care. A copy of the complaints procedure is contained within the written guidelines given out on admission and a copy is in each bedroom. This will need updating due to the recent change of Commission. Staff spoken to had completed training in adult protection and were aware of how to deal with complaints. 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 adequate 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 comfortable home although, there are areas of paintwork that need redoing. Evidence: A tour of the building was undertaken accompanied by one of the care staff, the bedrooms were seen of the two residents who were spoken to, these were clean and comfortable and contained some of the residents personal effects and furniture. The requirements from the previous random inspection carried out in October had been implemented. Several of the bedrooms had there carpets replaced that were causing an odour and had been redecorated. There were no fire doors wedged open while touring the building, the fire doors with heavy usage had the magnetic closures attached which close automatically when the fire alarm is raised. Both lounges and dining rooms were clean and appeared brighter than on previous visits and there was access to the well maintained patio area at the rear of the building. The manager said that there was a rolling programme of routine maintenance, refurbishment and redecoration, and that when a bedroom was free it was Care Homes for Older People Page 18 of 26 Evidence: redecorated. Adequate laundry facilities were provided and good infection control measures were in place. 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 living at the home have satisfactory numbers of trained staff to be able to meet their needs. The recruitment practice is clear and in place to protect residents. Evidence: The two requirements regarding staff levels and training had been implemented since the random inspection carried out in October last year. The home has a condition of their registration to provide three care staff during the day to care for residents needs. The rota showed that each shift was covered and during staff absences these were covered by the permanent staff to ensure continuity of care for the residents. During the day of inspection there was three care staff, the manager, cook and domestic staff on duty. Staff spoken to gave examples of their work routine and how their different roles were implemented. Staff files were also checked. These showed that the manager followed a clear recruitment procedure for the protection of residents. Training for staff had been updated including food hygiene, moving and handling, infection control, dementia care, medicines and first aid was in line to be the next course to be carried out. More than half of the staff team have either achieved the recommended NVQ training in health and social care, with several undertaking the next level of NVQ training. Care Homes for Older People Page 20 of 26 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 management and administration of the home is generally good. People living and working at the home are protected by the health and safety procedures in place. Evidence: Residents confirmed that they felt well looked after and the manager was always available if they wished to speak to her. She also spent time talking to the residents and organised residents meetings so future menus and activities could be arranged. The quality assurance system was effective and the manager is proactive in addressing quality issues within the home. The proprietor visits the home every fortnight and undertakes an audit of the service, the latest report was read with the actions to be implemented by the manager. The financial records for residents protection was checked and found to be safe and accurate. Care Homes for Older People Page 22 of 26 Evidence: Staff confirmed that they attend regular supervision with the manager to discuss training and goals regarding their professional life, and they said that they feel well supported by the manager, and that she was a good role model. A sample of the health and safety records were checked and found to be accurate, protecting residents, staff and visitors in the home. The manager informs the Commission of accidents, deaths and incidents that happen in the home, there had been a recent outbreak of a virus and infection control measures protected residents and staff. Overall, the service provides a clean and safe environment for residents to live in. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 15 Care plans must be written 06/02/2009 for all health and care needs, with a plan of how those needs should be met. So that peoples health and well being is promoted. 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 16 19 19 The Commissions new details will need to be replaced within the complaints policy. Several areas around the home should have there paintwork redone. The two damp areas in the upstairs lounge and staff room need attention. 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. 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 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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